THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
MAY BE USE AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE REVIEW IT CAREFULLY.
USE AND DISCLOSURE OF HEALTH INFORMATION
West-Val Pharmacy may use your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing your treatment, obtaining payment for your care and conducting health care operations. West-Val Pharmacy has established policies to guard against unnecessary disclosure of your health information.
To Provide Treatment. West-Val Pharmacy may use your health information to coordinate care within West-Val Pharmacy and with others involved in your care, such as your attending physician and other health care professionals.
When Legally Required. West-Val Pharmacy will disclose your health information when it is required to do so by any Federal, State or local law.
To Report Abuse, Neglect Or Domestic Violence. West-Val Pharmacy is allowed to notify government authorities if West-Val Pharmacy believes a patient is the victim of abuse, neglect or domestic violence.
To Conduct Health Oversight Activities. West-Val Pharmacy may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. West-Val Pharmacy, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related your receipt of health care or public benefits.
For Law Enforcement Purposes. As permitted or required by State law, West-Val Pharmacy may disclose your health information to a law enforcement official for certain law enforcement purposes.
In the Event of A Serious Threat To Health Or Safety. West-Val Pharmacy may, consistent with applicable law and ethical standards of conduct, disclose your health information if West-Val Pharmacy, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.
It is West-Val Pharmacy's duty to protect privacy, provide a notice of privacy practices and abide by the terms of the current notices.
Permitted uses and Disclosures. West-Val is permitted, but not required, to use and disclose protected health information, without an individual's authorizations, for the following purposes or situations: (1) To the individual (unless required for access or accounting of disclosures; (2) Treatment, Payment, and Health Care Operations; (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure, (5) Public Interest and Benefit Activities; and (6) Limited Data Set for the purposes of research, public health or health care operations. West-Val will rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make.
You have the right to request a limitation on our use and disclosure of your PHI. 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 Pharmacy Privacy Officer in writing using a form that we will provide to you.
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 such 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. We will be pleased to allow you to review or receive such records 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 fulfilling your request for records.
If we are unable to provide our records to you, we will provide you 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 Pharmacy Privacy Officer in writing using a form that we will provide you.
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 changes to your PHI in our records must be submitted to our Pharmacy Privacy Officer in writing, using a
form that we will provide to you.
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 Pharmacy Privacy Officer in writing, using a form that we will provide to you.
You have the right to obtain an accounting of some of our disclosures of your PHI made after April 14, 2003. Byan accounting, we mean a written record of these disclosures. Some of our disclosures of your PHI are not required by HI PAA to be included in the accounting. Most notable among these are disclosures for purposes of treatment, obtaining payment, and carrying out health care operations. Other disclosures of your PHI that are not required to be included in the accounting are disclosures made 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 Pharmacy Privacy Officer for more information on the disclosures not required to be included in the accounting. The period of time for which we are required to provide the accounting is the six-year period immediately prior to the date of your request for the accounting but no earlier than April 14, 2003;
however, your request for an accounting can be for a shorter period of time. All requests for an accounting of our disclosures of your PHI must be submitted to your Pharmacy Privacy Officer in writing, using a form that we will provide to you.
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.