HIPAA Notice of Privacy Practices & Patient Acknowledgement

Med Plug RX, LLC

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Med Plug RX, LLC (“Med Plug,” “we,” “our,” or “us”) is committed to protecting the privacy and security of your Protected Health Information (“PHI”) in accordance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and all applicable federal and state privacy laws.

This Notice describes how Med Plug may use and disclose your PHI, your rights regarding your PHI, and our legal obligations concerning your information.

WHO THIS NOTICE APPLIES TO

This Notice applies to all workforce members, employees, contractors, affiliated providers, pharmacies, business associates, and personnel acting on behalf of Med Plug RX, LLC.

YOUR PROTECTED HEALTH INFORMATION

Protected Health Information (“PHI”) includes information that identifies you and relates to:

  • Your physical or mental health condition
  • Healthcare services provided to you
  • Payment for healthcare services
  • Prescription information
  • Telehealth encounters
  • Communications regarding your care or services

Med Plug may collect, maintain, use, and disclose your PHI as permitted or required by law.

HOW MED PLUG MAY USE AND DISCLOSE YOUR INFORMATION

1. Treatment Purposes

We may use and disclose your PHI to coordinate healthcare services, treatment recommendations, prescription fulfillment, wellness services, telehealth services, and communications between providers, pharmacies, and care teams.

Examples include:

  • Communicating with affiliated healthcare providers
  • Coordinating prescription services with pharmacies
  • Reviewing treatment eligibility
  • Supporting telehealth consultations
  • Facilitating continuity of care

2. Payment Purposes

We may use and disclose your PHI to:

  • Process payments
  • Verify billing information
  • Collect balances owed
  • Coordinate benefits or payment processing
  • Maintain financial records related to your care or services

3. Healthcare Operations

We may use your PHI for operational and administrative purposes, including:

  • Quality assurance
  • Staff training
  • Compliance activities
  • Business management
  • Customer service
  • Audits and legal compliance
  • Performance improvement activities

4. Business Associates

Med Plug may share PHI with third-party service providers (“Business Associates”) who assist in operating our business, including:

  • Pharmacies
  • Telehealth platforms
  • Billing providers
  • Technology vendors
  • Administrative service providers
  • Healthcare professionals

All Business Associates are contractually required to safeguard your PHI and comply with HIPAA privacy and security standards.

5. Appointment, Service, and Communication Purposes

Med Plug may contact you regarding:

  • Appointment reminders
  • Prescription updates
  • Telehealth scheduling
  • Treatment-related communications
  • Administrative notifications
  • Account updates
  • Service-related announcements

Communications may occur via:

  • Phone call
  • Voicemail
  • Email
  • SMS/text messaging
  • Automated dialing systems where permitted by law

By providing your contact information, you consent to receive these communications from Med Plug and its affiliated providers and service partners.

Standard message and data rates may apply.

You may opt out of non-essential communications at any time.

6. Uses Required by Law

We may disclose your PHI when required by federal, state, or local law, including:

  • Court orders
  • Legal proceedings
  • Law enforcement requests
  • Public health reporting
  • Government investigations
  • Regulatory compliance activities

AUTHORIZATION FOR OTHER USES

Any use or disclosure of your PHI not described in this Notice will require your written authorization unless otherwise permitted or required by law.

You may revoke your authorization at any time in writing; however, revocation will not apply to actions already taken based on your prior authorization.

YOUR RIGHTS REGARDING YOUR PHI

Under HIPAA, you have the right to:

Access Your Records

Request access to or copies of your PHI.

Request Corrections

Request amendments to information you believe is inaccurate or incomplete.

Request Restrictions

Request limitations on certain uses or disclosures of your PHI.

Request Confidential Communications

Request communications through alternative methods or locations.

Receive an Accounting of Disclosures

Request a list of certain disclosures of your PHI made by Med Plug.

Obtain a Copy of This Notice

Request a paper or electronic copy of this Notice at any time.

SECURITY OF YOUR INFORMATION

Med Plug maintains administrative, technical, and physical safeguards designed to protect your PHI from unauthorized access, disclosure, alteration, or destruction.

Security measures may include:

  • Secure electronic systems
  • Password protection
  • Encryption technologies
  • Restricted employee access
  • HIPAA compliance training
  • Vendor compliance requirements

If a breach involving your unsecured PHI occurs, Med Plug will notify you as required by law.

ELECTRONIC COMMUNICATIONS

Email and text messaging may not always be fully secure. By communicating electronically with Med Plug, you acknowledge and accept the potential risks associated with electronic transmission of information.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

Med Plug RX, LLC
Email: [email protected]

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

Med Plug will not retaliate against you for filing a complaint.

CHANGES TO THIS NOTICE

Med Plug reserves the right to revise or update this Notice at any time. Any revised version will apply to all PHI maintained by Med Plug and will become effective upon posting or distribution.

EFFECTIVE DATE

Effective Date: May 6, 2026

PATIENT ACKNOWLEDGEMENT

I acknowledge that I have received and reviewed the Med Plug RX, LLC HIPAA Notice of Privacy Practices.

I understand that Med Plug RX, LLC may use and disclose my Protected Health Information as described in this Notice.


Patient Name: _______________________________________

Signature: ___________________________________________

Date: _______________________________________________

If signed by personal representative, please state relationship to patient: