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.
We
understand that medical information about you and your health is
personal. Baron’s Pharmacy is required by law to maintain the privacy
of your health information, to follow the terms of this notice, and to
provide you with this notice of our legal duties and privacy practices
with respect to your health information.
How Baron’s Pharmacy May Use or Disclose Your Health
Information:
Baron’s Pharmacy protects
the privacy of your health information. For some activities, we must have
your written authorization to use or disclose your health information;
however, the law permits Baron’s Pharmacy to use or disclose your health
information for the following purposes without your authorization:
·
For
Treatment.
Information obtained by Baron’s Pharmacy will be used to dispense
prescriptions to you. We may disclose health information about you to
pharmacists and other persons who are involved in dispensing your
prescription.
·
For
Payment.
We may use and disclose your health information so that your pharmacy
services may be billed to, and payment may be collected from, you, an
insurance company, or a third party.
·
For
Health Care Operations.
We may use and disclose health information about you for pharmacy
operations. Unless you provide us with alternative instructions, we may
send refill reminders and other materials related to your health care to
your home. These uses and disclosures are necessary to run the pharmacy
and ensure that you receive quality customer service.
·
As
Required by Law.
We will disclose health information about you when required to do so by
federal, state, or local law.
·
To Avert
a Serious Threat to Health or Safety.
We may use and disclose health information about you 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.
·
Public
Health Risks.
We may disclose health information about you for public health
activities. These activities generally include the following: (1) to
prevent or control disease, injury, or disability; (2) to report reactions
to medications or problems with products; (3) to notify people of recalls
of products they may be using; (4) to notify a person who may have been
exposed to a disease or may be at risk for contracting or spreading a
disease or condition; and (5) to notify the appropriate government
authority if we believe a person has been the victim of abuse, neglect, or
domestic violence (we will only make this disclosure if you agree and when
required or authorized by law).
·
For
Health Oversight Activities.
We may disclose health information to a health oversight agency for
activities authorized by law. These oversight activities, which are
necessary for the government to monitor the health care system, include
audits, investigations, inspections and licensure.
·
Lawsuits
and Disputes.
If you are involved in a lawsuit or dispute, we may disclose health
information about you in response to a court order or administrative
order. We may also disclose health information 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 (which may include written notice to you) or to obtain
an order protecting the information requested.
·
For Specific Government Functions.
Baron’s Pharmacy may disclose health
information for the following specific government functions: (1) health
information of military personnel as required by military command
authorities; (2) health information of inmates, to a correctional
institution, or law enforcement official; (3) in response to a request
from law enforcement, if certain conditions are satisfied; and (4) for
national security reasons.
When Baron’s Pharmacy May Not Use or Disclose Your Health
Information:
Except as described in this notice, Baron’s Pharmacy will not use or
disclose your health information without your authorization. If you do
authorize Baron’s Pharmacy to use or disclose your health information
for another purpose, you may revoke your authorization at any time.
You Have the Following Rights With Respect to Your Health
Information:
·
You have the
right to request restrictions on certain uses and disclosures of your
health information. Baron’s Pharmacy is not required to agree to a
restriction that you request. If we do agree to any restriction, we will
put the agreement in writing and follow it, except in emergency
situations. We cannot agree to limit the uses or disclosures of
information that are required by law.
·
You have the
right to inspect and copy your health information as long as Baron’s
Pharmacy maintains the health information. Your health information
usually will include prescription and billing records. To inspect or copy
your health information, you must submit a written request to Baron’s
Pharmacy. We may charge a fee for the costs of copying, mailing or other
supplies that are necessary to grant your request. We may deny your
request to inspect and copy in certain limited circumstances. If you are
denied access to your health information, you may request that the denial
be reviewed. You have a right to choose to obtain a summary instead of a
copy of your health information.
·
You have the
right to request that Baron’s Pharmacy amend your health information that
is incorrect or incomplete. To request an amendment, you must submit a
written request to Baron’s Pharmacy, along with the reason for the
request. Baron’s Pharmacy is not required to amend health information
that is accurate and complete. Baron’s Pharmacy will provide you with
information about the procedure for addressing any disagreement with a
denial.
·
You have a
right to receive an accounting of disclosures of your health information
we have made after April 14, 2003 for purposes other than disclosures (1)
for Baron’s Pharmacy treatment, payment, or health care operation; (2) to
you or based upon your authorization; and (3) for certain government
functions. To request an accounting, you must submit a written request to
Baron’s Pharmacy. You must specify the time period, which may not be
longer than six years.
·
You may
request communications of your health information by alternative means
or at alternative locations. For example, you may request that we
contact you about health matters only in writing or at a different
residence or post office box. To request confidential communication of
your health information, you must submit a written request to Baron’s
Pharmacy. Your request must state how or when you would like to be
contacted. We will accommodate all reasonable requests.
Changes to this Notice of Privacy Practices:
Baron’s Pharmacy reserves the right to change this notice. We reserve
the right to make the revised or changed notice effective for health
information we already have about you as well as any information we
receive in the future. Any revised notice will be posted in the
pharmacy. Upon request, we will provide a revised notice to you.
For More Information or to Report a Problem:
If
you have questions, would like additional information about pharmacy
privacy practices, or if you would like to exercise one or more of these
rights, contact Baron’s Pharmacy at (218) 263-7455 or submit a written
request to Baron’s Pharmacy, 1120 East 34th Street, Hibbing,
MN 55746. If you believe your privacy rights have been violated, you
can file a complaint with the privacy officer of Baron’s Pharmacy or the
Secretary of Health and Human Services. There will be no retaliation for
filing a complaint.
EFFECTIVE DATE:
This
notice is effective as of April 14, 2003.