Notice of Privacy Practices

About This Notice

Ray's Drugs & Medical Supplies is required by law to maintain the privacy of your protected health information (PHI), to provide you with notice of our legal duties and privacy practices with respect to your PHI, and to notify you in the event of a breach of your unsecured PHI. This Notice of Privacy Practices ("Notice") describes how we may use and disclose your PHI and informs you of your rights regarding your PHI.

We are required to abide by the terms of this Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new provisions effective for all PHI that we maintain. If we make a material change to this Notice, we will make the revised Notice available upon request and will post a copy in our pharmacy.

Our Duties

We are required by applicable federal and state law to:

• Maintain the privacy of your protected health information;
• Provide you with this Notice of our legal duties and privacy practices with respect to your protected health information;
• Follow the terms of the Notice that is currently in effect;
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

Uses and Disclosures of Health Information

The following categories describe the ways that we may use and disclose your protected health information. For each category, we explain what we mean and present examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

Treatment

We may use or disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes consultations between health care providers relating to your care and referrals for health care from one health care provider to another. For example, we may share your prescription information with your physician to coordinate your overall care.

Payment

We may use or disclose your PHI to obtain payment for services we provide to you. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we provide to you, such as determining eligibility or coverage, reviewing services provided to you for medical necessity, and undertaking utilization review activities.

Healthcare Operations

We may use or disclose your PHI for our healthcare operations. These uses and disclosures are necessary to run our pharmacy and make sure all of our patients receive quality care. For example, we may use health information about you to conduct quality assessment and improvement activities, for employee training, or to evaluate staff performance.

Required by Law

We may use or disclose your PHI when we are required to do so by law. For example, we may disclose your PHI to comply with federal, state, or local laws; judicial and administrative proceedings; or law enforcement requests.

Public Health

We may disclose your PHI for public health activities. These activities generally include disclosures to: prevent or control disease, injury, or disability; report births and deaths; report adverse reactions to medications; notify people of recalls of products they may be using; and notify a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition.

Health Oversight

We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Judicial and Administrative Proceedings

We may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process. In certain circumstances, we may disclose your PHI in response to a subpoena or discovery request if we receive satisfactory assurance that you have been notified of the request or that a qualified protective order has been obtained.

Law Enforcement

We may disclose your PHI, as allowed or required by law, to a law enforcement official for certain law enforcement purposes, including: as required by law in response to a court order, subpoena, warrant, summons, or similar process; to identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement; and to report a death we believe may be the result of criminal conduct.

Deceased Persons

We may release PHI to a coroner, medical examiner, or funeral director as necessary to carry out their duties. We may also release PHI about organ or tissue donation to organizations that handle organ, eye, or tissue procurement or transplantation.

Organ Donation

If you are an organ donor, we may release your PHI to organizations that handle organ procurement or organ, eye, or tissue transplantation, or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Research

Under certain circumstances, we may use and disclose your PHI for research purposes. All research projects are subject to a special approval process. Before we use or disclose PHI for research, the project will have been approved through a research approval process, and protocols are in place to ensure the privacy of your health information.

Serious Threats to Health or Safety

We may use and disclose your PHI 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, however, would only be to someone able to help prevent the threat.

Military and Veterans

If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.

Workers' Compensation

We may release your PHI for workers' compensation or similar programs that provide benefits for work-related injuries or illness.

Your Rights Regarding Your Health Information

You have the following rights regarding your protected health information that we maintain:

Right to Inspect and Copy

You have the right to inspect and copy your PHI that is contained in a designated record set. A "designated record set" contains medical and billing records and any other records that we use for making decisions about you. To inspect and copy your PHI, you must submit your request in writing to our Privacy Officer. We may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

Right to Request Amendment

You may ask us to amend your PHI if you feel that it is incorrect or incomplete. You have the right to request an amendment for as long as the information is kept by or for our pharmacy. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. In addition, you must provide a reason that supports your request.

Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures." This is a list of certain disclosures we made of your PHI for purposes other than treatment, payment, healthcare operations, or disclosures you authorized. To request this list, you must submit your request in writing to our Privacy Officer. Your request must state a time period, which may not be longer than six years.

Right to Request Restrictions

You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care. We are not required to agree to your request, unless you are asking us to restrict the disclosure of PHI to a health plan for services you have paid for in full out of pocket.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You may obtain a copy of this Notice at our pharmacy or by contacting our Privacy Officer.

Changes to This Notice

We reserve the right to change this Notice. We reserve the right to make the revised or 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 in our pharmacy. The Notice will contain the effective date on the first page, in the top right-hand corner.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our pharmacy or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with our pharmacy, contact our Privacy Officer using the information listed below. All complaints must be submitted in writing.

You will not be penalized or retaliated against for filing a complaint.

To file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, you may send a letter to:

U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

You may also call 1-877-696-6775 or visit www.hhs.gov/ocr/privacy/hipaa/complaints.

Contact Information

If you have any questions about this Notice, or if you want to exercise any of your rights listed above, please contact: