NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
Effective Date: April 14, 2003
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
This Pharmacy is covered by the medical information privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (generally called "HIPAA") and its Regulations. As a result, we are required by law to maintain the privacy of our patients' protected health information and to give our patients this notice of our legal duties and privacy practices. It is our obligation to abide by those practices, in the use and disclosure of that information.
The regulations provide for two categories of use and disclosure: information that we can use without the patient's prior consent, and information that we cannot use without the patient's prior authorization.
In the first category, we are permitted to use and disclose our patient's health information in connection with their medical treatment such as sending information about a patient's prescriptions to the patient's family doctor, or to a specialist who is treating the patient, or to a hospital where the patient is receiving care. Similarly, if a patient is covered by a pharmacy benefit plan, we are entitled to send the information about the medication we have dispensed to the patient, to the plan or to another business entity that is involved in our billing so that we may be paid. In addition, we can provide this information for health care operations such as evaluations of the quality of our patients' health care, in order to improve the success of treatment programs. The permitted use of our patients' health information for purposes of treatment, payment or health care operations may, under certain circumstances, be limited by other laws or regulations that provide for a higher degree of privacy protection than is required by HIPAA or the Regulations.
In addition, for a number of other specified purposes, but subject to certain detailed limitations and requirements, we may give out health information without a patient's prior authorization in connection with public health activities, in situations where there may be abuse, neglect or domestic violence, in connection with health oversight activities, judicial or administrative proceedings, law enforcement inquiries, deaths, organ donations, research studies, where there is a serious threat to health and safety, in cases of military or veterans' activities, where national security is involved, for determinations of medical suitability, for government programs for public benefit, for workers' compensation proceedings, when our records are being audited, when medical emergencies occur, and when we are communicating with our patient orally or in writing about refilling prescriptions, about generic drugs that may be appropriate for a patient's treatment, or about alternative therapies.
For purposes other than those mentioned above, we are required to ask for our patient's written authorization before using or disclosing any of their health information. If we request an authorization, any of our patients may decline to agree, and if a patient gives us an authorization, the patient has the right to revoke the authorization and by doing so, stop any future uses and disclosures the authorization covered.
If in the future we need to change any of the policies and practices described in this notice, we will give each of our patients a copy of the new notice not later than the patient's first visit after the change, and a new notice will be posted in the pharmacy. Even in the absence of any policy changes, each patient may obtain another copy of this notice or later versions of this notice at any time.
HIPAA and the Regulations provide our patients with rights concerning their health information. With limited exceptions (which are subject to review) each patient has the right to see and obtain a copy of our record of the patient's medication. The only charge for that service will be an amount equal to our cost in producing the information. Each of our patients are also entitled to ask for a list of our disclosures of the patient's health information within the prior six years, except for the disclosures made for the purposes of treatment, payment or health care operations as indicated above. If upon seeing the list of the patient's medications the patient believes that information in our records is incorrect or that important information is missing, the patient has the right to request that we correct the existing information or add the missing information.
Our patients also have the right to tell us to communicate with them about their health information in a confidential manner, such as sending mail to an address other than the home address or using a particular telephone number. In addition, a patient may give us a written request that we further restrict the use or disclosure of their health information except when specifically authorized by them, or when required by law or in emergency circumstances. We will consider the request but we are not legally required to agree to it.
If a patient believes that we have violated their rights as to the privacy of their health information, or if a patient disagrees with a decision we made about access to their health record, the patient has the right to notify our Contact Person whose name, address and telephone number are listed below. Our Contact Person is required to investigate, and if possible resolve, each such complaint, and to advise the patient accordingly. The patient also has the right to send a written complaint to the U.S. Department of Health and Human Services. Our Contact Person will provide the patient with the appropriate address upon request. Under no circumstances will any patient be retaliated against by this pharmacy, for filing a complaint.
We are required by law to protect the privacy of our patient's health information, to provide this notice about our privacy policies and practices, and follow the privacy policies and practices that are described in this notice.
Our Contact Person can be reached as follows:
Amelia Arnold, Pharm.D.
16 Commerce Drive, Suite 1
PO Box 528
Augusta, ME 04332-0528
Phone: 1-800-730-4840 Ext. 228
Fax: (207) 622-3264