HIPAA Notice of Privacy Practices
Effective Date: January 2024
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.
Our Commitment to Your Privacy
Community Pharmacy is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI), give you this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.
How We May Use and Disclose Your Health Information
We may use and disclose your PHI for the following purposes:
Treatment
We may use your PHI to provide you with pharmaceutical care and services. For example, we may contact your physician to clarify a prescription or discuss alternative medications. We may also share your PHI with other healthcare providers involved in your care.
Payment
We may use and disclose your PHI to obtain payment for services provided to you. For example, we may send your PHI to your insurance company to get paid for prescriptions we dispense to you.
Healthcare Operations
We may use and disclose your PHI for our healthcare operations, which include quality assessment activities, licensing and accreditation, and business management.
Other Permitted Uses and Disclosures
- As Required by Law: We will disclose PHI when required by federal, state, or local law.
- Public Health Activities: We may disclose PHI for public health purposes, such as reporting adverse reactions to medications.
- Health Oversight Activities: We may disclose PHI to health oversight agencies for audits, investigations, and inspections.
- Legal Proceedings: We may disclose PHI in response to a court order or subpoena.
- Law Enforcement: We may disclose PHI for law enforcement purposes as required by law.
- To Avert a Serious Threat: We may disclose PHI to prevent a serious threat to your health and safety or the health and safety of others.
- Workers' Compensation: We may disclose PHI for workers' compensation claims.
Uses and Disclosures Requiring Your Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes other than those described above, including:
- Marketing purposes (with limited exceptions)
- Sale of your PHI
- Most uses of psychotherapy notes
- Other uses not described in this notice
You may revoke your authorization at any time by submitting a written request, except to the extent that we have already acted on your authorization.
Your Rights Regarding Your Health Information
Right to Access
You have the right to inspect and obtain a copy of your PHI maintained by us. You must submit a written request. We may charge a reasonable fee for copying and mailing.
Right to Amend
You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. You must submit a written request with a reason for the amendment. We may deny your request in certain circumstances.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your PHI. This does not include disclosures for treatment, payment, or healthcare operations.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to your request, except for restrictions on disclosures to health plans for services you paid for in full out of pocket.
Right to Request Confidential Communications
You have the right to request that we communicate with you at a specific address or phone number. We will accommodate reasonable requests.
Right to a Paper Copy
You have the right to obtain a paper copy of this notice upon request, even if you agreed to receive it electronically.
Our Duties
- We are required by law to maintain the privacy and security of your PHI.
- We will notify you if a breach occurs that may have compromised the privacy or security of your PHI.
- We must follow the duties and privacy practices described in this notice.
- We will not use or disclose your PHI without your authorization, except as described in this notice.
Changes to This Notice
We reserve the right to change this notice and make the new provisions effective for all PHI we maintain. We will post the revised notice in our pharmacy and on our website. You may also request a copy of the current notice at any time.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
Contact Information
To exercise your rights, request a copy of this notice, or file a complaint, please contact:
Privacy Officer
Community Pharmacy
123 Main Street
Anytown, ST 12345
Phone: (555) 123-4567
Email: privacy@communitypharmacy.com
File a Complaint with HHS
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr