HIPAA Notice
The Health Insurance Portability and
Accountability Act (HIPAA) 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 this information carefully.
This Notice of Privacy Practices ( the "Notice") describes the privacy practices of SpecialtyScripts Pharmacy.
SpecialtyScripts Pharmacy wants you to know maintaining the privacy of your health information is central to our role as your trusted pharmacy (Protected Health Information, or PHI). PHI is information about you, including basic information that may identify you and relates to your past, present, and future health or condition and dispensing of prescription products to you.
Our Pledge Regarding Your Health Information:
We pledge to protect the privacy of your health information as required by federal and state laws, regulations, and other authorities and to keep you informed of your rights with this Notice. Our pharmacy personnel are committed to protecting the confidentiality of your PHI and will only disclose your PHI to a person other than you or your personal representative when required under federal or state law. This protection extends to any PHI that is oral, written, or electronic, such as prescriptions transmitted via fax, modem, or other electronic device. This Notice describes your rights and the obligations we have regarding the use and disclosure of your PHI. In some circumstances, as described below in this Notice, the laws permit us in serving your pharmacy needs to use and disclose your PHI without your express permission. In all other circumstances, we will obtain your written authorization before we use or disclose your PHI. Under federal and applicable state law, we are required to follow the terms of the Notice currently in effect. HIPAA's standards may be pre-empted by certain state laws relating to the privacy of health information. Please see State notices at the end of this provision.
How we may use and disclose your PHI without your permission:
Treatment, Payment, or Healthcare Operations: Below are examples of how Federal law permits use or disclosure of your PHI for these purposes without your permission.
- Treatment: Dispensing Medications. PHI obtained by SpecialtyScripts Pharmacy will be used to dispense prescription medications. We will document information related to the medications dispensed in services provided in your record. Patient Contacts. We may contact you to provide treatment-related services, such as refill reminders, treatment alternatives (e.g. available generics), and other health related benefits and services that may be of interest to you.
- Payment: we may contact your insurer, payor, or other agent and share your PHI with that entity to determine whether it will pay for your prescription and the payment amount. We may also contact you about a payment or balance due for prescriptions dispensed to you by SpecialtyScripts Pharmacy.
- Healthcare operations: Service. Your PHI may be used to monitor the effectiveness of our services. Transfer. Your PHI may be transferred for purposes of carrying out the pharmacy services if we buy or sell pharmacy locations. Benefits/research. We may also use your PHI to tell you about opportunities that may be of interest to you such as clinical research projects.
Other special circumstances: We are permitted under federal and applicable state law to use or disclose your PHI without your permission only when certain circumstances may arise, as described below. We are likely to use or disclose your PHI for the following purposes:
Business Associates: We provide some services through other companies termed "business associates". Federal law requires us to enter into business associate contracts to safeguard your PHI as required by SpecialtyScripts Pharmacy and the law.
Individuals involved in your care or payment for care: We may disclose your PHI to a friend, personal representative, or family member involved in your medical care. For example, if we can reasonably infer that you agree, we may provide prescriptions and related information to your caregiver on your behalf.
Disclosures to parents or legal guardians: If you are a minor, we may release your PHI to your parents or legal guardians when we are permitted or required under federal and applicable state law.
Workers compensation: We may disclose your PHI to the extent authorized and necessary to comply with laws relating to workers compensation or similar programs established by law.
Law enforcement: We may disclose your PHI for law enforcement purposes as required by law or in response to a court order subpoena, warrant, summons, or similar process; to identify or locate a suspect, fugitive, material witness, or a missing person; about a death resulting from criminal conduct; about crimes on the premises or against a member of our workforce; and in emergency circumstances, to report a crime, the location, victims, or the identity, description, or location of the perpetrator of a crime.
As required by law: We must disclose your PHI when required to do so by applicable or federal state law.
Judicial and administrative proceedings: If you are involved in a lawsuit or a legal dispute, we may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process.
Public health: We may disclose your PHI to federal, state, or local authorities, or other entities charged with preventing or controlling disease, injury, or disability for public health activities. These activities may include the following: disclosures to report reactions to medications or products to the US Food and Drug Administration or other authorized entity; disclosures to notify individuals, recalls, exposure to a disease, or risk for contracting or spreading a disease or condition.
Health oversight activities: We may disclose your 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 government monitoring of the healthcare system, government programs, and compliance with federal and applicable state law.
United States Department of Health and Human Services: Under federal law, we are required to disclose your PHI to the U.S. Department of Health and Human Services to determine if we are in compliance with federal laws and regulations regarding the privacy of health information.
Although we may not engage in the following activities, under federal or applicable state law, we are allowed to use or disclose your PHI without your permission for the following purposes.
Research: Under certain circumstances, we may use or disclose your PHI for research purposes. However, before disclosing your PHI, the research project must be approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.
Coroners, medical examiners, and funeral directors: We may release your PHI to assist in identifying a deceased person or determine a cause of death.
Administrator or executor: Upon your death, we may disclose your PHI to an administrator, executor, or other individual authorized under applicable state law.
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 transportation of organs for the purpose of tissue donation and transplant.
Notification: We may use or disclose your PHI to assist a disaster relief effort so that your family, personal representative, or friends may be notified about your condition, status, and location.
Correctional institution: If you are or become an inmate of a correctional institution, we may disclose to the institution or its agents PHI necessary for your health and the health and safety of others.
To avert a serious threat to health or safety: We may use and disclose your PHI to appropriate authorities when necessary, to prevent a serious threat to your health and safety, or the health and safety of another person or the public.
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.
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.
Protective services for the President and others: We may disclose your PHI to authorized federal officials so that they may provide protection to the President, other authorized persons, or foreign heads of state, or conduct special investigations.
How we may use or disclose your PHI for other purposes only with your permission. We will obtain your written authorization before using or disclosing your PHI for purposes other than those described above, or as otherwise required or permitted by law. You may revoke this authorization at any time by submitting a written notice to SpecialtyScripts Pharmacy. Your revocation will become effective immediately upon receipt of your written notice.
You have the following rights regarding your PHI:
Obtain a written copy of this notice at any time. To obtain a copy contact SpecialtyScripts Pharmacy at the provided location information.
Inspect and obtain a copy of your PHI. You have the right to inspect or obtain a copy of your PHI in the "designated record set", which includes prescription and billing records. To inspect or obtain a copy of your PHI submit a request in writing to SpecialtyScripts Pharmacy. We will respond within 30 days. We may deny the request to inspect and obtain a copy of your PHI in certain limited circumstances, such as if we have reasonably determined that providing access to your PHI would endanger your life or safety or cause substantial harm to you or another person. If we deny your request, you will be notified in writing, and given the opportunity to request of the review of the denial.
Request an amendment of your PHI. If you feel your PHI is incorrect or incomplete, you may request that we amend the information for as long as we maintain your PHI. To request such an amendment, submit the request in writing to SpecialtyScripts Pharmacy. The request must contain the following information: a) which information you wish to amend: b) what corrections you feel need to be made: c) why the information needs to be amended. We will respond to your written request with 60 days (with a possible 30 day extension). We will respond and indicate that: a) we agree to make the amendment: b) deny your request for amendment, and explain our reason, along with an outline on how to appeal our decision. If denied, you have the right to file a statement of disagreement with the decision. We will provide a rebuttal to your statement and maintain appropriate records of your disagreement and our rebuttal.
Receive an accounting of disclosures of PHI: After April 14, 2003, you have the right to request an accounting of your PHI disclosures for the purposes other than the treatment, payment, or health care operations. This accounting will also exclude: disclosures made directly to you, made with your authorization, made incidentally, made to caregivers, made for notification purposes, and certain other disclosures. To obtain accounting submit a written request to SpecialtyScripts Pharmacy. Requests must specify a time period, not to exceed 6 years. We will respond within 60 days of receipt of your request, with a possible 30 days extension. We will provide an accounting free of charge for the first request, but you may be charged for subsequent requests. We will provide you with a cost in advance, at which time you may withdraw or modify your request.
Request communications of PHI by alternative means: You have the right to request that we communicate with you in a certain way or at a certain location. For example, you may request that we contact you only in writing at a specific address. To request confidential communication of your PHI, submit a written request to SpecialtyScripts Pharmacy, Privacy Department. Your request must state how, where, or when you would like to be contacted. We will accommodate all reasonable requests.
Request a restriction of certain uses and disclosures of PHI: You have the fight to request a restriction or limitation on our use or disclosure of your PHI by submitting a written request to the SpecialtyScripts Pharmacy, Privacy Department. You must identify in this request: a) what particular information you would like to limit: b) whether you want to limit use, disclosure, or both, and: c) to whom you want the limits to apply. All requests will be considered, but we are not required to agree to those restrictions. We will provide you with a written response to your request with 30 days. If we agree to restrict use or disclosure of your PHI, we will not apply theses restrictions in the event of an emergency. We also have the right to terminate the restriction if: a) you agree orally or in writing, or: b) we inform you of the termination, which becomes effective only with regard to your PHI created or received after we inform you of the termination.
Complaints: If you believe your privacy rights have been violated, you can file a complaint with the SpecialtyScripts Pharmacy, Privacy Department, at the below address, or with the Secretary of the United States Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized in any way for filing a complaint.
Changes to this Notice: We reserve the right to change our privacy practices. We reserve the right to make the revised Notice effective for PHI we already have about you as well as any information we receive in the future, as of the effective date of the revised Notice. Upon request to the Privacy Department, SpecialtyScripts Pharmacy will provide a revised Notice to you.
Effective Date: This Notice is effective 4/14/2003
Massachusetts State Specific Provision
Medicaid Recipients: We will restrict disclosure of your PHI to purposes directly connected with the administration of your healthcare benefits.
We may be reached at the following address and phone number:
SpecialtyScripts Pharmacy
315 Pleasant Street
Building 1, 6th floor
Fall River, MA 02721
ATTN: Privacy Department
1-800-218-5688 (phone)
1-800-830-5292 (fax)
SP-Ops-103
