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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR COMMITMENT TO YOUR PRIVACY
As required by law, this notice provides you with information about your rights and our legal duties and privacy practices with respect to the privacy of PHI. This notice also discusses the uses and disclosures we will make of your PHI. We must comply with the provisions of this notice as currently in effect, although we reserve the right to change the terms of this notice from time to time and to make the revised notice effective for all PHI we maintain. You can always request a written copy of our most current privacy notice from our Privacy Officer.
USES AND DISCLOSURES
We can use or disclose your PHI for purposes of treatment, payment and health care operations.
We may also use your PHI in the following ways:
If you are available, we will give you an opportunity to object to these disclosures, and we will not make these disclosures if you object. If you are not available, we will determine whether a disclosure to your family or friends is in your best interest, based upon our professional judgment.
When permitted by law, we may coordinate our uses and disclosures of PHI with public or private entities authorized by law or by charter to assist in disaster relief efforts.
We will allow your family and friends to act on your behalf to pick up filled prescriptions, medical supplies, and similar forms of PHI, when we determine, in our professional judgment that it is in your best interest to make such disclosures.
We may contact you as part of our fundraising and marketing efforts as permitted by applicable law. You have the right to opt out of receiving such fundraising communications.
We may use or disclose your PHI for research purposes, subject to the requirements of applicable law. When required, we will obtain a written authorization from you prior to using your health information for research.
We will use or disclose PHI about you when required to do so by applicable law.
Note: incidental uses and disclosures of PHI sometimes occur and are not considered to be a violation of your rights. Incidental uses and disclosures are by-products of otherwise permitted uses or disclosures which are limited in nature and cannot be reasonably prevented.
OTHER USES AND DISCLOSURES
Subject to the requirements of applicable law, we will make the following uses and disclosures of your PHI:
Organ and Tissue Donation. If you are an organ donor, we may release PHI to organizations that handle organ procurement or transplantation as necessary to facilitate organ or tissue donation and transplantation.
Military and Veterans. If you are a member of the Armed Forces, we may release PHI about you as required by military command authorities or foreign military authority.
Worker's Compensation. We may release PHI about you for programs that provide benefits for work-related injuries or illnesses.
Public Health Activities. We may disclose PHI about you for public health activities, including disclosures:
Health Oversight Activities. We may disclose PHI to federal or state agencies that oversee our activities.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose PHI subject to certain limitations.
Law Enforcement. We may release PHI if asked to do so by a law enforcement official:
Coroners, Medical Examiners and Funeral Directors. We may release PHI to a coroner or medical examiner. We may also release PHI about patients to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities. We may release PHI about you to authorized federal officials for intelligence, counterintelligence, other national security activities authorized by law.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release PHI about you to the correctional institution or law enforcement official.
Serious Threats. As permitted by applicable law and standards of ethical conduct, we may use and disclose PHI if we, in good faith, believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public or is necessary for law enforcement authorities to identify or apprehend an individual.
You have the right to request restrictions on our uses and disclosures of PHI for treatment, payment and health care operations. However, we are not required to agree to your request unless the disclosure is to a health plan in order to receive payment, the PHI pertains solely to your health care items or services for which you have paid the bill in full, and the disclosure is not otherwise required by law. To request a restriction, you may make your request in writing to the Privacy Officer.
You have the right to reasonably request to receive confidential communications of your PHI by alternative means or at alternative locations. To make such a request, you may submit your request in writing to the Privacy Officer.
You have the right to inspect and copy the PHI contained in our pharmacy records, except:
In order to inspect or obtain a copy your PHI, you may submit your request in writing to the Privacy Officer.
We may also deny a request for access to PHI under certain circumstances if there is a potential for harm to yourself or others. If we deny a request for access for this purpose, you have the right to have our denial reviewed in accordance with the requirements of applicable law.
You have the right to request an amendment to your PHI but we may deny your request for amendment, if we determine that the PHI:
Any agreed upon amendment will be included as an addition to, and not a replacement of, already existing records. In order to request an amendment to your PHI, you must submit your request in writing to the Privacy Officer at our pharmacy, along with a description of the reason for your request.
You have the right to receive an accounting of disclosures of PHI made by us to individuals or entities other than to you for the six years prior to your request, except for disclosures:
(i) to carry out treatment, payment and health care operations as provided above;
(ii) incidental to a use or disclosure otherwise permitted or required by applicable law;
(iii) pursuant to your written authorization;
· to persons involved in your care or for other notification purposes as provided by law;
· for national security or intelligence purposes as provided by law;
· to correctional institutions or law enforcement officials as provided by law;
· as part of a limited data set as provided by law.
To request an accounting of disclosures of your PHI, you must submit your request in writing to our Privacy Officer. Your request must state a specific time period for the accounting.
You have the right to receive a notification, if there is a breach of your unsecured PHI, which requires notification under the Privacy Rule.
If you believe that your privacy rights have been violated, you should immediately contact the pharmacy's Privacy Officer at 817-481-5780 or firstname.lastname@example.org. We will not take action against you for filing a complaint. You also may file a complaint with the Secretary of the U. S. Department of Health and Human Services, 200 Independence Ave. S.W., Wash
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