Notice of Privacy PraticesRITECARE PHARMACY 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 UNDER HIPAA OMNIBUS RULE OF 2013. PLEASE REVIEW IT CAREFUL RITECARE PHARMACY (the “Pharmacy”)is required by federal law, Health Insurance Portability & Accountability Act of 2013, HIPAA Omnibus Rule, (formally HIPAA 1996 & HI TECH of 2004) to take reasonable steps to protect the confidentiality of your Protected Health Information (PHI) and to provide you with notice of our legal duties and privacy practices with respect to PHI., Your PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services. Your PHI includes your prescription records and related information maintained by the pharmacy. This Notice of Privacy Practices (“Notices”) describes how we may use and disclose your PHI to carry out treatment, payment, or health care operations and for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to your PHI. The Pharmacy is required to follow the terms of this Notice We will not use or disclose your PHI without your written authorization, except as described in this Notice. Unless otherwise permitted by applicable laws and rules or by your written authorization, we will not directly or indirectly receive remuneration in exchange for your PHI. We reserve the right to change our privacy practices and this Notice and to make new Notice effective for all your PHI that we maintain. Any revised Notice will be available at the Pharmacy and, upon your request. USE AND DISCLOSE OF PROTECTED HEALTH INFORMATION We are permitted under federal law to use and disclose PHI without your specific permission for three types of routine purposes: treatment, payment, and health care operations. The following are examples of ways we may use and disclose your PHI: To provide you with or coordinate healthcare treatment and services For example, our pharmacists will use your PHI to fill your prescriptions and to counsel you about the appropriate use of your medications. We also may use and disclose your PHI to provide you with information regarding possible alternative treatment options and other health-related benefits and services that we believe might interest you. For example, we may send you reminders to refill your prescription, information about new or update products that may enhance or improve your treatment. To bill or collect payment an insurance company. For example, we may communicate your PHI to your insurance company so that it can process payment for your prescriptions. Remember, you will be able to restrict disclosures to your insurance carrier for services for which you wish to pay "out of pocket” under this new Omnibus Rule. To conduct health care operations, which generally are the administrative activities that we undertake in order to operate our pharmacy For example, we may use your PHI to evaluate the performance of our pharmacists and to engage in other quality assurance activities. OTHER USES AND DISCLOSURES OF PROTECTED HEALTH In general, we are required to obtain your written authorization to use and disclose your PHI for purposes unrelated to treatment, payment, or health care operations. However, there are exceptions to this general rule under which we are permitted or required to make certain uses and disclosures of such information without your permission. These situations include: As required by law: We must disclose your PHI when required to do so by law. Public health: We may disclose your PHI for public health activities, such as disclosures to a public health authority or other government agency that is permitted by law to collect or receive the information (e.g. the Food and Drug Administration) Abuse or neglect: If you have been a victim of abuse neglect, or domestic violence, we may disclose your PHI to the government agency authorized to receive such information. Health oversight: We may disclose your PHI to a health oversight agency for activities authorized by law, such as: civil or criminal investigation; inspections, licensure or disciplinary actions, or other activities necessary for appropriated oversight of retail pharmacies, governmental health benefit programs, or compliance with laws. Judicial and administrative proceedings: We may disclose PHI in response to a court or agency order, and in some cases, in response to a subpoena or other lawful process not accompanied by a court order. Law enforcement: We may disclose your PHI for law enforcement purposes, such as providing information to the police about victim of a crime. Coroners, medical examiners and funeral directors: We may disclose PHI to a coroner, medical examiner, or funeral director to carry out their duties. Research: We may disclose your PHI to researchers when the research is being conducted under established protocols to ensure the privacy of your information. Serious threat to health or safety: We may disclose your PHI if we believe it is necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Worker’s Compensation: We may disclose your PHI as authorized by, and as necessary to comply with, laws relating to workers’ compensation or similar programs established by law. National security and intelligence activities: We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. Organ and tissue donation: If you are an organ donor, we may release your PHI to organizations that handle organ, eye or tissue procurement, donation and transplantation. 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, your location, and your general condition. Inmates: If you are, or become an inmate of a correctional institution, we may disclose your PHI to the institution or its agents when necessary for your health or the health and safety of others. Military and veterans: If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate military authority. Protective services for the President and others: We may release your PHI to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations. Additionally, under the new HIPPA Omnibus rule, we will obtain your written authorization before using or disclosing your PHI for the following purposes: 1) Uses and disclosures of psychotherapy notes (to the extent maintained by the Pharmacy) 2) Uses and disclosures of PHI for marketing purposes, including subsidized treatment communications 3) Disclosures that constitute a sale of PHI 4) Other uses and disclosures not described in this Notice. You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the authorization. When using or disclosing your PHI or requesting your PHI from another covered entity, we will make reasonable efforts to limit such use, disclosure, or request to the minimum necessary to accomplish the intended purpose of such use, disclosure, or request. We are also likely to use or disclose your PHI for the following purposes: Use of business Associates: There are some services that provided by us through arrangements with our business associates. Examples of our business associates include claims processors or administrators, pharmacy benefit managers, etc. When these services are contracted for, we may disclose your PHI to our business associates so that they can perform job we have asked them to do. We may for example, use a business associates to bill you or your third-party payer for services rendered. In addition, our business associates may re-disclose your PHI to their business associates who are subcontractors in order for the subcontractors to provide services to the business associates. The subcontractors will be subjected to the same restrictions and conditions that apply to the business associates. To protect your PHI, we require the business associates to agree in writing to appropriately safeguard your PHI. Communication with individuals involved in your care or payment for your care: Healthcare professionals such as our pharmacists, using their professional judgment, may disclose your PHI to a family member, other relative, close personal friend or any person you may identify, when such communication is relevant to that person’s involvement in your care or payment related to your care. Food and Drug Administration (FDA): We may disclose your PHI to the FDA, or the person under the jurisdiction of the FDA, as may be necessary to enable product recall, to make repairs or replacements, to conduct post-marketing surveillance or to report information pertaining to adverse events with respect to drugs, foods, supplements, product or product defect. The use and disclosures of your PHI described above are permitted or required by federal law. Some states have laws that require additional privacy safeguards above and beyond the federal requirements. Thus, if a state law is more restrictive regarding the uses and disclosures of your PHI or provides you with greater rights with respect to your PHI, we will comply with the state law. Incidental Disclosure Rule: We will take reasonable administrative, technical and security safeguards to ensure the privacy of your PHI when we use or disclose it (i.e. we shred all paper containing PHI, require employees to speak with privacy precautions when discussing PHI with you, we use computer passwords and change them periodically (i.e. when an employee leaves us), we use firewall and router protection to the federal standard, we back up our PHI data off-site and encrypted to federal standard, we do not allow unauthorized access to areas where PHI is stored or filed and/or we have any unsupervised business associates sign Business Associate Confidentiality Agreements). However, in the event that there is a breach in protecting your PHI, we will follow Federal Guide Lines to HIPAA Omnibus Rule Standard to first evaluate the breach situation using the Omnibus Rule, 4-Factor Formula for Breach Assessment. Then we will document the situation, retain copies of the situation on file, and report all breaches (other than low probability as prescribed by the 4 Omnibus Rule) to the US Department of Health and Human Services at http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html We will also make proper notification to you and any other parties of significance as required by HIPAA Law. YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION If you got this Notice via email or website, you have the right to get, at any time, a paper copy by asking our Privacy Officer. You may also obtain a copy of the Notice at the pharmacy counter. To Inspect and Copy: You have the right to access and get a copy of you PHI contained a designated record set for as long as we maintain your PHI. The designated record set usually will include prescription and billing records. To inspect or copy your PHI, you must complete the Request to Access Protected Health Information form and give it to a Pharmacy associate for review. If the request can be granted, then the Pharmacy associated will provide you with a report containing your PHI that we maintain in our designated record set. The Requested to Access Protected Health Information form is available upon request at the Pharmacy counter. We may charge you a fee for the cost of copying, mailing and supplies that are necessary to fulfill your request. We may deny your request to inspect and copy your PHI in certain limited circumstances. If you are denied access to your PHI, you may request that this denial be reviewed. To Request Amendment / Correction: If you think PHI we have about you is incorrect, or incomplete, you may ask us to amend it. You may request an amendment for as long as we maintain your PHI. To request an amendment, you must complete the Request to Amend a Record form and give it to a pharmacy associate for review. If the request can be granted, then the Pharmacy associate will amend the appropriate records.. The Request to Amend a Record form is available upon request at the Pharmacy counter. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with our denial and we may record your rebuttal to your statement. To an Accounting of Disclosures: You have the right to receive an accounting of the disclosures we have made of your PHI. This accounting includes only those PHI disclosures required to be accounted for under HIPPA. This accounting is also limited to the time period that these disclosures needed to be accounted for under HIPPA. The right to receive an accounting is subjected to certain other exceptions, restrictions, and limitations. To request an accounting, you must submit a written request to our Privacy Officer at address listed below. Your request must specify the time period, which may not be longer than the time period that these PHI disclosures needed to be accounted for under HIPPA. The first accounting you request within a 12 month period will be provided free of charge, but we may charge you for the additional accounting. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time. To Request Restrictions: You have the right to request additional restrictions on our use or disclosure of your PHI by completing the request for Request for Restriction form and give it to a pharmacy associate for review. We may not be required to agree to your restriction request s and in certain cases we may deny your request. The Request for Restriction is available upon request at the pharmacy counter. To Request Alternative Communications: You have the right to request communications of your PHI by alternative means or alternative locations. For example, you may request that we contact you about medical matters only in writing or at a different residence or post office box. To request confidential communication of your PHI, you must complete the Request for Confidential Communication form and give it to a pharmacy associate for review. If the request is granted, then the pharmacy associate will make the appropriate changes. We will accommodate all reasonable requests: however, in case of emergency situations, we may contact you by whatever means we deem necessary. The Request for Confidential Communication form is available upon request at the pharmacy counter. To receive written notification of a breach of your unsecured PHI: You have the right to receive written notification of a breach where your unsecured PHI has been accessed, used, acquired, or disclosed to an unauthorized person as a result of such breach, , and the breach compromised the security and privacy of your PHI. Unless specified in writing by you to receive this breach notification by electronic mail, we will provide this notification by first class mail or, if necessary, by such other substituted forms of communication allowable under the law. To Complain or Get More Information: We will follow our rules as set forth in this Notice. If you want more information or if you believe your privacy rights have been violated (i.e. you disagree with a decision of ours about inspection / copying, amendment / correction, accounting of disclosures, restrictions or alternative communications). We never will penalize you for filing a complaint. To do so, please file a formal, written complaint within 180 days with the Secretary of Health and Human Services or our Privacy Officer at the following address: Attn: Anh Vu, Ritecare Pharmacy Privacy Officer 12014 E. Colonial Dr., suite 140 Orlando, FL 32826 407-203-6895 Fax: 407-203-6897 Email: email@example.com Effective date: This Notice is effective as of September 23, 2013.