The Health Insurance Portability and Accountability Act (“HIPAA “)
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICALINFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices describes the privacy practices of AMC. AMC is required by law to maintain the privacy of Protected Health Information (“PHI”) and to provide you with notice of our legal duties and privacy practices with respect to PHI. AMC, its employees, and workforce members who are involved in providing and coordinating health care are all bound to follow the terms of this Notice. The members of the AMC will share PHI with each other for the treatment, payment and health care operations as permitted by HIP AA and this Notice.
PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition, the provision of health
care products and services to you or payment for such services. This Notice describes how we may use and disclose PHI about you, as well as how
you obtain access to such PHI.
This Notice also describes your rights with respect to your PHI. We are required by HIPAA to provide this Notice to you. AMC is required to follow the terms of this Notice or any change to it that is in effect. 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 provide any revised Notice to you.
This Notice of Privacy Practices (“Notice”) describes:
- How we may use and disclose your protected health information (“PHI”)
- Your rights to access and amend your PHI
We are required by law to:
- Maintain the privacy of your PHI
- Provide you with notice of our legal duties and privacy practices with respect to PHI
- Abide by the terms of the Notice currently in effect for AMC
PERMITTED USES AND DISCLOSURES OF YOUR PHI
We may use and disclose your PHI for the following purposes.
- Treatment: We may use and disclose your PHI to healthcare professionals or other third parties to provide, coordinate and manage the delivery of health care. For example, your pharmacist may disclose PHI about you to your doctor in order to coordinate the prescribing and
delivery of your drugs. We also may provide you with treatment reminders and information about potential side effects, drug interactions and other treatment-related issues involving your medicine.
- Payment: We.may use and disclose PHI about you to receive payment for our services, manage your account, fulfill our responsibilities
under your benefit plan, and process your claims.
- Individuals Involved in Your Care or Payment for Your Care: We may disclose PHI about you to someone who assists in or pays for
your care. Unless you write to us and specifically tell us not to, we may disclose your PHI to someone who has your permission to act on
your behalf. We will require this person to provide adequate proof that he or she has your permission.
- Parents or Legal Guardians: If you are a minor or under a legal guardianship, we may release your PHI to your parents or legal guardians when we are permitted or required to do so under federal and applicable state law.
- Business Associates: We arrange to provide some services through contracts with business associates so that they may help us operate
more efficiently. We may disclose your PHI to business associates acting on our behalf. If any PHI is disclosed, we will protect your
information from unauthorized use and disclosure using confidentiality agreements. Our business associates may, in turn, use vendors to
assist them in providing services to us. If so, the business associates must enter into a confidentiality agreement with the vendor, which
protects your information from unauthorized use and disclosure.
- Abuse, Neglect or Domestic Violence: We may disclose your PHI to a social service, protective agency or other government authority if
we believe you are a victim of abuse, neglect or domestic violence. We will inform you of our disclosure unless informing you would place
you at risk of serious harm.
- Health Oversight: We may disclose PHI to a health oversight agency performing activities authorized by law, such as investigations and
audits. These agencies include governmental agencies that oversee the healthcare system, government benefit programs, and organizations
subject to government regulation and civil rights laws.
- Creation of De-Identified Health Information: We may use your PHI to create data that cannot be linked to you by removing certain
elements from your PHI, such as your name, address, telephone number, and member identification number. We may use this de-identified
information to conduct certain business activities; for example, to create summary reports and to analyze and monitor industry trends.
- Law Enforcement: We may disclose your PHI, as required by law, in response to a subpoena, warrant, summons, or, in some
circumstances, to report a crime.
- Coroners and Medical Examiners: We may disclose your PHI to a coroner or a medical examiner for the purpose of determining cause of
death or other duties authorized by law.
YOUR RIGHTS WITH RESPECT TO YOUR PHI
You have the following rights regarding PHI we maintain about you:
- Right to Inspect and Copy: Right to Inspect and Copy: Subject to some restrictions, you may inspect and copy PHI that may be used to
make decisions about you. If we maintain an electronic health record containing your PHI, you have the right to request that we send a
copy of your PHI in an electronic format to you or to a third party that you identify.
- Right to Amend: If you believe PHI about you is incorrect or incomplete, you may ask us to amend the information. You must provide a
reason supporting your request to amend.
- Confidential Communications: You may ask that we communicate with you in an alternate way or at an alternate location to protect the
confidentiality of your PHI. Your request must state an alternate method or location you would like us to use to communicate your PHI to
- Right to be Notified: You have the right to be notified following a breach of unsecured PHI if your PHI is affected.
- Right to a Paper Copy of This Notice: You have the right to request a paper copy of this Notice at any time.
- Right to File a Complaint: If you believe we have violated your privacy rights, you may file a written complaint to AMC Pharmacy at the
address listed below. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. You will not
face retaliation for filing a complaint.
We reserve the right to revise this Notice. A revised Notice will be effective for PHI we already have about you, as well as any PHI we may receive in the future. Upon request, we will provide a revised Notice to you.