Med Depot Pharmacy Notice of Privacy
Practices Effective Date: April
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.
We understand that medical information about you and your health is personal. Med Depot Pharmacy is required by law to maintain the privacy of your health information, to follow the terms of this Notice, and to provide you
with this notice of our legal duties and privacy practices with respect to your health information. We are required to follow the terms of the Notice that is currently in effect. A paper copy of this
notice may be obtained at the Med Depot Pharmacy upon request.
How Med Depot Pharmacy May Use or
Disclose Your Health Information
Med Depot Pharmacy protects the privacy of your health information. For some
activities, we must have your written authorization to use or disclose your health information. However, the law permits Med Depot Pharmacy to use or disclose your health information for the following purposes without your authorization:
- For TreatmentInformation obtained by the Pharmacy
will be used to dispense prescriptions to you. We may disclose health information about you to pharmacists and other persons who are involved in dispensing your prescriptions.
- For Payment We may use and disclose your health
information so that your pharmacy services may be billed to, and payment collected from your, an insurance company, or a third party.
- For Health Care Operations We may use and disclose
health information about you for pharmacy operations. Unless you provide us with alternative instructions, we may send refill reminders and other materials related to your health care to your home.
These uses and disclosures are necessary to run the Pharmacy and make sure that you receive quality service.
- As Required by LawWe will disclose health information
about you when required to do so by Federal and State Law.
- To Avert a Serious Threat to Health or SafetyWe may
use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure would be
only to a person able to help prevent the threat.
- Public Health RisksWe may disclose health information
about you for public health activities. Those activities generally include the following: (1) to prevent or control disease, injury or disability (2) to report reactions to medications or problems
with products. (3) to notify people of product recalls (4) to notify a person that may be exposed to a disease or may be at risk of spreading a disease (5) to notify the appropriate government
authority if we believe a person has been the victim of abuse, neglect, or domestic violence. (You MUST agree to this disclosure or be required by law)
- Health Oversight ActivitiesWe may disclose health
information to a health oversight agency for activities authorized by law.
- Lawsuits and DisputesIf you are involved in a lawsuit
or dispute, we may disclose health information about you in response to a court order or administrative order. We may disclose information about you in response to a subpoena, or other lawful
process, but only if efforts have been made to tell you about the request.
- For Specific Government FunctionsWe may disclose
health information for the following specific government functions (1) health information of military personnel, as required by military authorities (2) health information of inmates to a
correctional institution or law enforcement official (3) in response to a request from law enforcement, if certain conditions are satisfied, and (4) for national security reasons.
- 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 to other similar programs established by law.
- 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 or 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
- Fundraising. We may contact you as part of a fundraising effort.
- 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.
When Med Depot Pharmacy May NOT Use or
Disclose Your Health Information
Except as described in the Notice, Med Depot Pharmacy will
not use or disclose your health information without your written authorization. If you do authorize Med Depot Pharmacy to use
or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
You Have the Following Rights With Respect to Your Health
- You have the right to request restrictions on certain uses and disclosures of your health information. We are not required to agree to the restrictions that you
request. If we do agree to any restrictions, we will put the agreement in writing and follow it except in emergency situations. We cannot agree to limit the disclosure of any information that is
required by law.
- You have the right to inspect and copy your health information as long as the Pharmacy maintains the health information. To inspect a copy of your records, you must
submit a request in writing. We may charge a fee for the costs of copying, mailing, or supplies necessary to grant your request. In certain limited situations, we may deny your request. If your
request is denied, you may request that the denial be reviewed.
- You have the right to request that we amend or correct any health information that is incorrect or incomplete. To request an amendment, you must submit a request in
writing along with the reason for the request. We are not required to amend health information that is accurate and complete.
- You have the right to receive an accounting of disclosure of your health information we have made after April 14, 2003 for purposes other than disclosures for (1)
payment, treatment, or health care operations (2) to you or based upon your authorization (3) for certain government functions. You must submit your request in writing.
- You may request communication of your health information by alternative means or at alternative locations. You may request that we contact you only in writing or at
a different residence or post office box. To request confidential communication of your health information, you must submit a written request. We will accommodate all reasonable requests.
Changes to this Notice of Privacy
Med Depot Pharmacy reserves the right to change this Notice. We reserve the
right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. Any revised Notice will be posted in the
Pharmacy. Upon request we will provide a revised Notice to you.
For More Information or to Report a
If you have questions or would like additional information about Pharmacy privacy practices, you may contact the
Compliance Officer, Med Depot Pharmacy 800 W Jefferson St. Kirksville, MO 63501 or phone 660-665-7239. If you believe your
privacy rights have been violated, you can file a complaint with the Compliance Officer at the above address, or with the Secretary of Health and Human Services. There will be no retaliation for
filling a complaint.