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Kerr Drug Notice of Privacy Practices
“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.”
Kerr Drug, Inc. (“Kerr Drug”) is required, under a federal regulation known as the “HIPAA Privacy Rule”, to maintain the privacy of Protected Health Information (“PHI”) and to provide our respected customers with details of our legal duties and privacy practices concerning PHI. PHI is information that identifies you and relates to your past, present, or future physical or mental health or condition and related health care services. This Notice of Privacy Practices (“Notice”) explains how we may use and disclose PHI to provide treatment, payment or health care operations and for other purposes permitted or required by law. Also, this Notice describes your rights with respect to PHI about you.
Kerr Drug is obligated to follow the terms described in this Notice. We will not use or disclose PHI about you without your written authorization, except as described in this Notice. Kerr Drug reserves the right to alter our privacy practices and apply these revisions to PHI previously created or retained. Upon request, we will provide any revised Notice to you. We want you to know that this new enforcement will not change the value of service you have always received at Kerr Drug. We have continually upheld our own strict policies and procedures regarding PHI about you.
1. Use and Disclosure of PHI. The following are descriptions and examples of how we use and disclose PHI:
• We will use PHI for treatment. We may use and disclose PHI about you to provide, coordinate or manage your health care services. Example: Information that you or your physician provides to the pharmacist will be used to properly fill your prescription. We will document in your record information related to both medications dispensed to you and services provided.
• We will use PHI for payment. We may give PHI about you to others to bill and collect payment for treatment provided to you. Example: We contact your insurer or pharmacy benefit manager to determine payment for your prescription and the amount of your co-payment. We bill you or a third-party payer for the cost of the prescription medications dispensed to you. The information on the accompanying bill may include information that identifies you, as well as the medications you are taking.
• We will use PHI for health care operations. We may use and disclose PHI in performing business activities. Example: The pharmacy may use information in your health care record to monitor the performance of the pharmacists providing treatment to you. This information may be used for a number of reasons, including our effort to continually improve the quality and effectiveness of the health care and services we provide.
We also are likely to use or disclose PHI for the following purposes without your authorization:
• Business Associates: There are some services provided by us through contracts with business associates. When these services are contracted for, we may disclose PHI about you so the business associates can perform the job we have asked them to do and bill you or your third-party payer for services rendered. In order to protect your PHI, we require all business associates to appropriately safeguard the information.
• Communications with Individuals Involved in your Care or Payment for your Care. Unless you object, we may share medical information about you with a friend or family member who is involved in your medical care. We also may share information with someone who helps pay for some or all of your care, such as other family members who are insured under your insurance policy. You can object to the sharing of this information by telling us that you do not want any or all people involved in your care to get this information. If you are not present or cannot agree or object, we will decide whether it is in your best interest to share needed information with someone who is involved in your care or payment for your care.
• Marketing of Health-Related Products and Services. “Marketing” means a communication for which we receive any sort of payment from a third party where the communication encourages you to use a service or buy a product. Before we may use or share your medical information to market a health-related product or service to you, we must get your written permission to do so. The consent form will tell you that we have been paid to make the communication to you. “Marketing” does not include: (i) prescription refill reminders or other information that describes a drug you currently are being prescribed, so long as any payment we receive for those reminders is to cover the cost of making the reminder; (ii) face-to-face communications with you; or (iii) gifts of token value, like pens or key chains stamped with our name or the name of a health care product or service company.
• Fundraising Activities. We may us medical information about you to contact you in an effort to seek donations for community service programs, patient care, medical research, and education. If you do not want us to contact you for fundraising efforts, you must notify our Privacy Officer in writing at the address below. If you have not done so already, we will ask you each time we contact you for fundraising efforts if you would like to opt out of receiving future fundraising communications. If you do opt out of future fundraising communications, we will not use or share your information for fundraising purposes, but we still may send you general fundraising communications that we send to the community that are not based on information from your ability to get service at Kerr Drug. If you decide to opt out of some or all future fundraising communications, you may tell us later that you would like to receive these communications again.
• 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 replacements.
• Workers’ Compensation. We may disclose PHI about you as authorized by and as necessary to comply with laws relating to worker’s compensation.
• Public Health. We may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability. We also may disclose PHI to law enforcement authorities in order to stop a threat to the health or safety of a person or the public.
• Law Enforcement. We may disclose PHI about you for law enforcement purposes, as required by law or in response to a valid subpoena or other legal process. We may also disclose information to law enforcement personnel to report a crime that takes place at a pharmacy.
• As Required by Law. We must disclose PHI about you when required by federal, state, or local law.
• Reporting of Victims. We may disclose PHI in order to report abuse, neglect, or domestic violence.
• Health Oversight Activities. We may disclose PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.
• Judicial and Administrative Proceeding. If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the requested PHI.
• Research. We may disclose PHI about you to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information has approved their research. Kerr Drug is not allowed to receive any money or other thing of value in connection with the use or disclosure of your medical information for research purposes unless the money we receive reflects the cost to prepare and transmit the medical information to the researcher, or unless we seek your written consent in advance.
• Coroners, Medical Examiners, and Funeral Directors. We may release PHI about you 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 carry out their duties.
• Organ or Tissue Procurement Organizations. Consistent with applicable law, we may disclose PHI about you to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
• Specialized Government Functions. We may disclose PHI about you for specific government functions. Example: We may disclose PHI about you if it relates to military and veterans’ activities, national security and intelligence activities, protective services for the President, and medical suitability or determinations of the Department of State.
• Emergencies. We may share with a public or private agency (for example, the American Red Cross) PHI about you for disaster relief purposes. Even if you object, we still may share the PHI about you if necessary under the emergency circumstances.
• Notification. Unless you object, we may use or disclose PHI to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and your general condition.
• Correctional Institution. If you are or become an inmate of a correctional institution, we may disclose PHI to such correctional institution or its agents when necessary for your health or the health and safety of others.
• Sale of Medical Information. Kerr Drug currently does not sell patients’ medical information. If Kerr Drug ever decides to sell medical information in the future, it would not be permitted to sell your medical information unless it first got your written permission to do so. The consent form would have to inform you that Kerr Drug would receive payment of some kind for sharing your information. However, because a “sale” has a specific definition under the law, it does not include all situations where Kerr Drug receives a payment of some kind for the disclosure. For example, a disclosure for which we charge a fee to cover the cost to prepare and send the information does not qualify as a “sale” of your information.
2. North Carolina State Law. If you receive services in North Carolina, some North Carolina State laws provide you more protection than HIPAA, and where applicable, we will follow the requirements of those State laws. The following North Carolina laws may apply to you:
• Minors. Under North Carolina law, a parent, guardian, or other person with the authority to act in loco parentis has authority to decide how to use the medical information about a minor patient and is entitled to such medical information, except: (i) when the law provides otherwise, such as in cases of suspected abuse or neglect of a minor: and (ii) when minors have the right to consent to medical treatment on their own behalf, with or without the consent of a parent or guardian, for the diagnosis and treatment of certain illnesses including: venereal disease and other diseases that must be reported to the State, pregnancy, abuse of controlled substances or alcohol, and emotional disturbance. Abortion services, however, still require the consent of the parent, guardian, or a grandparent with whom the minor has been living for at least six (6) months unless a court has determined that the minor should be treated as an adult. Minors may petition a court to waive this requirement for parental consent.
• Behavioral Health. If you request treatment and rehabilitation for drug dependence, your request will be treated as confidential. We will not disclose your name to any police officer or other law-enforcement officer unless you consent to our sharing of it. Even if we refer you to another person for treatment and rehabilitation, we will continue to keep your name confidential.
• Communicable Diseases. If you suffer from a communicable disease (for example, tuberculosis, syphilis or HIV/AIDS), information about your disease will be treated as confidential. Other than circumstances described to you in other sections of this notice, we will not release any information about your disease except as required to protect public health, prevent the spread of a disease, or at the request of the state or local Health Director.
• Disclosure. Prescription orders on file at our pharmacies are confidential. We will disclose such orders only to the following people:
• You, if you are an adult, an emancipated minor, or a minor who can consent to the treatment described in the prescription;
• Your guardian;
• Your parent if you are an unemancipated minor and cannot consent to the treatment described in the prescription;
• The licensed practitioner who issued the prescription (e.g. doctor, nurse practitioner);
• The licensed practitioner who is treating you;
• Your pharmacist;
• A person to whom you give written authorization;
• A person authorized by subpoena, a court’s order, or statute;
• Insurance companies or others who pay for your prescription;
• Members and employees of the North Carolina Board of Pharmacy;
• The executor or administrator of your estate or your surviving spouse; and
• Medical researchers.
If your pharmacy should close, for thirty (30) days before its closing you have the right to have your files transferred to the pharmacy of your choice.
3. Other Uses and Disclosures of PHI. Kerr Drug will obtain your written authorization before using or disclosing PHI for purposes other than those provided for above or as otherwise permitted or required by law. You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing PHI about you, except to the extent that we have already taken action in reliance on the authorization. We are unable to take back any disclosures we previously made.
4. Your Health Information Rights. You have the following rights pertaining to your PHI:
• Obtain a paper copy of the Notice upon request. You may request a paper copy of this Notice, or any revised notice, at any time by asking your Kerr Drug pharmacist. If we have all of any part of your medical information in an electronic format, you may ask for an electronic copy of the information or ask that we send an electronic copy to any person or entity you designate in writing. Your medical information is contained in records that belong to Kerr Drug. If you ask for a copy of your medical information, we may charge a fee for the cost of copying, mailing or other supplies needed for your request, and we may collect the fee before giving the copy to you. You may also receive this Notice electronically by visiting kerrdrug.com.
• Request a restriction on certain uses and disclosures of PHI. You may request that Kerr Drug not disclose your medical information to any persons or entities that may be responsible for paying all or any portion of the charges you incur while a patient of Kerr Drug. If you pay all such charges in full at the time of such request, we are required to agree to your request. You have the right to REQUEST additional restrictions to be placed on our disclosure or use of PHI about you by requesting those restrictions by contacting your Kerr Drug pharmacist. You may ask that we not share your medical information with your insurance company for some or all of the prescriptions you fill at Kerr Drug. If you pay the charges for the prescriptions you do not want to disclose in full at the time of services, we have to agree to your request. “In full” means the amount of charge for the prescription, not your copay, coinsurance, or deductible responsibility when your insurer pays for your care. Please note that once information about your prescriptions as been shared with your insurance company, we cannot agree to your request. If you think you may want to ask us not to disclose to your insurance company your medical information relating to a prescription, please ask your doctor to make it clear and conspicuous in his or her prescription order. If you are personally presenting Kerr Drug with your prescription order, please inform your Kerr Drug pharmacist at the time you present your prescription order to be filled.
• Inspect and obtain a copy of your PHI. You have the right to see a copy of PHI about you contained in a designated record set for as long as Kerr Drug maintains the PHI. This record usually will include both prescription and billing records. To receive a copy of PHI contained in Kerr Drug’s designated record set about you, contact the local Kerr Drug Pharmacy where the services were provided. If Kerr Drug has all or any portion of your health information in an electronic format, you may request an electronic copy of those records or request that we send an electronic copy to any person or entity you designate in writing.
• Request an amendment of PHI. If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it for as long as Kerr Drug maintains the PHI. To request an amendment, contact your local Kerr Drug Pharmacy where the services were provided. You must include a reason that supports your request. In certain cases, we may deny your request for amendment. If Kerr Drug denies your request for amendment for certain reasons, you have the right to file a statement of disagreement, and we may give rebuttal to your statement.
• Receive an accounting of disclosures of PHI. You have a right to receive an accounting of the disclosures we have made of PHI about you after April 14, 2003 for some purposes, not including treatment, payment, or health care operations. The accounting also will exclude certain other disclosures, such as disclosures made directly to you, incidental disclosures, disclosures you authorize, disclosures to friends or family members involved in your care, and disclosures for notification purposes. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to the address below or contact your local Kerr Drug Pharmacy where the services were provided. Your request must specify the time period, but may not be longer than six (6) years. The first accounting you request within a twelve (12) month period will be provided free of charge, but you may be charged for the cost of providing any additional accounting. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time.
• Request communications of PHI by alternative means or at alternative locations. You have the right to ask that we tell you about medical matters in a certain way or at a certain place. For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box. To request a change in the confidential communication of PHI, you must submit a request in writing to the address below. Your request must state how or where you would like to be contacted. We will accommodate all reasonable requests, but, when appropriate, we may condition our accommodation upon receiving information regarding how payment will be handled and receipt of an alternative address or other method of contact.
• Changes to this Notice. We can change this Notice and make the changed Notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice at all Kerr Drug locations.
• Investigation of Breaches of Privacy. We will investigate any unauthorized use or disclosure of your medical information that we discover to determine if it is a breach of a federal privacy or security law about medical information. If we determine that a breach has occurred, we will notify you in writing about the breach and tell you what we intend to do to limit the damage (if any) caused by the breach, and about steps you should take to protect yourself from possible harm as a result of the breach.
5. For More Information or to Report a Problem. If you have questions or would like additional information about Kerr Drug privacy practices, you may contact Kerr Drug at the below address. If you believe your privacy rights have been violated, please contact our Privacy Officer at the below address. You may also file a complaint with the Secretary of Health and Human Services. If you file a complaint, we will not take any action against you or change our treatment of you in any way.
THIS NOTIFICATION IS EFFECTIVE AS OF APRIL 14, 2003.
(Version 3.0, revision effective 1/30/2010, revised 7/17/2013).