We have created this privacy statement in order to demonstrate our firm commitment
to privacy. The following discloses our information gathering and dissemination
practices for this web site. We use your IP address to help diagnose problems
with our server, and to administer our Web site.
Your IP address is used to help identify you and to gather broad demographic
cookies to identify you so we can retrieve your information so you don't have
to re-enter it each time you visit our site. Our site's registration form requires
users to give us contact information, like their name and email address, and
We use customer contact information from the registration form to send the
user information about our company. The customer's contact information is also
used to contact the visitor when necessary if they have subscribed to the mail
list. Users may opt-out of receiving future mailings by choosing to un-subscribe.
Unique identifiers are collected to verify the user's identity and for use in
our record system. This site may contain links to other sites. We are not responsible
for the privacy practices or the content of such web sites. Our site uses an
order form for customers to request information, products, and services.
We collect visitor's contact information and unique identifiers. Contact information
from the order form is used to send orders and information about our company
to our customers. The customer's contact information is also used to get in
touch with the visitor when necessary. Users may opt-out of receiving future
mailings. Unique identifiers are collected from Web site visitors to verify
the user's identity and for use as account numbers in our record system.
Security: This site has security measures in place to protect the loss,
misuse and alteration of the information under our control. All data is protected
using the most advanced methods available. We do not store financial information
like credit card numbers or personal information like social security numbers
on this site.
Un-Subscribe: This site gives users the following options for removing
their information from our database to not receive future communications or
to no longer receive mail list messages.
Correct/Update: This site gives users the following options for changing
and modifying information previously provided. You can send email to us by visiting
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
At Legacy rfla, we value your relationship, and want you to know we
respect your privacy. We are committed to protecting your private personal
health information, and we will only use and disclose your personal health
information as necessary to provide you with health care products and services.
Protected health information (PHI) is any information that we possess, use
and disclose that identifies you and relates to your past, current or future
physical and mental health condition or illness and the health care products
and services that have been provided to you.
This purpose of this "Notice of Privacy Practices" (Notice)
is to help you understand our legal duties to protect your PHI and how
we may use and disclose your PHI in relation to your past, present and
future physical or mental health condition or illness and its treatment.
The use and disclosure of your PHI will primarily involve the health care
products and services that we provide you, such as dispensing your prescriptions.
Specifically, we will use and disclose your PHI as necessary in providing
treatment to you, obtaining payment for health care products and services
provided to you and other health care operations as described later in
this Notice. This Notice also describes your legal rights related to your
PHI that is in our possession. We take the obligations described in this
Notice very serious, because we are legally required to comply with this
notice, and because we respect you and your right to privacy.
Your PHI will only be used and disclosed as described in this Notice.
Should a situation requiring use and disclosure of your PHI that is not
described in this Notice occur, we will obtain your written authorization
before the use and disclosure. At some future date it may be necessary
for us to revise this Notice. If this occurs, we will post the revised
Notice in the pharmacy and, if you request, provide a written Notice to
The Health Insurance Portability and Accountability Act of 1996 (HIPAA),
provides you with several rights related to your PHI. These rights are
summarized below. If you would like more information about your rights,
please ask to speak with our Privacy Officer at the address or telephone
Right to Receive Notice of Privacy Practices: You have the right to receive
this written Notice of Privacy Practices describing how we will protect
your PHI and your rights related to PHI. You are entitled to request this
written Notice at any time.
Right to Request Limitation of Use and Disclosure of PHI: You have the
right to request a limitation on our use and disclosure of your PHI. But
please be aware that we may not be able to agree to your requested limitation
if it results in our not being able to provide health care products and
services to you or if we are required to use and disclose the PHI under
federal or state law. All requests for limitation on the use and disclosure
of your PHI must be submitted to our Privacy Officer in writing using
a form that we will provide to you.
Right to Review and Receive a Copy of Records: You have the right to
review or receive photocopies of our records that contain your PHI, to
the extent that these records are part of a designated record set as defined
by HIPAA. The most common type of records are your prescriptions on file
with us, our patient profile for you and our billing records for health
care products and services that have been provided to you. If you wish
to review or obtain a copy of a family member's PHI you may need to complete
a "Right to Access and Consent for Release of PHI to Patient's Authorized
Representative". This is of course subject to any limitations on
use and disclosure of PHI we have on file for that family member. We will
be pleased to allow you to review such records meeting the requirements
of this Notice of Privacy Practices at no charge during normal business
hours. However, we may charge you a reasonable, cost-based fee for photocopies
of the records, together with any expenses for mailing, special courier,
faxing and supplies necessary to complete your records request.
If we are unable to provide our records to you, we will provide you a
written explanation of why we are not able to provide the records. Depending
on the reason, you may submit a written request for us to reconsider.
All requests to review or receive photocopies of our records that contain
your PHI must be submitted to our Privacy Officer in writing using a form
that we will provide to you.
Right to Request Amendments to Records: You have the right to request
changes in the content of your PHI contained in our records where you
believe the content is incomplete, inaccurate or for some other reason
needs to be changed. We may not be able to agree to your requested change
if we no longer have the records or if the requested change would cause
your PHI to become inaccurate. If we are not able to agree to your requested
change we will notify you in writing as to why we are not able to agree.
You will then have the right to submit to us a written statement of disagreement,
to which we may elect to further respond in writing to you. All requests
for change to your PHI in our records must be submitted to our Privacy
Officer in writing using a form that we will provide to you.
Right to Request Confidential Communications: You have the right to request
that we communicate with you about your PHI in a confidential manner and
only to locations (such as a post office box) or by means (such as personal
cellular telephone) specified by you. All requests for confidential communications
must be submitted to our Privacy Officer in writing. using a form that
we will provide to you.
Right to an Accounting of Non-Treatment, Payment and Operations (TPO)
Disclosures: You have the right to obtain an accounting of some of our
disclosures of your PHI made after April 14,2003. By accounting we main
a written record of these disclosures. Some of our disclosures of your
PHI are not required by HIPAA to be included in the accounting. Most notable
among these are disclosures for purposes of TPO. Other disclosures of
your PHI that are not required to be included in the accounting are disclosures
make directly to you or that you have authorized, made to family, friends
and others who assist you with your care (caregivers) and made for other
purposes allowed by HIPAA. Please consult with our Privacy Officer for
more information on the disclosures not required to be included in the
We are required to provide an accounting of disclosures for the six (6)
year period immediately prior to the date of your request for the accounting;
however, your request for an accounting can be for a shorter period of
time and cannot precede the HIPAA compliance date. You may obtain from
us, without charge, one accounting during a twelve-month period. However,
if you request additional accountings during the same twelve month period
we may charge you a reasonable, cost-based fee for printing or photocopying
of the accounting, together with any expenses for mailing, special courier,
faxing and supplies necessary to fulfill your request for the accounting.
If it becomes necessary for us to charge you for an accounting, we will
notify you in advance and allow you to withdraw or modify your request
for the accounting. All requests for an accounting of our disclosures
of your PHI must be submitted to our Privacy Officer in writing.
Right to File a Complaint: You have the right to file a complaint if
you believe that we have violated your rights as described above, and
to not fear retaliation or adverse action by us against you for exercising
your right. You can file the complaint with us directly, or with the United
States Department of Health and Human Services (HHS). Please be assured
that we will work with you to resolve any complaint including providing
you with the address for filing a complaint with HHS. If you have any
concern about our privacy practices or wish to file a complaint, please
contact our Privacy Officer at the address or telephone number of our
If you have any questions about any of your privacy rights as described,
please contact our Privacy Officer at the address or telephone number
listed at the beginning of this document.
Normal Pharmacy Activities Resulting in Uses and Disclosures of your
The Health Insurance Portability and Accountability Act of 1996 (HIPAA),
requires that this "Notice" describe how we may use and disclose
your protected health information (PHI). These uses and disclosures are
summarized below, but if you would like more information about any of
these please contact our Privacy Officer at the address or telephone number
of our pharmacy.
Treatment: HIPAA regulations define treatment as "the provision,
coordination, or management of health care and related services by one
or more health care providers, including the coordination or management
of health care by a health care provider with a third party; consultation
between health care providers relating to a patient; or the referral of
a patient for health care from one health care provider to another".
We will maintain records that contain your PHI and we will use and disclose
your PHI as necessary to provide health care products and services to
carry out and support your treatment. As a pharmacy, we will use and disclose
your PHI as necessary to maintain your patient profile, which includes
information about you, your medical condition, medications and prescription
devices that you use, any allergies that you may have and other information,
such as any health insurance that you may have. We will use and disclose
your PHI in dispensing prescription medicines and related products and
services, including counseling you and your caregivers about proper use
of your medications. We will also use your patient profile to watch for
medication related problems, such a drug interactions and overuse or under
use of your medications that may present a risk to you. We may discuss
such problems with your other health care professionals, such as your
physician or dentist, and through such discussions, we may use and disclose
your PHI. And of course, we will use and disclose your PHI to you and
your caregivers (if you allow us), in our discussions with you and your
caregivers about your treatment.
Payment: HIPAA regulations define payment, in relation to health care
providers such as pharmacies, as activities to obtain reimbursement for
the health care products and services that we provide to you. These activities
include primarily billing you directly or someone who pays for your health
care, such as a family member or health insurance company, for health
care products and services that we provide to you. Activities related
to billing may include claims management, collections and related health
care data processing. Depending on who pays for the health care products
and services that we provide you, other activities may include eligibility
determination; drug coverage determination; medical necessity under a
health plan; appropriateness of care, or justification of charges; including
prior authorization of drugs and services; prospective and retrospective
drug utilization review services. Some examples of PHI that may be used
and disclosed to collect payment are:
Name Address Birthdate Gender Social Security Number Insurance Member
ID Number Relationship to Insured Health Plan Information Health Care
We will use and disclose your PHI to carry out the above activities as
necessary or required to obtain payment for the health care products and
services that we provide to you. In relation to this, public and private
health care insurance programs that may provide or pay for your health
care can conduct audits, inspections and investigations of us in relation
to our activities and your activities. We may be required to disclose
your PHI to these programs for purposes of audits, inspections and investigations.
Health care operations: HIPAA defines health care operations as those
activities necessary and related to our providing of health care products
and services to you. These activities include, but may not be limited
to, the following:
- Conducting quality assessment and improvement activities, case management,
disease management and care coordination, contacting of health care providers
and patients with information about treatment alternatives and related
functions that do not include treatment.
- Conducting or arranging for medical review, legal services and auditing
functions, including fraud and abuse detection and compliance programs.
- Our pharmacy management and general administrative activities, including,
but not limited to, activities relating to implementation of and compliance
with the requirements of HIPAA.
We will use and disclose your PHI to carry out the above activities as
necessary or required, and especially to monitor and improve the quality
of the health care products and services that are provided to you by us
and other health care professionals.
In addition to treatment, payment and health care operations as described
above, we may use and disclose your PHI for the following purposes:
Business associates: The health care system is very complex and as such
we may not be able to provide health care products and services to you
without the involvement of other businesses or persons. Depending on what
these other businesses or persons do for us, they may become "business
associates" as defined by HIPAA. In many situations it will be necessary
for us to provide your PHI to these business associates so that they can
carry out the activities that we need to have performed in order to provide
you health care products and services. For patients that have health insurance
that includes a pharmacy benefit, one of our most common business associates
is a health insurance company or a pharmacy benefits company that processes
claims we submit for payment for health care products and services on
your behalf. We have written contracts with all of our business associates
to whom we provide your PHI so that they can carry out their activities
on our behalf. In an effort to provide you a level of comfort, you should
know, these contracts require our business associates to give us their
assurance that they, like us, will protect the privacy of your PHI.
Communications with you concerning your health and treatment: We want
to do whatever we can to assist you with maintaining your health and obtaining
the most benefit from your treatment. We routinely monitor your prescription
medications for appropriateness and take other steps to help you use your
medication properly. For example, if you forget to obtain a refill of
your medication, we may contact you to remind you to obtain the refill.
We may also call you or send you materials regarding products and services
that we believe may be of benefit to you. In the event that a pharmaceutical
manufacturer or the Food and Drug Administration (FDA) is to issue a medication
recall, we may contact you if you are taking the medication subject to
Federal and state government agencies: We may disclose your PHI to federal
and state government agencies for a variety of purposes, most of which
are directed at monitoring health care quality and safety, government
programs related to health care and our compliance with laws applicable
to health care. For example, the United State Drug Enforcement Administration
(DEA) monitors the distribution and use of controlled substances, while
the FDA monitors adverse drug events. We may disclose your PHI to such
agencies where required by the agency so that the agency can carry out
its required activities. Related to this, some private businesses, such
as the manufacturers of medications and medical devices, are legally required
to conduct post marketing surveillance in order to ensure the safety of
their products. Disclosing your PHI for such surveillance may be necessary.
A number of state agencies also conduct health care quality and safety
activities, for which we may disclose your PHI. For example, some states
maintain a controlled substance monitoring program and require that we
report to the state the prescriptions for controlled substances that we
dispense to you.
Federal and state government health care insurance programs: If you apply
for and receive benefits from federal and state health care programs,
such as Medicare or Medicaid, your PHI may be disclosed to the agency
granting these benefits. If you are employed by a business that is required
to carry workers' compensation insurance, and you are injured in such
a way that the workers' compensation plan covers your health care, it
may be necessary to disclose you PHI to the workers' compensation plan.
Such plans have a right to conduct audits, inspections and investigations
of our activities and your activities, and where required, we will disclose
your PHI for these activities.
Public health and safety: There are several federal and state laws that
require health care providers to report to various government agencies
matters related to public health. If your physical or mental health condition
and illness is of a nature that requires that it be reported, then we
will disclose your PHI to the appropriate government agency in order to
comply with these laws. In addition to reporting about physical and mental
health conditions and illnesses, we may also disclose your PHI to government
agencies in other situations where we are required to submit reports,
such as suspected domestic, child or elder abuse or neglect.
Law enforcement activities: A number of federal, state and local government
agencies are charged with enforcing the health care and drug laws, and
other laws in relations to the health care products and services that
we may provide to you. In addition, as a state licensed pharmacy, a variety
of federal, state and local health care agencies, such as the state board
of pharmacy, regulate our activities. These agencies may engage in a number
of activities designed to monitor and improve federal and state health
care programs and systems, including conducting of inspections and investigations
of our activities and the health care products and services that we provide
to our patients. At any time we are required by federal or state laws,
or by court order, subpoena of other legal mandate, to disclose your PHI
we will do so as necessary.
Legal disputes: Lawsuits and other legal disputes are common today, and
depending on the issues, may involve your PHI that we possess. In the
event that you are involved in a lawsuit or other legal proceeding, whether
as a plaintiff or a defendant, and without regard to the basis for the
lawsuit, such as medical malpractice or divorce, we will disclose your
PHI when required to comply with a court order, subpoena, discovery proceeding,
such as a deposition, or other legal mandate served upon us. We will attempt
to notify you prior to the disclosure if you are not the party to the
legal dispute requesting your PHI so that you and your attorney can determine
whether you want to take legal actions to prevent disclosure of your PHI.
Disclosures for the benefit of you and others: Events can occur where
we would use and disclosure your PHI for your benefit and to prevent or
reduce the risk of harm to you. For example, if you are in a car accident
and are unconscious in a hospital emergency room and the emergency room
medical staff calls us with a request for your PHI, we may disclose it
for the purpose of assisting in your prompt medical treatment. The same
is true if a family member, friend or caregiver contacts us in an emergency
situation, or where an emergency situation is not present, but we have
reason to believe you are at risk of harm or serious injury and we believe
that disclosing your PHI will assist them in caring for you. We may also
disclose your PHI upon your death to a funeral director, embalmer, medical
examiner or coroner's office to assist them in carrying out their legal
responsibilities related to your death. Finally, we may disclose your
PHI where necessary to protect the health and safety of others.
Disclosures for national security and intelligence: We are legally required
to disclose your PHI when necessary to national security and intelligence
and counter-intelligence activities. Any disclosure for these purposes
would be made only to authorized government officials.
Disclosures if you are in the military or a veteran: We may disclose
your PHI, if you are a member of any branch of the armed services, whether
on active or reserve status. If you are a veteran, we may release your
PHI. Particularly if you are receiving health care products and services
from the Veterans Services. Any disclosure for these purposes would be
made only to authorized government officials.
Disclosures of a miscellaneous nature: We may be required to disclose
your PHI if you are placed into custody of a federal or state correctional
system if necessary to protect the health and safety of you and others.
Health care is an area where much research is being conducted, and we
may disclose your PHI for purposes of a research project, but only if
we are satisfied that the research project has been approved by a responsible
institutional review board and the research project has established adequate
methods to protect your privacy. Much health care research is sponsored
through organizations that conduct fundraising activities, and we may
inquire with you using your PHI to determine your interest in participating
in or otherwise supporting a fundraising activity. Finally, given the
national need for organ donations, we may disclose your PHI to organizations
that manage organ transplantation programs.
If you have any questions about any of the uses and disclosures of your
PHI as described above, Please contact our Privacy Officer at the address
or telephone number listed at the beginning of this document.
Uses and Disclosures not Contained in this Notice
If a use and disclosure of your PHI is not contained in this Notice,
we will obtain your written authorization before the use and disclosure.
You may have the right to refuse to authorize the use and disclosure,
or if you grant the authorization, to revoke the authorization at any
time. If such authorization is requested, we will provide you with a form
that describes the proposed use and disclosure and your rights related
to the requested authorization.
HIPAA requires that we give you this "Notice of Privacy Practices"
and make a good faith effort to obtain your written acknowledgement that
you were given this notice. Upon giving you this Notice, you will be asked
to sign a document acknowledging that you received this notice. We appreciate
your cooperation in reviewing this notice and in giving us your written
HIPAA also requires that this Notice, at a minimum, cover the following
- How we will use and disclose your personally identifiable health information.
- Your rights with respect to your personally identifiable health information.
- Our legal duties to protect the confidentiality of your personally
identifiable health information.
In preparing this Notice, we made every effort to comply with this HIPAA
requirement. Also, you should be aware that the Federal regulation HIPAA
does not take precedence over State Law when the State Law is more strict.
You may have additional protections under State Law.
Please consult our Privacy Officer if you have any questions or want
more information concerning your health care and privacy rights under
HIPAA or the laws of our state, or our privacy practices. Also, you should
consult our Privacy Officer if you wish to file a complaint about our
privacy practices or if you believe we have violated any of your rights
as described in this Notice.
Thank you for allowing us the privilege of being your pharmacy, we look
forward to providing you with high quality health care products and services
that will help to keep you healthy.