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.
I. Who We Are
This Notice describes the privacy practices of CoverMyMeds LLC, covermymeds.com and CoverMyMeds' employees and contractors ("we" or "us"). This Notice applies to services furnished to you or to your health care provider on your behalf.
II. Our Privacy Obligations
We are required by law to maintain the privacy of your health information ("Protected Health Information" or "PHI") and to provide you with this Notice of our legal duties and privacy practices with respect to your Protected Health Information. When we use or disclose your Protected Health Information, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).
III. Permissible Uses and Disclosures Without Your Written Authorization
In certain situations, which we describe in Section IV below, we must obtain your written permission to use and/or disclose your PHI. However, we do not need any type of authorization from you for the following uses and disclosures:
A. Uses and Disclosures For Treatment, Payment and Health Care Operations. We may use and disclose PHI, but not your "Highly Confidential Information" (defined in Section IV.C below), for the following purposes described below:
Treatment. We may use and disclose your PHI for treatment purposes; for example, we may disclose PHI to health care providers involved in your treatment and, specifically, involved in prescribing and dispensing medication to help treat your injury or illness.
Payment. We may use and disclose your PHI to obtain payment for prescription drugs and other health care services you receive -- for example, we may disclose your PHI as necessary to claim and obtain payment from your health insurer, HMO, or other company that arranges or pays the cost of some or all of your prescription drugs ("Your Payor") and to verify that Your Payor will pay for these products and related health care services.
Health Care Operations. We may use and disclose your PHI for certain health care operations, such as quality assessment and improvement activities, business planning and development, customer service or for health care fraud and abuse detection or compliance.
B. Public Health Activities. We may disclose your PHI for certain public health activities - for example, to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration
C. Health Oversight Activities. We may disclose your PHI to a health oversight agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid.
D. Judicial and Administrative Proceedings. We may disclose your PHI in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
E. Law Enforcement Officials. We may disclose your PHI to the police or other law enforcement officials as required or permitted by law or in compliance with a court order or a grand jury or administrative subpoena.
F. Research. We may use or disclose your PHI without your consent or authorization if an Institutional Review Board or Privacy Board approves a waiver of authorization for disclosure.
G. Health or Safety. We may use or disclose your PHI to prevent or lessen a serious and imminent threat to a person's or the public's health or safety.
H. Specialized Government Functions. We may use and disclose your PHI to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
I. Workers' Compensation. We may disclose your PHI as authorized by and to the extent necessary to comply with state law relating to workers' compensation or other similar programs.
J. As Required by Law. We may use and disclose your PHI when required to do so by any other law not already referred to in the preceding categories.
IV. Uses and Disclosures Requiring Your Written Authorization
A. Use or Disclosure with Your Authorization. For any purpose other than one described above in Section III, we only may use or disclose your PHI when you give us your written permission on an authorization form ("Your Authorization"). For instance, you will need to complete and sign an authorization form before we can send your PHI to an attorney representing the other party in a lawsuit in which you are involved.
B. Marketing. We must also obtain your written permission ("Your Marketing Authorization") prior to using your PHI to send you any marketing materials. (We can, however, provide you with marketing materials in a face-to-face encounter without obtaining Your Marketing Authorization. We are also permitted to give you a promotional gift of nominal value, if we so choose, without obtaining Your Marketing Authorization.) In addition, we may communicate with you about products or services relating to your treatment, case management or care coordination, or alternative treatments, therapies, providers or care settings without Your Marketing Authorization.
C. Uses and Disclosures of Your Highly Confidential Information. Federal and state law requires special privacy protections for certain highly confidential information about you ("Highly Confidential Information"). This Highly Confidential Information may include the subset of your PHI that: (1) is maintained in psychotherapy notes; (2) is about mental health and developmental disabilities services; (3) is about alcohol and drug abuse prevention, treatment and referral; (4) is about HIV/AIDS testing, diagnosis or treatment; (5) is about sexually-transmitted disease(s); and (6) is about genetic testing. In order for us to disclose your Highly Confidential Information for a purpose other than those permitted by law, we must have your written permission.
V. Your Rights Regarding Your Protected Health Information
A. For Further Information; Complaints. If you would like more information about your privacy rights, if you are concerned that we have violated your privacy rights, or if you disagree with a decision that we made about access to your PHI, you may contact our Privacy Office, located at 10574 Ravenna Road, Twinsburg, Ohio 44087, U.S.A You may also file written complaints with the Director, Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Privacy Office will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with us or the Director.
B. Right to Request Additional Restrictions. You have the right to request a restriction on the uses and disclosures of your PHI (1) for treatment, payment and healthcare operations purposes, and (2) to individuals involved in your care or with payment related to your care.Ê For example, you have the right to request that we not disclose your PHI to a health plan for payment or healthcare operations purposes, if that PHI pertains to a health care item or service for which we have been involved and which has been paid out of pocket in full.Ê We are required to comply withÊyour request for thisÊtype of restriction.Ê For all other requests for restrictions on use and disclosures of your PHI, we are not required to agree to your request, but will attempt to accommodate reasonable requests when appropriate. If you wish to request restrictions, please obtain a request form from our Privacy Office and submit the completed form to the Privacy Office. We will send you a written response.
C. Right to Receive Confidential Communications. You may request, and we will accommodate, any reasonable written request for you to receive your PHI by alternative means of communication or at alternative locations.
D. Right to Revoke Your Authorization. You may withdraw (revoke) Your Authorization, Your Marketing Authorization or any written authorization regarding your Highly Confidential Information (except to the extent that we have taken action in reliance upon it) by delivering a written statement to the Privacy Office identified below.
E. Right to Inspect and Copy Your Health Information. You may request access to your records maintained by us. Under limited circumstances, we may deny you access to a portion of your records. If you would like to access your records, please obtain a record request form from the Privacy Office and submit the completed form to the Privacy Office. If you request copies, we will charge you $0.75 (seventy-five cents) for each page. We will also charge you for our postage costs, if you request that we mail the copies to you.
F. Right to Amend Your Records. You have the right to request that we amend Protected Health Information maintained in your records. If you desire to amend your records, please obtain an amendment request form from the Privacy Office and submit the completed form to the Privacy Office. We will comply with your request unless we believe that the information that would be amended is accurate and complete or other special circumstances apply.
G. Right to Receive An Accounting of Disclosures. Upon request, you may obtain an accounting of certain disclosures of your PHI made by us during any period of time prior to the date of your request provided such period does not exceed six years. If you request an accounting more than once during a twelve (12) month period, we will charge you $0.75 per page of the accounting statement.
H. Right to Receive A Copy of this Notice. Upon request, you may obtain a copy of this Notice, either by email or in paper format. Please submit your request to:
Privacy Office
CoverMyMeds10574 Ravenna Road
Twinsburg, Ohio 44087, U.S.A
E-mail: privacymatters@covermymeds.com
VI. Effective Date and Duration of This Notice
A. Effective Date. This Notice is effective on May 1, 2010.
B. Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all Protected Health Information that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new notice on our Internet site at http://www.covermymeds.com. You also may obtain any new notice by contacting the Privacy Office.
VII. Privacy Office
You may contact the Privacy Office at:
Privacy Office
CoverMyMeds10574 Ravenna Road
Twinsburg, Ohio 44087, U.S.A
E-mail: privacymatters@covermymeds.com