Notice of Privacy Practices
Effective Date: March 31, 2013
Revised Date: March 1, 2017
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.
Patient Services and Solutions, Inc. (d/b/a Shared Solutions®, Shared Solutions Pharmacy™, and Teva Support Solutions®) is required by law to maintain the privacy of your health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information. Protected health information is information that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose protected health information to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to your protected health information. We are required to provide this notice to you by the Health Insurance Portability and Accountability Act (“HIPAA”). We are also required to follow the terms of this Notice that is currently in effect.
How We May Use or Disclose Your Health Information
Treatment
We may use and disclose your health information to provide and coordinate the treatment, medications or services you receive. For example, we may contact you regarding medications, supplies, refill reminders, product recalls, side effects, drug interactions, injection training, or other product or service recommendations, such as patient support programs or disease management information.
Payment
We may use or disclose your health information for payment-related purposes. For example, we may contact your insurer, pharmacy benefit manager or other health care payer to determine whether it will pay for your medications, supplies or services. We may also use or disclose your health information to bill you or a third-party payer for the cost of the medications, supplies or services provided to you.
Health Care Operations
We may use or disclose your health information to carry out our own business planning and administrative operations. Examples of operational activities include, but are not limited to, quality assessment and improvement, associate training, licensing, case management, and other administrative activities.
Individuals Involved in Your Care or Payment of Your Care
We may disclose health information about you to a relative, a friend, or any other person you may identify, provided the information is directly relevant to that person’s involvement with your health care or payment for that care unless you object. For example, if a family member or a caregiver calls us with prior knowledge of a pharmacy order, we may confirm whether or not the order has been filled.
Food and Drug Administration (FDA)
We may disclose to the FDA, or persons under the jurisdiction of the FDA, health information with respect to an FDA-regulated product or activity for which that person has responsibility, for the purpose of activities related to the quality, safety or effectiveness of such FDA-regulatory product or activity. Examples include collecting or reporting adverse events, product defects or problems, or post-marketing surveillance information to enable product recalls, repairs or replacement.
Additional Reasons for Disclosure
We may use or disclose your health information in order to provide you with appointment and event reminders or information about treatment alternatives or other health-related services you may be interested in. We may also use or disclose health information about you in support of:
- Law Enforcement – to federal, state and local law enforcement officials or in response to a court order, subpoena, warrant or other lawful process.
- Research – to researchers, provided measures are taken to protect your privacy.
- Business Associates – to persons who perform functions, activities or services to us or on our behalf that require the use or disclosure of health information and assure us they will protect the information.
- Industry Regulation – to boards of pharmacy, U.S. Department of Labor, U.S. Department of Health and Human Services, state insurance departments and other government agencies that may regulate us.
- Public Health and Safety – to address matters of public interest as required or permitted by law (e.g. abuse and neglect, threats to public health and safety, and national security) or to avert a serious threat to yourself or another person.
- Decedents – to a coroner, medical examiner or funeral director as consistent with applicable law.
- Organ and Tissue Donation – to entities engaged in the procurement, banking, or transplantation of organs for the purpose of organ or tissue donation and transplant.
- Worker’s Compensation – to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
- Specialized Government Functions – to military and veterans affairs or national security and intelligence activities.
- Required by Law - when required to do so by federal, state or local law.
Marketing
We must obtain your written authorization to use and disclose your health information for most marketing purposes.
Sale of Protected Health Information
We must obtain a written authorization from you for any disclosure of protected health information that constitutes a sale of protected health information.
Other Uses and Disclosures of Health Information
Other uses and disclosures of health information not covered by this Notice will be made only with your written authorization. If you authorize us to use or disclose your health information, you may revoke the authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your health information for the reasons covered by your written authorization; however, we will not reverse any uses or disclosures already made in reliance on your prior authorization.
Your Health Information Rights
Right to a Paper Copy of This Notice
You may request a paper copy of this notice at any time, even if you previously agreed to receive an electronic copy, by contacting the Chief Privacy Officer.
Right to Inspect and Copy
You have the right to inspect and copy your health information that may be used to make decisions about your care or payment for your care. If your health information is maintained in an electronic format, you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. Your request must be in writing, and there may be a fee for the cost of copying and/or mailing your request. In limited circumstances, your request to inspect and copy may be denied. Generally, if you are denied access to your health information, you may request a review of the denial.
Right to Request an Amendment
You may ask us to amend your health information if you believe it is inaccurate or incomplete. Your request must include the reason for amendment. If the request is denied, you may file a written statement of disagreement. Your request must be in writing.
Right to Request Restrictions
You may ask us to restrict the way we use or disclose your health information by making the request in writing. We will consider, but are not required to agree to, such requests. However, we must agree if you request that we not disclose health information to your health plan regarding a specific health care item or service for purposes of payment or health care operations and you have paid for the item or service in full out of pocket and the disclosure is not otherwise required by law.
Right to Request Confidential Communications
You may ask us to communicate with you in a certain way. For example, you can request that we only contact you using a certain method or at a certain location. We will accommodate reasonable requests. Your request must be made in writing.
Right to Accounting of Disclosures
You may ask us to provide a list of certain disclosures of your health information that we have made to others, except for those necessary to carry out health care treatment, payment or operations and the disclosures you have authorized. Your request must be made in writing, and must specify the time period.
Right to Breach Notification
You have the right to be notified if you are affected by a breach of unsecured protected health information.
Changes to This Notice
We reserve the right to change our practices and this Notice and to make the new Notice effective for all health information we maintain. Upon request, we will provide any revised Notice to you.
Complaints
If you believe your privacy rights under this policy have been violated, you may file a written complaint with the Chief Privacy Officer, P.O. Box 7588, Overland Park, KS 66207-0588. Alternatively, you may voice your concern to the Secretary of the U.S. Department of Health and Human Services. You will not be penalized or retaliated against for filing a complaint.
Contact Information
If you have any questions about this Notice, please contact:
Chief Privacy Officer
P.O. Box 7588
Overland Park, KS 66207-0588
Toll Free Number: 1-800-887-8100