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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. .
At Best Quality Health, we value your relationship, and want you to know we
respect your privacy. We are committed to protecting your private personal
health information, and we will only use and disclose your personal health
information as necessary to provide you with health care products and services.
Protected health information (PHI) is any information that we possess, use and
disclose that identifies you and relates to your past, current or future
physical and mental health condition or illness and the health care products and
services that have been provided to you.
This purpose of this "Notice of Privacy Practices" (Notice) is to help you
understand our legal duties to protect your PHI and how we may use and disclose
your PHI in relation to your past, present and future physical or mental health
condition or illness and its treatment. The use and disclosure of your PHI will
primarily involve the health care products and services that we provide you,
such as dispensing your prescriptions. Specifically, we will use and disclose
your PHI as necessary in providing treatment to you, obtaining payment for
health care products and services provided to you and other health care
operations as described later in this Notice. This Notice also describes your
legal rights related to your PHI that is in our possession. We take the
obligations described in this Notice very serious, because we are legally
required to comply with this notice, and because we respect you and your right
to privacy.
Your PHI will only be used and disclosed as described in this Notice. Should
a situation requiring use and disclosure of your PHI that is not described in
this Notice occur, we will obtain your written authorization before the use and
disclosure. At some future date it may be necessary for us to revise this
Notice. If this occurs, we will post the revised Notice in the pharmacy and, if
you request, provide a written Notice to you.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA),
provides you with several rights related to your PHI. These rights are
summarized below. If you would like more information about your rights, please
ask to speak with our Privacy Officer at the address or telephone number above.
Right to Receive Notice of Privacy Practices: You have the right to receive
this written Notice of Privacy Practices describing how we will protect your PHI
and your rights related to PHI. You are entitled to request this written Notice
at any time.
Right to Request Limitation of Use and Disclosure of PHI: You have the right
to request a limitation on our use and disclosure of your PHI. But please be
aware that we may not be able to agree to your requested limitation if it
results in our not being able to provide health care products and services to
you or if we are required to use and disclose the PHI under federal or state
law. All requests for limitation on the use and disclosure of your PHI must be
submitted to our Privacy Officer in writing using a form that we will provide to
you.
Right to Review and Receive a Copy of Records: You have the right to review
or receive photocopies of our records that contain your PHI, to the extent that
these records are part of a designated record set as defined by HIPAA. The most
common type of records are your prescriptions on file with us, our patient
profile for you and our billing records for health care products and services
that have been provided to you. If you wish to review or obtain a copy of a
family member's PHI you may need to complete a "Right to Access and Consent for
Release of PHI to Patient's Authorized Representative". This is of course
subject to any limitations on use and disclosure of PHI we have on file for that
family member. We will be pleased to allow you to review such records meeting
the requirements of this Notice of Privacy Practices at no charge during normal
business hours. However, we may charge you a reasonable, cost-based fee for
photocopies of the records, together with any expenses for mailing, special
courier, faxing and supplies necessary to complete your records request.
If we are unable to provide our records to you, we will provide you a written
explanation of why we are not able to provide the records. Depending on the
reason, you may submit a written request for us to reconsider. All requests to
review or receive photocopies of our records that contain your PHI must be
submitted to our Privacy Officer in writing using a form that we will provide to
you.
Right to Request Amendments to Records: You have the right to request changes
in the content of your PHI contained in our records where you believe the
content is incomplete, inaccurate or for some other reason needs to be changed.
We may not be able to agree to your requested change if we no longer have the
records or if the requested change would cause your PHI to become inaccurate. If
we are not able to agree to your requested change we will notify you in writing
as to why we are not able to agree. You will then have the right to submit to us
a written statement of disagreement, to which we may elect to further respond in
writing to you. All requests for change to your PHI in our records must be
submitted to our Privacy Officer in writing using a form that we will provide to
you.
Right to Request Confidential Communications: You have the right to request
that we communicate with you about your PHI in a confidential manner and only to
locations (such as a post office box) or by means (such as personal cellular
telephone) specified by you. All requests for confidential communications must
be submitted to our Privacy Officer in writing. using a form that we will
provide to you.
Right to an Accounting of Non-Treatment, Payment and Operations (TPO)
Disclosures: You have the right to obtain an accounting of some of our
disclosures of your PHI made after April 14,2003. By accounting we main a
written record of these disclosures. Some of our disclosures of your PHI are not
required by HIPAA to be included in the accounting. Most notable among these are
disclosures for purposes of TPO. Other disclosures of your PHI that are not
required to be included in the accounting are disclosures make directly to you
or that you have authorized, made to family, friends and others who assist you
with your care (caregivers) and made for other purposes allowed by HIPAA. Please
consult with our Privacy Officer for more information on the disclosures not
required to be included in the accounting.
We are required to provide an accounting of disclosures for the six (6) year
period immediately prior to the date of your request for the accounting;
however, your request for an accounting can be for a shorter period of time and
cannot precede the HIPAA compliance date. You may obtain from us, without
charge, one accounting during a twelve-month period. However, if you request
additional accountings during the same twelve month period we may charge you a
reasonable, cost-based fee for printing or photocopying of the accounting,
together with any expenses for mailing, special courier, faxing and supplies
necessary to fulfill your request for the accounting. If it becomes necessary
for us to charge you for an accounting, we will notify you in advance and allow
you to withdraw or modify your request for the accounting. All requests for an
accounting of our disclosures of your PHI must be submitted to our Privacy
Officer in writing.
Right to File a Complaint: You have the right to file a complaint if you
believe that we have violated your rights as described above, and to not fear
retaliation or adverse action by us against you for exercising your right. You
can file the complaint with us directly, or with the United States Department of
Health and Human Services (HHS). Please be assured that we will work with you to
resolve any complaint including providing you with the address for filing a
complaint with HHS. If you have any concern about our privacy practices or wish
to file a complaint, please contact our Privacy Officer at the address or
telephone number of our pharmacy.
If you have any questions about any of your privacy rights as described,
please contact our Privacy Officer at the address or telephone number listed at
the beginning of this document.
Normal Pharmacy Activities Resulting in Uses and Disclosures of your PHI
The Health Insurance Portability and Accountability Act of 1996 (HIPAA),
requires that this "Notice" describe how we may use and disclose your protected
health information (PHI). These uses and disclosures are summarized below, but
if you would like more information about any of these please contact our Privacy
Officer at the address or telephone number of our pharmacy.
Treatment: HIPAA regulations define treatment as "the provision,
coordination, or management of health care and related services by one or more
health care providers, including the coordination or management of health care
by a health care provider with a third party; consultation between health care
providers relating to a patient; or the referral of a patient for health care
from one health care provider to another". We will maintain records that contain
your PHI and we will use and disclose your PHI as necessary to provide health
care products and services to carry out and support your treatment. As a
pharmacy, we will use and disclose your PHI as necessary to maintain your
patient profile, which includes information about you, your medical condition,
medications and prescription devices that you use, any allergies that you may
have and other information, such as any health insurance that you may have. We
will use and disclose your PHI in dispensing prescription medicines and related
products and services, including counseling you and your caregivers about proper
use of your medications. We will also use your patient profile to watch for
medication related problems, such a drug interactions and overuse or under use
of your medications that may present a risk to you. We may discuss such problems
with your other health care professionals, such as your physician or dentist,
and through such discussions, we may use and disclose your PHI. And of course,
we will use and disclose your PHI to you and your caregivers (if you allow us),
in our discussions with you and your caregivers about your treatment.
Payment: HIPAA regulations define payment, in relation to health care
providers such as pharmacies, as activities to obtain reimbursement for the
health care products and services that we provide to you. These activities
include primarily billing you directly or someone who pays for your health care,
such as a family member or health insurance company, for health care products
and services that we provide to you. Activities related to billing may include
claims management, collections and related health care data processing.
Depending on who pays for the health care products and services that we provide
you, other activities may include eligibility determination; drug coverage
determination; medical necessity under a health plan; appropriateness of care,
or justification of charges; including prior authorization of drugs and
services; prospective and retrospective drug utilization review services. Some
examples of PHI that may be used and disclosed to collect payment are:
Name Address Birthdate Gender Social Security Number Insurance Member ID
Number Relationship to Insured Health Plan Information Health Care Provider
Information
We will use and disclose your PHI to carry out the above activities as
necessary or required to obtain payment for the health care products and
services that we provide to you. In relation to this, public and private health
care insurance programs that may provide or pay for your health care can conduct
audits, inspections and investigations of us in relation to our activities and
your activities. We may be required to disclose your PHI to these programs for
purposes of audits, inspections and investigations. Health care operations:
HIPAA defines health care operations as those activities necessary and related
to our providing of health care products and services to you. These activities
include, but may not be limited to, the following:
- Conducting quality assessment and improvement activities, case management,
disease management and care coordination, contacting of health care providers
and patients with information about treatment alternatives and related functions
that do not include treatment.
- Conducting or arranging for medical review, legal services and auditing
functions, including fraud and abuse detection and compliance programs.
- Our pharmacy management and general administrative activities, including,
but not limited to, activities relating to implementation of and compliance with
the requirements of HIPAA.
We will use and disclose your PHI to carry out the above activities as
necessary or required, and especially to monitor and improve the quality of the
health care products and services that are provided to you by us and other
health care professionals.
In addition to treatment, payment and health care operations as described
above, we may use and disclose your PHI for the following purposes:
Business associates: The health care system is very complex and as such we
may not be able to provide health care products and services to you without the
involvement of other businesses or persons. Depending on what these other
businesses or persons do for us, they may become "business associates" as
defined by HIPAA. In many situations it will be necessary for us to provide your
PHI to these business associates so that they can carry out the activities that
we need to have performed in order to provide you health care products and
services. For patients that have health insurance that includes a pharmacy
benefit, one of our most common business associates is a health insurance
company or a pharmacy benefits company that processes claims we submit for
payment for health care products and services on your behalf. We have written
contracts with all of our business associates to whom we provide your PHI so
that they can carry out their activities on our behalf. In an effort to provide
you a level of comfort, you should know, these contracts require our business
associates to give us their assurance that they, like us, will protect the
privacy of your PHI.
Communications with you concerning your health and treatment: We want to do
whatever we can to assist you with maintaining your health and obtaining the
most benefit from your treatment. We routinely monitor your prescription
medications for appropriateness and take other steps to help you use your
medication properly. For example, if you forget to obtain a refill of your
medication, we may contact you to remind you to obtain the refill. We may also
call you or send you materials regarding products and services that we believe
may be of benefit to you. In the event that a pharmaceutical manufacturer or the
Food and Drug Administration (FDA) is to issue a medication recall, we may
contact you if you are taking the medication subject to the recall.
Federal and state government agencies: We may disclose your PHI to federal
and state government agencies for a variety of purposes, most of which are
directed at monitoring health care quality and safety, government programs
related to health care and our compliance with laws applicable to health care.
For example, the United State Drug Enforcement Administration (DEA) monitors the
distribution and use of controlled substances, while the FDA monitors adverse
drug events. We may disclose your PHI to such agencies where required by the
agency so that the agency can carry out its required activities. Related to
this, some private businesses, such as the manufacturers of medications and
medical devices, are legally required to conduct post marketing surveillance in
order to ensure the safety of their products. Disclosing your PHI for such
surveillance may be necessary. A number of state agencies also conduct health
care quality and safety activities, for which we may disclose your PHI. For
example, some states maintain a controlled substance monitoring program and
require that we report to the state the prescriptions for controlled substances
that we dispense to you.
Federal and state government health care insurance programs: If you apply for
and receive benefits from federal and state health care programs, such as
Medicare or Medicaid, your PHI may be disclosed to the agency granting these
benefits. If you are employed by a business that is required to carry workers'
compensation insurance, and you are injured in such a way that the workers'
compensation plan covers your health care, it may be necessary to disclose you
PHI to the workers' compensation plan. Such plans have a right to conduct
audits, inspections and investigations of our activities and your activities,
and where required, we will disclose your PHI for these activities.
Public health and safety: There are several federal and state laws that
require health care providers to report to various government agencies matters
related to public health. If your physical or mental health condition and
illness is of a nature that requires that it be reported, then we will disclose
your PHI to the appropriate government agency in order to comply with these
laws. In addition to reporting about physical and mental health conditions and
illnesses, we may also disclose your PHI to government agencies in other
situations where we are required to submit reports, such as suspected domestic,
child or elder abuse or neglect.
Law enforcement activities: A number of federal, state and local government
agencies are charged with enforcing the health care and drug laws, and other
laws in relations to the health care products and services that we may provide
to you. In addition, as a state licensed pharmacy, a variety of federal, state
and local health care agencies, such as the state board of pharmacy, regulate
our activities. These agencies may engage in a number of activities designed to
monitor and improve federal and state health care programs and systems,
including conducting of inspections and investigations of our activities and the
health care products and services that we provide to our patients. At any time
we are required by federal or state laws, or by court order, subpoena of other
legal mandate, to disclose your PHI we will do so as necessary.
Legal disputes: Lawsuits and other legal disputes are common today, and
depending on the issues, may involve your PHI that we possess. In the event that
you are involved in a lawsuit or other legal proceeding, whether as a plaintiff
or a defendant, and without regard to the basis for the lawsuit, such as medical
malpractice or divorce, we will disclose your PHI when required to comply with a
court order, subpoena, discovery proceeding, such as a deposition, or other
legal mandate served upon us. We will attempt to notify you prior to the
disclosure if you are not the party to the legal dispute requesting your PHI so
that you and your attorney can determine whether you want to take legal actions
to prevent disclosure of your PHI.
Disclosures for the benefit of you and others: Events can occur where we
would use and disclosure your PHI for your benefit and to prevent or reduce the
risk of harm to you. For example, if you are in a car accident and are
unconscious in a hospital emergency room and the emergency room medical staff
calls us with a request for your PHI, we may disclose it for the purpose of
assisting in your prompt medical treatment. The same is true if a family member,
friend or caregiver contacts us in an emergency situation, or where an emergency
situation is not present, but we have reason to believe you are at risk of harm
or serious injury and we believe that disclosing your PHI will assist them in
caring for you. We may also disclose your PHI upon your death to a funeral
director, embalmer, medical examiner or coroner's office to assist them in
carrying out their legal responsibilities related to your death. Finally, we may
disclose your PHI where necessary to protect the health and safety of others.
Disclosures for national security and intelligence: We are legally required
to disclose your PHI when necessary to national security and intelligence and
counter-intelligence activities. Any disclosure for these purposes would be made
only to authorized government officials.
Disclosures if you are in the military or a veteran: We may disclose your
PHI, if you are a member of any branch of the armed services, whether on active
or reserve status. If you are a veteran, we may release your PHI. Particularly
if you are receiving health care products and services from the Veterans
Services. Any disclosure for these purposes would be made only to authorized
government officials.
Disclosures of a miscellaneous nature: We may be required to disclose your
PHI if you are placed into custody of a federal or state correctional system if
necessary to protect the health and safety of you and others. Health care is an
area where much research is being conducted, and we may disclose your PHI for
purposes of a research project, but only if we are satisfied that the research
project has been approved by a responsible institutional review board and the
research project has established adequate methods to protect your privacy. Much
health care research is sponsored through organizations that conduct fundraising
activities, and we may inquire with you using your PHI to determine your
interest in participating in or otherwise supporting a fundraising activity.
Finally, given the national need for organ donations, we may disclose your PHI
to organizations that manage organ transplantation programs.
If you have any questions about any of the uses and disclosures of your PHI
as described above, Please contact our Privacy Officer at the address or
telephone number listed at the beginning of this document.
Uses and Disclosures not Contained in this Notice
If a use and disclosure of your PHI is not contained in this Notice, we will
obtain your written authorization before the use and disclosure. You may have
the right to refuse to authorize the use and disclosure, or if you grant the
authorization, to revoke the authorization at any time. If such authorization is
requested, we will provide you with a form that describes the proposed use and
disclosure and your rights related to the requested authorization.
HIPAA requires that we give you this "Notice of Privacy Practices" and make a
good faith effort to obtain your written acknowledgement that you were given
this notice. Upon giving you this Notice, you will be asked to sign a document
acknowledging that you received this notice. We appreciate your cooperation in
reviewing this notice and in giving us your written acknowledgment.
HIPAA also requires that this Notice, at a minimum, cover the following three
areas.
- How we will use and disclose your personally identifiable health
information.
- Your rights with respect to your personally identifiable health
information.
- Our legal duties to protect the confidentiality of your personally
identifiable health information.
In preparing this Notice, we made every effort to comply with this HIPAA
requirement. Also, you should be aware that the Federal regulation HIPAA does
not take precedence over State Law when the State Law is more strict. You may
have additional protections under State Law.
Please consult our Privacy Officer if you have any questions or want more
information concerning your health care and privacy rights under HIPAA or the
laws of our state, or our privacy practices. Also, you should consult our
Privacy Officer if you wish to file a complaint about our privacy practices or
if you believe we have violated any of your rights as described in this Notice.
Thank you for allowing us the privilege of assisting you with your health care needs. We look forward to providing you with high quality health care products and services.
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