CONFIDENTIALITY PRACTICES

FOX Insurance Company’s, FOX Rx Care plan is committed to protecting your health information. This notice describes how FOX Insurance Company and the FOX Rx Care plan will use, share and protect your health information under the Medicaid program. It also explains your rights to privacy of your health information as required by law. If FOX confidentiality practices materially change, a new notice will be mailed to you within 60 days.

USE, SHARE AND PROTECTION OF HEALTH INFORMATION

FOX staff will only use your health information when doing their jobs. When health information is shared with other agencies or organizations, FOX requires the other agencies and organizations to safeguard your health information. The purposes of the use and sharing of health information are for operating the FOX Rx Care plan for:

Treatment

FOX may disclose your health information to your doctors, hospitals or other health care providers for their provision, coordination or management of your health care and related services. For example, FOX health care professionals may review your treatment plan by your health care provider for medical necessity.
 
Payment

FOX will use and share your health information to pay for drug claims from health care providers and to determine your eligibility to participate in the FOX RX CARE plan. For example, FOX may use and disclose your information to determine if you are eligible for insurance coverage or benefits under a different health plan or other program.

Health Care Operations

FOX will use and share your health information to evaluate the quality of care you receive from us, to train or to evaluate those who are involved in your care.

Other Uses, Sharing of health information or disclosures of health information required or allowed by Law:

Information purposes

The FOX Rx Care plan may mail to you helpful information such as health plan choices and program benefit updates, free medical exams and consumer protection info.

Other Government Agencies or organizations providing Benefits, Services or disaster relief

FOX may share information with other government agencies or organizations that are providing benefits or services when the information is necessary in order for you to receive those benefits or services.

Public Health

FOX may disclose health information to the appropriate agencies for public health activities for disease control and prevention, problems with medical products or medications and also victims of abuse, neglect or domestic violence as required by law.

Health Oversight Activities

FOX may use or disclose information to authorized health oversight agencies responsible for the Medicaid program and the Health and Human Services, Office of Civil Rights.

Judicial and Administrative Hearings

FOX may disclose specific health information in judicial proceedings as required by law to administer the FOX program.

Law enforcement purposes

FOX may disclose specific health information for law enforcement purposes as required by law. Coroners, Medical Examiners and Funeral Directors FOX may disclose specific health information to the appropriate authorized persons to carry out their jobs as required by law.

Organ Donation and Disease Registries

FOX may disclose specific health information to authorized entities involved with organ donation and transplantation, communicable disease registries and cancer registries.

Research Purposes

FOX may disclose specific health information to entities authorized to conduct a research project. To Avert a Serious Threat to Health

Safety or emergency situation

FOX may disclose specific health information to prevent a serious threat to a persons or the publics health or safety.

Specialized Government Functions

FOX may disclose health information for national security and intelligence and protective services for the President and others as required by law. Also, FOX Rx Care may disclose health information to the appropriate military authorities if you are or have been a member of the arm services.

Correctional Institutions

FOX may disclose health information to correctional facility or law enforcement officials to maintain the health, safety and security of the corrections system.

Workers Compensation

FOX may disclose health information to workers compensation programs that provide benefits for work-related injuries or illness without regard to fault.

YOUR RIGHTS TO PRIVACY

You Have the Right to:

Request Restriction

You may request, in writing, that FOX limit the use or disclosure of your health information except for treatment, payment and health care operations purposes. FOX Rx Care is not required by law to agree to your request.

Request Confidential Communications

You may request, in writing, that FOX Rx Care communicate with you in a different way or to a different location. For example, a different mailing address or calling you at a different phone number.

Inspect and Copy

You may request to inspect or have a copy of any part of the designated record set maintained by FOX.

Amend

You may request, in writing with the reason, to change or add information to your health record. However, original documentation maintain by FOX may not be erased.

Accounting of Disclosures

You may request, in writing, an accounting of disclosures of your health information except for purposes of treatment, payment, health care operations and disclosures required by law for purposes of national security or law enforcement.

No individual will be retaliated against for filing a complaint

FOX Insurance Company
Attn: Compliance Officer
40 West 25th Street
6th Floor New York
NY 10010
Tel: 1-877-369-9564 (Ext. 126) 

You can also file a complaint to

Secretary of Health and Human Services
200 Independence Ave. SW
Washington D.C. 20201
Tel: (877) 696-6775