NOTICE OF PRIVACY PRACTICES
Effective November 1, 2016
This Notice Describes How Your Medical Information May Be Used and Disclosed and How You Can Get Access to This Information.
Please Review Carefully
Dear Brand Direct Health® Member,
You may have read about patient privacy and the laws that are in effect to guard said privacy. As with most government regulations, this seems to be overwhelming and confusing; however, rest assured that this is nothing more than what we have always done to protect patient privacy.
This pamphlet describes the privacy of your prescription information and under what circumstances we are allowed to provide this information to other healthcare professionals.
We strongly believe that the transfer of correct, updated, and appropriate information—through your physician, your pharmacist, or other caregivers—is the cornerstone of providing good care. However, what is updated and appropriate must be balanced to maintain and secure your personal privacy.
We will work hard to earn your trust in our pharmacy and in our company. We thank you for that trust, for believing in our full dedication to providing you the best services, and for being a Brand Direct Health® member.
What is This Notice?
We are required by law to maintain the privacy of Protected Health Information (PHI) and to provide you with a notice of our responsibilities regarding your PHI.
Protected Health Information (PHI) is specific information relating to your physical or mental health or condition that may identify you.
This Notice of Privacy Practices (which shall be called “Notice”) describes how we may use and disclose your PHI to perform payment, treatment, or healthcare operations, or for other specified purposes permitted by law. This Notice also addresses your rights to access and amend PHI. We are required to provide this notice to you by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended from time to time
We will not use or disclose your PHI without your written authorization, except as described in or permitted by this Notice. We reserve the right to change our practices and amend this Notice, making the amended Notice effective for all PHI we maintain. We will provide you with any revised Notice upon request.
Note: You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop disclosing your PHI, with the exception of any action already taken based on prior authorization.
Protection of Your Privacy
Regardless of the situation, we are always aware of the importance of patient privacy, and we assure you we will use as little PHI as necessary to perform our services.
When We May Use & Disclose Your PHI
We may use and disclose your PHI under specific circumstances, so long as they are under the categories of Payment, Treatment, or Healthcare Operations (PTO). The following are examples of these circumstances; however, not every use or disclosure is listed.
We may use your PHI for various payment-related functions. For example, we may contact your health plan, PBM, or other healthcare payer to determine if your prescription is covered and at what amount your copay is set. Information transferred to determine your copay and prescription price includes PHI that identifies you and the medications you are taking.
We may use and disclose your PHI to provide and coordinate the treatment, services, and prescriptions you receive. For example, we may contact you about various program benefits, like product recommendations, therapeutic substitution, refill reminders, counseling, product interactions, or product recalls.
We may use and disclose your PHI for certain operational, administrative, and quality assurance activities. For example, we may use your PHI to assist in call center requests, to provide your physicians with information about other treatments you may be undergoing, or to provide other clinical services that may improve the quality and effectiveness of the healthcare and service we provide. We may also disclose your PHI to “business associates” if they need this information to provide a service to us and if they agree to abide by specific HIPAA rules relating to the protection of your PHI.
We may use your PHI to provide information about benefits available to you, and, in limited situations, about health-related products or services we feel may be of interest to you.
Other Uses and Disclosures of PHI
There are many less common situations where we may release your PHI. We will obtain your written authorization before using or disclosing your PHI for purposes other than those provided above (or as otherwise permitted or required by law).
Health Oversight Activities
We may disclose your PHI to an oversight agency for activities authorized by law. These activities may include audits, investigations, and/or credentialing necessary for licensure and monitoring of the healthcare system or maintaining compliance with civil rights laws.
We may use your PHI to send you communications regarding fundraisers; however, you may choose to opt out of such communications at any time.
We may, in rare cases, disclose your PHI to researchers when their research has been approved by an institutional review board or a privacy board that has established protocols to ensure the privacy of your PHI.
Creation of De-Identified Health Information
We may use your PHI to create de-identified data (i.e. summary reports and industry trend analytics) to facilitate business activities. Any identifying elements of your PHI that would link to you, including your name, address, telephone number, member ID, etc., will be removed before such use.
Judicial and Administrative Proceedings
We may disclose your PHI in response to a court or administrative order, subpoena, or other lawful process if you are involved in a lawsuit or a dispute, but only if efforts have been made by the requesting party or by us to inform you.
Workers’ Compensation Cases
To comply with laws relating to workers’ compensation or other similar programs, we may disclose your PHI to the extent authorized by law.
Military and Veterans
If you are a member of the US armed forces, we may release your PHI, as required by military command authorities or by law.
If you are a minor who has lawfully provided consent for treatment and you wish to be treated as an adult for purposes of access and disclosure of records related to such treatment, please notify our office, attention: Privacy Officer.
As required by law, we may release your PHI to a coroner, medical examiner, or funeral director if necessary to identify a deceased person, determine the cause of death, or assist in body handling.
As Required by Law
We may disclose your PHI when required to do so by federal, state, or local law.
Other Circumstances Where We May Use or Disclose Your Protected Health Information (PHI)
There are circumstances where we may be required to release your PHI; however, these circumstances may never arise. If or when they do, we will follow HIPAA guidelines and procedures specifically designed to safeguard your information.
While the list contained in this Notice is not comprehensive or all-inclusive, we are permitted to use or disclose your PHI for the following purposes:
Coordination of Care with People Involved in Managing Your Health
We may disclose any PHI to a family member, close relative, personal friend, or any other person you identify if it is relevant to that person’s direct involvement in your ongoing care, general condition, location, or payment related to your care, unless you advise us otherwise in writing.
As required by law, we may disclose your PHI for law enforcement purposes or in response to a court order or subpoena.
As required by law, we may disclose your PHI to any public health or legal authority charged with the prevention or control of disease.
Food and Drug Administration (FDA)
We may disclose your PHI to the FDA, or persons with authority under the jurisdiction of the FDA, only as it relates to your prescriptions, supplements, or products to assist in product recalls, replacements, etc.
To Avert a Serious Threat to Public Health
We may disclose your PHI when necessary to prevent a serious threat to your health and safety or to protect the health and safety of the public.
National Security or Intelligence Activities
We may release your PHI to federal officials for intelligence, counterintelligence, protection of the President, or national security activities authorized by law.
For Questions or More Information
If you have questions or would like additional information about Brand Direct Health’s® Privacy Notice, you may contact our Privacy Officer via any of the contact methods listed on the front of this Notice.
Your Health Information Rights
Request Restriction on 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 our office, attention: Privacy Officer. We are not required to agree to those restrictions if the use or disclosure of your PHI is legally required or necessary to administer our business.
You have the right to request that we communicate your PHI with you in an alternate way or location to ensure confidentiality. Your written request must include your preferred alternate method or location for PHI communication.
Notification of a Breach
You have the right to be notified if your PHI is affected as a result of an unsecured PHI breach.
Inspect and Obtain a Copy of Your PHI
In most cases, you have the right to access and copy the PHI we maintain about you. To inspect or copy your PHI, you must send a written request to our office, attention: Privacy Officer. We may charge a fee for any costs incurred during the fulfillment of your PHI request, or we may deny your request in certain limited circumstances.
Amending Your PHI
You have the right to request an amendment to your PHI information if you believe it to be incorrect or incomplete, provided you supply reasoning to support your request.
Accounting of Disclosures of Your PHI
Subject to certain exceptions and limitations, you have the right to receive an accounting of disclosures we have made of your PHI for purposes other than PTO. You must submit a written request to our office to receive an accounting. Your request must specify the time period, which may not be longer than 6 years and may not include dates before April 14, 2003.
Submitting Written Requests
You may obtain forms for submitting written requests by contacting our office, attention: Privacy Officer. Please refer to the front of this Notice for our contact information.
If you feel your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Secretary of Health and Human Services.
For questions regarding this Notice, please
contact our Privacy Officer at:
ProCare Pharmacy Care, LLC
D/B/A Brand Direct Health®
Attention: Privacy Officer
1267 Professional Parkway
Gainesville, GA 30507