| Value
Drugs Statement of Pharmacy Privacy
All Value Drugs pharmacies are required by law to
maintain the privacy of Protected Health Information ("PHI") and to
provide individuals with notice of our legal duties and privacy
practices with respect to PHI. 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. This
Notice of Privacy Practices ("Notice") describes how we may use and
disclose PHI to carry out treatment, payment or health care
operations and for other specified purposes that are permitted or
required by law. The Notice also describes your rights with respect
to PHI about you.
All Value Drugs pharmacies
are required to follow the terms of this Notice. We will not use or disclose PHI about
you without your written authorization, except as described in this
Notice. We reserve the right to change our practices and this Notice
and to make the new Notice effective for all PHI we maintain. Upon
request, we will make available to you any
revised Notice.
Your Health Information Rights
You have the following rights with
respect to PHI about you:
Obtain a paper copy of the Notice
upon request. You may
request a copy of the Notice at any time. Even if you have agreed to
receive the Notice electronically, you are still entitled to a paper
copy.
Inspect and obtain a copy of PHI.
You have the right to access and copy PHI about you contained in a
designated record set for as long as Duane Reade maintains the PHI.
The designated record set usually will include prescription and
billing records that we use to make treatment and billing decisions.
We may charge you a fee for the costs of copying, mailing and
supplies that are necessary to fulfill your request. We may deny
your request to inspect and copy in certain limited circumstances.
In some cases, you may request that the denial be reviewed.
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. You may request an
amendment for as long as we maintain the PHI. You must include a
reason that supports your request. 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 the
decision and we may give a rebuttal to your statement. We will
include a copy of your statement of disagreement and our rebuttal in
your record.
Request a restriction on certain
uses and disclosures of PHI.
You have the right to request
additional restrictions on our use or disclosure of PHI, however we
are not required to agree to those restrictions.
Receive an accounting of
disclosures of PHI. You have the right to receive an accounting
of the disclosures we have made of PHI about you after April 14,
2003 other than disclosures made: to you; based on your written
authorization; to carry out treatment; for payment or health care
operations; or as part of a limited data set (that does not include
your name or other personal identifiers) to researchers. The right
to receive an accounting is subject to certain other exceptions,
restrictions, and limitations. Your request must specify the time
period, but may not be longer than six years. The first accounting
you request within a 12 month period will be provided free of
charge, but we reserve the right to charge you a reasonable fee for
the cost of providing additional accountings.
Examples of How We May Use and
Disclose PHI
We may use and disclose your PHI,
without your authorization, for treatment, payment and health care
operations.
Using PHI for treatment.
Treatment is the provision, coordination or management of healthcare
and related services. For example, we may use your PHI to fill
prescriptions and conduct drug utilization reviews.
Using your PHI for payment.
Payment includes actions that we may
take to be reimbursed by your third party insurance provider, to
make coverage determinations, and to assist us with billing claims
management. For example, we may contact your insurer or pharmacy
benefit manager to determine whether it will pay for your
prescription and the amount of your co-payment. We may bill you or a
third-party payor for the cost of prescription medications dispensed
to you. The information on or accompanying the bill may include
information that identifies you, as well as the prescriptions you
are taking.
Using PHI for health care
operations. Our health care operations involve a range of
activities necessary to run our business. This includes services
from third parties (or business associates) with whom we have
contracted for quality assessment and improvement, business planning
and development, information management, general administrative
activities, legal services, and other services related to our
operations. We may disclose PHI about you to our business associates
so that they can perform the job we have asked them to do. To
protect PHI about you, we require the business associate to
safeguard the PHI.
Communication with individuals
involved in your care or payment for your care: Health
professionals such as pharmacists, using their professional
judgment, may disclose to a family member, other relative, close
personal friend or any person you identify, PHI relevant to that
persons involvement in your care or payment related to your care.
As required by law: We may use
or disclose your PHI as required by law. Examples include use or
disclosure of PHI for law enforcement purposes, for judicial or
administrative proceedings (subject to certain conditions), for
public health purposes, for health oversight activities, in cases of
suspected abuse, neglect or domestic violence and for worker�s
compensation compliance. In cases of HIV or
AIDS, we will comply with provisions of New York state law that
place additional or more stringent conditions on the use
and disclosure of records related to HIV or AIDS treatment,
including the provisions of 10 NYCCRR 63.6. This will include, among
other things, not disclosing information in response to subpoenas,
unless accompanied by a court order.
For notification of relatives or
representatives: We may use
or disclose PHI about you to notify or assist in notifying a family
member, personal representative, or another person responsible for
your care, your location, and your general condition.
Other Information about PHI and
this Notice
Value Drugs will obtain your written
authorization before using or disclosing PHI about you for purposes
other than those provided for above or as otherwise permitted or
required by law. 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 your
previous authorization.
Please note that this Notice does not
apply to information that has been un-identified. Un-identified
information is information that does not identify an individual and
with respect to which there is no reasonable basis to believe that
the information can be used to identify an individual.
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