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Notice of Privacy Practices |
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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.
Vail Ranch Pharmacy, including its subsidiaries, is required by law to maintain
the privacy of Protected Health Information ("PHI") and to provide you with notice
of our legal duties and privacy practices with respect to PHI. PHI is information
that may identify you and that relates to your past, present or future physical
or mental health or condition and related health care services. This Notice of Privacy
Practices ("Notice") describes how we may use and disclose PHI to carry out treatment,
payment or health care operations and for other specified purposes that are permitted
or required by law. The Notice also describes your rights with respect to your PHI.
We are required to provide this notice to you by the Health Insurance Portability
and Accountability Act ("HIPAA").
Vail Ranch Pharmacy is required to follow the terms of this Notice. We will not
use or disclose your PHI without your written authorization, except as described
or otherwise permitted by this Notice. We reserve the right to change our practices
and this Notice and to make the new Notice effective for all PHI we maintain. Upon
request, we will provide any revised Notice to you.
Examples of How We Use and Disclose Protected Health Information
About You
The following categories describe different ways that we use
and disclose your protected health information. We have provided you with examples
in certain categories; however, not every use or disclosure in a category will be
listed.
Treatment.
We may use your
health information to provide and coordinate the treatment, medications and services
you receive. For example, we may contact you regarding medications, equipment, supplies,
compliance programs such as drug recommendations, therapeutic substitution, refill
reminders, other product or service recommendations such as specialty and infusion
therapies, counseling and drug utilization review (DUR), product recalls or disease
state management.
Payment.
We may use your health
information for various payment-related functions. Example: We may contact your
insurer, pharmacy benefit manager or other health care payor to determine whether
it will pay for your medications, equipment and supplies and the amount of your
co-payment. We will bill you or a third-party payor for the cost of medications,
equipment and supplies dispensed to you. The information on or accompanying the
bill may include information that identifies you, as well as the medications you
are taking.
Health Care Operations.
We
may use your health information for certain operational, administrative and quality
assurance activities. Example: We may use information in your health record to monitor
the performance of the staff and pharmacists providing treatment to you. This information
will be used in an effort to continually improve the quality and effectiveness of
the health care and service we provide. We may disclose health information to business
associates if they need to receive this information to provide a service to us and
will agree to abide by specific HIPAA rules relating to the protection of health
information.
We may also use your health information to provide you with information about benefits
available to you, and, in limited situations, about health-related products or services
that may be of interest to you.
We are permitted to use or disclose your PHI for the following
purposes. However, Vail Ranch Pharmacy may never have reason to make some of these
disclosures.
To Communicate with Individuals Involved in Your Care or Payment for Your Care.
We may disclose to a family member, other relative, close personal
friend or any other person you identify, PHI directly relevant to that person's
involvement in your care or payment related to your care.
Food and Drug Administration (FDA).
We may disclose to the FDA, or persons under the jurisdiction of the FDA, PHI relative
to adverse events with respect to drugs, foods, supplements, products and product
defects, or post-marketing surveillance information to enable product recalls, repairs,
or replacement.
Worker's Compensation.
We may
disclose your PHI to the extent authorized by and to the extent necessary to comply
with laws relating to worker's compensation or other similar programs established
by law.
Public Health.
As required
by law, we may disclose your PHI to public health or legal authorities charged with
preventing or controlling disease, injury, or disability.
Law Enforcement.
We may disclose
your PHI for law enforcement purposes as required by law or in response to a subpoena
or court order.
As Required by Law.
We will
disclose your PHI when required to do so by federal, state, or local law.
Health Oversight Activities.
We may disclose your PHI to an oversight agency for activities authorized by law.
These oversight activities include audits, investigations, inspections, and credentialing,
as necessary for licensure and for the government to monitor the health care system,
government programs, and compliance with civil rights laws.
Judicial and Administrative Proceedings.
If you are involved in a lawsuit or a dispute, we may disclose
your PHI in response to a court or administrative order. We may also disclose health
information about you in response to a subpoena, discovery request, or other lawful
process instituted by someone else involved in the dispute, but only if efforts
have been made, either by the requesting party or us, to tell you about the request
or to obtain an order protecting the information requested.
Research.
We may disclose your
PHI to researchers when their research has been approved by an institutional review
board or privacy board that has reviewed the research proposal and established protocols
to ensure the privacy of your information.
Coroners, Medical Examiners, and Funeral Directors.
We may release your PHI to a coroner or medical examiner. This
may be necessary, for example, to identify a deceased person or determine the cause
of death. We may also disclose PHI to funeral directors consistent with applicable
law to enable them to carry out their duties.
Organ or Tissue Procurement Organizations.
Consistent with applicable law, we may disclose your PHI to organ
procurement organizations or other entities engaged in the procurement, banking,
or transplantation of organs for the purpose of tissue donation and transplant.
Notification.
We may use or
disclose your PHI to notify or assist in notifying a family member, personal representative,
or another person responsible for your care, regarding your location and general
condition.
Fundraising.
We may contact
you as part of a fundraising effort.
Correctional Institution.
If
you are or become an inmate of a correctional institution, we may disclose to the
institution or its agents PHI necessary for your health and the health and safety
of other individuals.
To Avert a Serious Threat to Health or Safety.
We may use and disclose your PHI when necessary to prevent a
serious threat to your health and safety or the health and safety of the public
or another person.
Military and Veterans.
If you
are a member of the armed forces, we may release PHI about you as required by military
command authorities. We may also release PHI about foreign military personnel to
the appropriate foreign military authority.
National Security, Intelligence Activities, and Protective
Services for the President and Others.
We may release
PHI about you to federal officials for intelligence, counterintelligence, protection
to the President, and other national security activities authorized by law.
Victims of Abuse or Neglect.
We may disclose PHI about you to a government authority if we reasonably believe
you are a victim of abuse or neglect. We will only disclose this type of information
to the extent required by law, if you agree to the disclosure, or if the disclosure
is allowed by law and we believe it is necessary to prevent serious harm to you
or someone else.
Other Uses and Disclosures of PHI.
We will obtain your written authorization before using or disclosing
your PHI for purposes other than those provided for above (or as otherwise permitted
or required by law). You may revoke an authorization in writing at any time. Upon
receipt of the written revocation, we will stop using or disclosing your PHI, except
to the extent that we have already taken action in reliance on the authorization.
Your Health Information Rights
Obtain a paper copy of the Notice upon request. You may
request a copy of our current Notice at any time. Even if you have agreed to receive
the Notice electronically, you are still entitled to a paper copy. You may obtain
a paper copy from a pharmacy, home care facility, mail service location or the Privacy
Office.
Request a restriction on certain uses and disclosures
of PHI.
You have the right to request additional restrictions on our use or disclosure
of your PHI by sending a written request to the Privacy Office. We are not required
to agree to those restrictions. We cannot agree to restrictions on uses or disclosures
that are legally required, or which are necessary to administer our business.
Inspect and obtain a copy of PHI.
In most cases, you have the right to access and copy the PHI that we maintain about
you. To inspect or copy your PHI, you must send a written request to the Privacy
Office. We may charge you a fee for the costs of copying, mailing and supplies that
are necessary to fulfill your request. We may deny your request to inspect and copy
in certain limited circumstances.
Request an amendment of PHI.
If you feel that PHI we maintain about you is incomplete or incorrect, you may
request that we amend it. To request an amendment, you must send a written request
to the Privacy Office. You must include a reason that supports your request. In
certain cases, we may deny your request for amendment.
Receive an accounting of disclosures of PHI.
You have the right to receive an accounting of the disclosures
we have made of your PHI after April 14, 2003 for most purposes other than treatment,
payment, or health care operations. The right to receive an accounting is subject
to certain exceptions, restrictions, and limitations. To request an accounting,
you must submit a request in writing to the Privacy Office. Your request must specify
the time period. The time period may not be longer than six years and may not include
dates before April 14, 2003.
Request communications of PHI by alternative means or at
alternative locations.
For instance, you may request that
we contact you at a different residence or post office box. To request confidential
communication of your PHI, you must submit a request in writing to the Privacy Office.
Your request must tell us how or where you would like to be contacted. We will accommodate
all reasonable requests.
Where to obtain forms for submitting written requests.
You may obtain forms for submitting written requests from the Vail Ranch Pharmacy
store, or by contacting us at Vail Ranch Pharmacy, 32675 Temecula Pkwy Ste B, Temecula,
CA 92592 or by telephone at (951) 303-8300.
Incidental Disclosures.
Vail Ranch Pharmacy will make reasonable efforts to avoid incidental
disclosures of protected health information. An example of an incidental disclosure
is conversations that may be overheard between the pharmacy staff and the patient
at the drive-thru, as a result of the speaker system. To reduce the likelihood of
this happening, we recommend that you go inside the store to the pharmacy for any
consultations.
Minors.
If you are a minor who has lawfully provided consent for treatment
and you wish for Vail Ranch Pharmacy to treat you as an adult for purposes of access
to and disclosure of records related to such treatment, please notify a staff member,
pharmacist or the Privacy Office.
For More Information or To Report a Problem.
If you have questions or would like additional information about
Vail Ranch Pharmacy's' privacy practices, you may contact us at Vail Ranch Pharmacy,
32675 Temecula Pkwy Ste B, Temecula, CA 92592 or by telephone at (951) 303-8300. If you
believe your privacy rights have been violated, you can file a complaint with the
Vail Ranch Pharmacy Store. There will be no retaliation
for filing a complaint.
Effective Date
This Notice is effective as of April 13, 2003 |
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