HIPAA Notice of Privacy Practices

How we protect your health information.

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.

When this Notice of Privacy Practices refers to “we” or “us,” it is referring to Ricker Pharmacy and all of the pharmacists who provide health care services and the employees of our pharmacy.

We are required by law to maintain the privacy of your protected health information (“PHI”), to follow the terms of the Notice currently in effect, to give you this Notice setting forth our legal duties and privacy practices concerning your PHI, and to notify affected individuals following a breach of unsecured PHI. This Notice describes how we may use and disclose your PHI. Additionally, this Notice explains the rights you have with respect to your PHI, and certain obligations we must abide by in accordance with the law. We reserve the right to amend this Notice. If we make any material revisions to this Notice, we will post a copy of the revised Notice in the pharmacy, on our website, and will offer you a copy of the revised Notice.

Use and Disclosure of Your PHI

We will use and disclose your PHI for treatment, payment and health care operations. We may also use your PHI for other purposes that are permitted and/or required by law and pursuant to your written authorization. The following lists examples of how we may use and/or disclose your PHI. Any other uses not described in this Notice will only be made with your explicit written authorization, which you may revoke at any time by providing us with written notice of your revocation.

Treatment

We may use and disclose your PHI in order to provide you with prescription and supply services. We may disclose your PHI to other pharmacists, pharmacy technicians and health care providers involved in your care. You will receive an individual notice and have the opportunity to opt out of any subsidized treatment communications.

Payment

We will use and disclose your PHI in order to obtain payment for the health care services we provide to you. We may also need to disclose your PHI to receive prior approval from your health plan, or to determine if your health plan will cover a certain prescription or service.

Health Care Operations

We may use and disclose your PHI in connection with the management of our pharmacy — for example, quality assessment and improvement, internal compliance audits, and performance evaluations. Additionally, we may use your PHI for our business management and general administrative activities.

Prescription Refill Reminders, Treatment Alternatives or Health-Related Benefits

We may use and disclose your PHI to contact you to remind you about prescription refills, to tell you about treatment options or alternatives, or to inform you about health-related benefits or services that may be of interest to you.

Family Members, Relatives or Close Friends

Unless you object to such disclosure, we may disclose your PHI to your family members, relatives or close personal friends, or any other persons identified by you as being involved in the treatment or payment for your medical care. If you are not present to agree or object, we may exercise our professional judgment to determine whether the disclosure is in your best interest, and will only disclose PHI relevant to your treatment or payment.

Other Permitted and Required Uses and Disclosures

We may use your PHI without obtaining your authorization and without offering you the opportunity to agree or object, in circumstances that include:

As required by law, provided the use or disclosure is made in compliance with applicable law.
To a public health authority authorized by law to collect or receive such information — including preventing or controlling disease, reporting deaths, reporting adverse effects of medications, notification of communicable disease, and reporting abuse or neglect under certain circumstances.
To a health oversight agency for oversight activities authorized by law, including audits, inspections, and civil, administrative or criminal investigations.
For judicial or administrative proceedings, in response to a subpoena, court order, or discovery request — only where efforts have been made to inform you or obtain an order protecting the information.
To law enforcement to report certain injuries, comply with court orders or warrants, identify a suspect, fugitive, missing person or victim, or report a crime.
To a coroner or medical examiner to perform duties authorized by law, such as identification of a deceased person or determining cause of death.
To funeral directors, consistent with applicable law, as necessary to carry out their duties.
To organ procurement organizations or similar entities to facilitate organ, eye or tissue donation and transplantation.
For research purposes, provided certain approvals take place and assurances are given.
To avert a serious threat to health or safety, so long as disclosure is only to a person reasonably able to prevent or lessen such threat.
For military and veterans activities, to assure proper execution of a military mission and to determine eligibility for benefits.
For national security and intelligence activities, for lawful intelligence, counter-intelligence and other national security purposes.
For protection of the President and other authorized persons, or foreign heads of state, or to conduct authorized investigations.
To a correctional institution or law enforcement custodian if you are an inmate or under custody.
To the extent necessary to comply with laws relating to workers' compensation and work-related injuries.

Your Rights as Our Patient

As our patient, you have a number of rights associated with your PHI:

Request restrictions. You may request restrictions or limitations on how we use and/or disclose your PHI. We do not have to agree, except for transactions you paid for in full out-of-pocket. Your written request must specify what you'd like restricted, and to whom the restriction applies.
Confidential communications. You have the right to receive communications about your PHI by alternative means or at alternative locations — for example, prescription-related communications at an address other than your home. Submit this request in writing to our Privacy Officer; we will accommodate all reasonable requests.
Access and copies. You have the right to access, inspect and obtain a copy of your PHI, including electronic PHI, except for certain PHI exempted under HIPAA. You may be charged a reasonable, cost-based fee to cover copy costs and postage. If access is denied, you're entitled to a written explanation and may request the denial be reviewed.
Accounting of disclosures. You have the right to receive an accounting of disclosures of your PHI for up to six years prior to your request. Your first request in a twelve-month period is free; subsequent requests may carry a reasonable, cost-based fee.
Amendment. If you believe your PHI is incorrect or incomplete, you may request an amendment in writing, stating your reasons. We may deny the request in certain circumstances, and you have the right to respond with a written statement of disagreement.
Paper copy. You have the right to obtain a paper copy of this Notice at any time, even if you originally received it electronically.
Opt-out of fundraising. Your PHI will not be used for fundraising purposes or sold without your prior authorization.

Additional Information, Questions or Complaints

If you believe your privacy rights have been violated, you may file a complaint without retaliation with the Privacy Officer of the pharmacy, or with:

Secretary of the Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C. 20201

Questions about your privacy rights?

Reach out to our Privacy Officer any time — we're happy to walk you through it.