HIPPA Statement
NOTICE OF PRIVACY PRACTICE FOR
PROTECTED HEALTH INFORMATION
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET
ACCESS TO THIS INFORMAITON. PLEASE READ 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 to comply with HIPAA and the Regulations in the use and
disclosure of health information by which our patients can be
individually identified. This health information is referred to
as “Protected Health Information” or “PHI” for
short. We are also required under Section 164.520 to give our
patients this notice of our legal duties and privacy practices
concerning their PHI, and also tell our patients about their rights
under HIPAA and the Regulations.
1. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
There are two categories for
the use and disclosure of our patients’ PHI: (1) information that
we can use and disclose without the patient’s prior consent; and
(2) information that we cannot use or disclose without the
patient’s prior authorization.
(A) PATIENTS’ PRIOR CONSENT NOT REQUIRED
(1)Treatment: In the
first category, we are permitted to use and disclose our
patients’ PHI in connection with their medical treatment in
situations such as allowing a family member or other relative or close
personal friend or other person involved in the patient’s health
care to pick up the patient’s prescriptions and to receive
Protected Health Information that is directly related to the
patient’s care. In doing so, we are to use our professional
judgment and experience with common practice in determining what is in
the patient’s best interests. Other examples include
sending information about a patient’s perscriptions 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,
particularly if the patient has suffered a health emergency.
(2) Payment: If a
patient is covered by a pharmacy benefit plan, we are entitled to send
PHI to the plan describing the medications or health care equipment we
have dispensed so that we can be paid.
(3) Health Care Operations:
In addition, we can provide PHI for health care operations such as
evaluations of the quality of our patients’ health care in order
to improve the success of treatment programs. Other examples
include reviews by health care professionals, insurance premium rating,
legal and auditing functions and business planning and management.
(4) Other Permitted Uses
and Disclosures: There are a number of other specified purposes for
which we may disclose a patient’s PHI without the patient’s
prior consent (but with certain restrictions). Examples include public
health activities; situations where there may be abuse, neglect or
domestic violence; in response to law enforcement inquiries; in the
event of death; where organ donations are involved; in support of
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 proceedings; when our records are being
audited; when medical emergencies occur; and when we communicate with
our patients orally or in writing about refilling prescriptions, about
generic drugs that may be appropriate for a patient’s treatment,
or about alternative therapies.
(B) PATIENT’S PRIOR AUTHORIZATION REQUIRED
For purposes other than those
mentioned above, we are required to ask for our patients’ written
authorizations before using or disclosing any of their PHI. 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 covered. An example of a situation where
the patient’s prior authorization would be required would be if
we wish to conduct marketing program that would involve the use of PHI.
2. PATIENTS’ RIGHTS
HIPAA and the Regulations
provide our patients with rights concerning their PHI. With
limited exceptions (which are subject to review) each patient has the
right to the following:
- Patient’s Record: Each patient can obtain a copy of his or her PHI by completing our request form. The only charge will be based on our cost in responding to the request. The amount of the charge will vary depending on the format the patient requests and whether the patient wants the record or a summary, and whether it is to be delivered by mail or otherwise. The patient will be told of the fee when the patient’s request is received.
- Accounting for Disclosures: By completing our request form, each patient is entitled to obtain a list of the disclosures of the patient’s PHI that have occurred within a period of 6 years after April 14, 2003, except for disclosures made for the purposes of treatment, payment or health car operations and certain others. There will be no additional requests made in the same period of time.
- Amendments: Each patient may ask to change the record of his or her own PHI by completing our request form explaining why the change should be made. We will review the request, but may decline to make the change if in our professional judgment we conclude that the record should not be changed.
- Communications: By completing our request form, each patient can ask us to communicate with him or her about their own PHI in a confidential manner such as by sending mail to an address other than the home address or using a particular telephone number.
- Special Restrictions: By completing our request form, each patient can ask us to adopt special restrictions that further limit our use and disclosure of the patents’ PHI (except where use and disclosure are required of us by law or in emergency circumstances). We will consider the request; but in accordance with HIPAA and the Regulations, we are not required to agree with the request.
- Complaints: If a patient believes that we have violated the patient’s rights as to the patient’s PHI under HIPAA and the regulations, or if a patient disagrees with a decision we made about access to the patient’s PHI, the patient has the right to complete our complaint form and return it to Teton Pharmacy. We are required to investigate, and if possible, to 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.
We are required by law to
protect the privacy of our patients’ PHI, to provide this notice
about our privacy practices, and follow the privacy practices that are
described in this notice. We reserve the right to make changes in
our privacy practices that will apply to all the PHI we maintain.
A new notice will be available on request before any significant
changes are made.
3101 Valencia
Idaho Falls, Idaho 83404
Phone: (208) 529-3636
Fax: (208) 528-6562