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.  Kearney Park 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.  We are required to follow the terms of the Notice that is currently in effect.  A paper copy of this notice is available upon request

HOW KEARNEY PARK PHARMACY MAY USE OR DISCLOSE YOUR HEALTH INFORMATION

Kearney Park 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 Kearney Park Pharmacy to use or disclose your health information for the following purposes without your authorization:

 For Treatment: Information obtained by the Pharmacy will be used to dispense prescriptions to you.  We may disclose health information about you to other pharmacists and other persons who are involved in dispensing your prescription.

 For Payment: We may use and disclose your health information so that our pharmacy services may be billed to, and payment may be collected from, you and 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 health care to your home.  These uses and disclosures are necessary to run the Pharmacy and make sure 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 thereat 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 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: Kearney Park 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 KEARNEY PARK PHARMACY MAY NOT USE OR DISCLOSE YOUR HEALTH INFORMATION

Except as described in this Notice, Kearney Park Pharmacy will not use or disclose your health information without your written authorization.  If you do authorize Kearney Park 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.  Kearney Park 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 the 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 the Pharmacy.  We may charge you a fee for the costs of copying, mailing or other supplies that are necessary to grant your request.

 You have the right to request that Kearney Park Pharmacy amend your health information that is incorrect or incomplete.  To request an amendment, you must submit a written request to the Pharmacy, along with the reason for your request.  Kearney Park Pharmacy is not required to amend health information that is accurate and complete.  Kearney Park will provide you with information about the procedure for addressing any disagreement with a denial. 

 You have the right to receive an accounting of disclosures of your health information we have made after March 20, 2012 for purposes other than disclosures (1) for Kearney Park 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 the pharmacy.  You must specify the time period, which may be no longer than six years.

*If you would like to exercise one or more of these rights, submit a written request to Kearney Park Pharmacy, HIPPA Information, 972-329-1168*

CHANGES TO THIS NOTICE OF PRIVACY PRACTICES

Kearney Park 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 available in the Pharmacy.  Upon request, we will provide a revised Notice to you.

TO REPORT A PROBLEM

If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer at Kearney Park Pharmacy.  There will be no retaliation for filing a complaint.