HomeMed 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. PLEASE REVIEW IT CAREFULLY.
HomeMed Pharmacy, LLC and its affiliates are required by law to maintain the privacy of Protected Health Information ("PHI") and to provide our customers with notice of our legal duties and privacy practices with request to your PHI. PHI is information, including basic demographic information that may identify you and that relates to your past, present, or future physical or mental health condition and related health care services. This Notice of Privacy Practices ("Notice") describes how we may use and disclose PHI to carry our treatment, payment, or health care operations and for other specific purposes that are permitted or required by law. It also describes your rights with respect to PHI about you.
We are required to follow the terms of this Notice as currently in effect. We will not use or disclose PHI without your written authorization, except as described in this Notice. We reserve the right to change our practices and this Notice and to make any new notice of privacy rights effective for all PHI we maintain. Upon your request, we will provide you with a copy of any revised notice of privacy practices.
HomeMed Pharmacy may use or disclose your Protected Health Information for the following purposes:
For Treatment: Treatment includes providing, coordinating, or managing health care and related services. For example, information obtained by the pharmacist will be used to dispense prescription medications to your or to coordinate or manage health care with a health care provider involved in your care or to consult with a health care provider relating to your treatment.
For Payment: We may use or disclose your health information for such activities as obtaining reimbursement for services or products, billing or collection activities, or utilization review.
For Health Care Operations: HomeMed Pharmacy may use your PHI for our business operations, including quality assessment activities, auditing, and customer service. This information will be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.
For Other Specific Purposes That Are Permitted Or Required By Law: For example, if you are involved in a lawsuit, we may disclose PHI in response to a court or administrative order. Public Health and Welfare is another example. As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
For Personal Communication: We may contact you to provide refill reminders or information about treatment alternatives or other health-related benefits and services.
Other Permitted Uses: HomeMed Pharmacy may disclose PHI as necessary for workers compensation, national security purposes, or to correctional institutions or law enforcement officials, medical examiners, health oversight agencies, or in response to law enforcement agencies. HomeMed may also transfer your records as part of a sale of its business where permitted by law.
Your rights with respect to your Protected Health Information:
You have the following rights with respect to your PHI, which you can exercise by completing a written request, available on our website, and sending the request to our privacy officer or by contacting the privacy officer by telephone:
- The right to obtain a paper copy of the Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled o a paper copy.
- The right to request additional restrictions on uses and disclosures of your PHI. We are not required to agree to any such requested restriction(s).
- The right to inspect and copy PHI contained in a designated record set for as long as we maintain the PHI. The "designated record set" usually includes prescription and billing records. We may charge you a fee for the costs of copying, mailing, or other supplies that are necessary to respond to your request. We may deny your request to insect and copy in certain limited circumstances. If you are denied access to your PHI, you may request that the denial be reviewed.
- The right to request an amendment to your PHI for as long as we maintain the information. You must include a reason that supports your request for amendment. In certain cases, we may deny your request. You then have the right to submit a statement of disagreement with the decision and we may provide you with a rebuttal to your statement.
- The right to receive an accounting of the disclosures of your PHI on or after April 14, 2003. This accounting excludes disclosures made for treatment, payment, or health care operations; disclosures made directly to you; disclosures to friends or family members involved in your care; disclosures for notification purposes; disclosures authorized by you; or disclosures as part of a limited data set in accordance with the law.
The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. You must submit your request in writing to the Contact Office listed at the end of this Notice. Your request must specify the time period, but may be no longer than six years. We will provide you with the first accounting you request within a 12 month period free of charge, but we may charge you for the cost of providing additional accountings. We will notify you of the cost prior to providing the accounting.
- The right to request communications of PHI by alternative means or at alternative locations. Your request must state how or when and where you would like to be contacted. We will accommodate all reasonable requests.
Other Uses and Disclosures of Your Protected Health Information:
We will obtain your separate written authorization before we use or disclose PHI for purposes other than those described in this Notice or as otherwise permitted or required by law. You may revoke this authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing PHI, except to the extent that we have already taken action in reliance on the authorization.
To Request More Information Or To File a Complaint:
If you have questions or would like additional information about our privacy practices, you may contact us as follows at the contact office listed below. If you believe your privacy rights have been violated, you can file a complaint with our privacy officer or with the Secretary of Health and Human Services. We will not retaliate against you for filing a complaint.
HomeMed Pharmacy, LLC
6210 Technology Center Dr, Suite 300
Indianapolis, IN 46278
Telephone: (317) 616-4500
This notice is effective as of April 14, 2003.