BALLARD PLAZA PHARMACY NOTICE OF PRIVACY PRACTICES
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, BALLARD PLAZA PHARMACY HAS NEVER AND WILL NEVER SELL OR DISCLOSE, WITHOUT AUTHORIZATION, THE PROTECTED HEALTH INFORMATION OF OUR PATIENTS TO THIRD PARTIES FOR THE PURPOSES OF MARKETING!
Under applicable law, we are required to protect the privacy of your individual health information we refer to in this notice as “PROTECTED HEALTH INFORMATION” (PHI). We are also required to provide you with this notice regarding our policies and procedures regarding your PHI and to abide by the terms of this notice, as it may be updated from time to time.
We are permitted to make certain types of uses and disclosures under applicable law for treatment, payment, and healthcare operations purposes. We may obtain information to dispense prescriptions and for the documentation of pertinent information in your records that may assist us in managing your medication therapy or your overall health.
The following are examples and descriptions of the uses and disclosures of PHI:
The use of PHI for treatment
An example would be the use of information obtained to dispense prescribed medications Information related to the services provided and medications dispensed would be documented in an individual’s record.
The use of PHI for payment
An example would be contacting the pharmacy benefit manager or insurer to confirm payment for an individual’s prescription and amount of the co-payment. The pharmacy bills either the individual or a third-party payer for the prescription medication costs. An individual’s prescription or personal identifying information may be included on or with the bill.
The pharmacy is allowed to disclose or use PHI for the following purposes:
Communication with individuals involved in your care or payment for your care:
Using their judgment, pharmacists and other professional health care givers may disclose relevant PHI regarding personal care or payment related to care to those identified by an individual, such as family members, relatives and friends.
A pharmacy may make face-to-face communications to an individual to provide information about treatment alternatives, health care related benefits or services of interest, or refill reminders.
Food and Drug Administration (FDA):
To enable the FDA to recall, repair or replace products the pharmacy may disclose to the FDA, PHI associated with adverse outcomes with respect to foods, drugs, products and product defects and supplements.
An individual’s PHI may be disclosed by the pharmacy if authorized or is necessary to act in accordance with any laws reguIating worker’s compensation or similar law established programs.
As required by law for law enforcement purposes, a valid subpoena, or another legal process, a pharmacy may disclose an individual’s PHI.
Health oversight activities:
For any law authorized activities, the pharmacy may disclose an individual’s PHI to an oversight agency. Such activities include inspections, investigations, and audits deemed necessary for the licensure to monitor government programs, the health care system and compliance with civil rights laws.
PHI regarding the prevention and control of disease, injury and disability may be disclosed to public health or legal authorities as required by law.
PHI may be disclosed to an institution or its agents to protect the health and safety of an individual or other inmates, if said individual becomes or is already an inmate of a correctional institution.
To avert serious threat to health or safety:
In the case of a serious threat to health or injury of an individual, PHI may be disclosed as a method of prevention.
Military and veterans:
PHI may be released about members of the armed forces, as military command authorities require.
National security and intelligence activities:
PHI may be disclosed to federal intelligence agents, counterintelligence and law authorized security activities.
Protective services for the President and others:
To conduct a special investigation, or protect the President, foreign Heads of State or authorized persons, PHI may be disclosed to authorized federal agents.
Victims of abuse, neglect or domestic violence:
If abuse neglect or domestic violence is suspected, PHI may be released to the appropriate government authority if the victim agrees with the disclosure, to avert serious harm to an individual.
As required by law:
A pharmacy may disclose an individual’s PHI when required to do so by law.
Individual Health Information Rights
With respect to your PHI, you have the following rights:
- Upon request, to obtain a paper copy of this Notice.
- To request additional restrictions on certain uses and disclosures of your PHI. Requests must be made in writing and submitted to the pharmacy’s Privacy Officer or the store owner. The pharmacy is not required to agree with those limitations.
- To attain and inspect a copy of PHI. Please submit a request in writing to the Privacy Officer or store owner. Fees may be applied to cover the costs of supplies, copying and mailing.
- To request an amendment of PHI. If an individual feels that their PHI maintained by the pharmacy is inaccurate in any way, they may request it be amended. An amendment may be requested as long as the Pharmacy maintains the PHI. Please submit the request in writing and submit it to the Privacy
Officer or store owner. A reason for the request must be included to support the request. In some cases, the request may be denied.
- To receive an accounting of disclosures of PHI after April 14, 2003. The accounting will be limited to disclosures made above and beyond treatment, health care operations and payment A specific time period, of no more than six years, must be included. The initial request for accounting is free, additional accountings within a twelve month period will have associated fees.
- To request communications of PHI by alternative methods or at alternative locations. Please submit a written request to the Privacy Officer or store owner. Most reasonable requests will be accommodated.
For additional Information:
If you have any additional questions or for more information about the pharmacy’s privacy practices, please contact the Privacy Officer or the store owner.
In the case of suspected violation of privacy rights, complaints may be filed with the Secretary of Health and Human Services. Filing a complaint will not result in any retaliation efforts.
This notice will be in effect as of April 14, 2003.