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NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED BY UNITED STATES PHARMACEUTICAL GROUP, L.L.C., d/b/a NATIONSHEALTH
("NationsHealth"), AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
NationsHealth recognizes that your health information is personal, and we are
committed to protecting it. NationsHealth's use and disclosure of your health
information is also very important to our ability to provide you with quality
care, and to comply with certain laws. This Notice applies to NationsHealth's
uses and disclosures of individually identifiable Protected Health Information
("PHI") received or created by NationsHealth as a healthcare provider under the
Standards for Privacy of Protected Health Information disseminated under the
Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), subject
to applicable state laws.
I. We Are Legally Required to Safeguard Your PHI. NationsHealth is
required by law to:
A. Maintain the privacy of your PHI;
B. Provide you with this Notice; and
C. Comply with this Notice.
II. Future Changes to Our Privacy Practices and This Notice.
NationsHealth reserves the right to change its privacy practices and to
make any such change applicable to your PHI obtained before the change.
If a change in our practices is material, we will revise this Notice to
reflect the change. You may obtain a copy of any revised Notice by
contacting NationsHealth's Privacy Office at 13630 N.W. 8th Street, Suite 210,
Sunrise, Florida 33325, telephone (800) 246-2195, or on our website at
www.nationshealth.com.
III. NationsHealth Use and Disclosure of Your PHI. The law permits
us to use and disclose your PHI for purposes of providing treatment, obtaining
payment and for certain operations related to healthcare. This Section
III provides some examples of each of these permitted uses and disclosures.
A. Permitted Uses and Disclosures for purposes of treatment, payment
and healthcare operations.
We may use and disclose your PHI to provide treatment to you or for the
treatment activities of another healthcare provider. Some examples include:
We may disclose your PHI to pharmacists, physicians, nurses, and other
healthcare providers and suppliers who are involved in your care for purposes
of your treatment.
We may also use and disclose your PHI to tell you and your physician or other
healthcare provider about or recommend treatment options or alternatives, or to
tell you and your physician or other healthcare provider about health-related
benefits, products or services. In addition, depending on your condition,
we may use and disclose your PHI for purposes of contacting you regarding your
prescription or supply refills, compliance with dosage or testing requirements,
proper prescription drug administration, precautions and side effects, as well
as product usage and storage, as applicable.
We may use and disclose your PHI for our various therapeutic intervention
programs.
We may review your PHI to help us identify potential issues related to your
treatment, such as proper dosage or potential drug interactions. We may
use and disclose your PHI for purposes of contacting your physician or other
healthcare provider prior to dispensing a prescribed drug in the event we have
identified a potentially inappropriate therapy, such as potential drug to drug
interactions, or if we have identified issues related to frequency or dosage,
as well as other recommendations regarding your treatment regimen.
We may also use and disclose your PHI to contact your physician for purposes of
recommending alternative medications or supplies when appropriate, alerting
your physician regarding potential drug interactions, potential dosing or
testing or side effect issues related to your compliance with therapy.
We may also use and disclose your PHI to advise you or your physician or other
healthcare provider that an alternative generic medication is available or that
a specific medication or supply is not preferred or approved by your health
plan or third party payor.
We may also use or disclose your PHI in order to get paid for the prescription
medications or supplies provided to you by NationsHealth or for the payment
activities of another entity. For example:
We may use your PHI to create the bills that we submit to the insurance company
or health insurance plan to receive payment for the services we provide to you.
We may use your PHI to determine if you are eligible for insurance coverage or
benefits under a health plan or other program.
We may disclose certain portions of your PHI to your insurer or health
insurance plan for payment audit purposes or to our business associates who
perform billing, adjudication, claims processing or other related services for
us.
We may use your PHI during payment-related data processing.
We may also use or disclose your PHI for our operations related to healthcare.
For example:
We may use your PHI to evaluate the quality of care you received from us, or to
evaluate the performance of those involved with your care.
We may use and disclose your PHI to provide utilization reports and other data
analyses to your health insurance plan for purposes of prescription benefits
management.
We may also use and disclose your PHI to perform periodic quality assurance
reviews and audits, to develop protocols, and for purposes of case management
and care coordination.
PHI may be provided to our internal auditors, attorneys, accountants, and other
consultants to make sure we are complying with the laws that affect us.
We may use and disclose your PHI in conducting data analysis for purposes of
providing information and data to your plan sponsor, new program development
and providing services to improve outcomes and effectively manage the costs of
prescription drugs and supplies.
In addition, we may also disclose your PHI to another healthcare provider,
health insurance plan, or healthcare clearinghouse for purposes of their
operations related to healthcare. However, we will only do so if they
have or have had a relationship with you and if the PHI they request pertains
to that relationship. In addition, we will disclose your PHI to these
third parties for limited purposes only, such as conducting quality improvement
activities, reviewing the performance of a healthcare provider, or training
purposes.
B. Uses and Disclosures That Require Us to Give You the Opportunity
to Object.
Unless you object, and except as may otherwise be prohibited by law, we may
provide relevant portions of your PHI to a family member, friend, or other
person you indicate is involved in your healthcare or in helping you get
payment for your healthcare. In an emergency or when you are not capable
of agreeing or objecting to these disclosures, we will disclose PHI as we
determine is in your best interest, but will advise you of such use and
disclosure after the emergency, and give you the opportunity to object to
future disclosures to family and friends. Unless you object, we may also
disclose your PHI to persons performing disaster relief notification
activities.
C. Certain Other Uses and Disclosures Which Do Not Require Your
Authorization. The law allows us to use and disclose PHI without your
authorization in the following circumstances:
1. When Required by Law. We use and disclose PHI
when we are required to do so by federal, state or local law.
2. For Public Health Activities. We use and
disclose PHI when we are so required to by public health and other government
authorities. For example, we may be required to disclose information to
the Federal Food and Drug Administration (FDA) relative to adverse events with
respect to medications, products, product recalls, defects or replacements.
We also use and disclose PHI as necessary to report suspected child
abuse.
3. For Reports About Victims of Abuse, Neglect or Domestic Violence.
We will use and disclose your PHI in reports about victims of abuse,
neglect, or domestic violence only if we are required or authorized by law to
do so, or if you otherwise agree.
4. To Health Oversight Agencies. We will use and
disclose PHI as requested by government agencies who have authority to audit or
investigate our operations.
5. For Lawsuits and Disputes. If you are involved
in a lawsuit or dispute, we may use and disclose your PHI in response to a
subpoena or other lawful request, but only if efforts have been made to tell
you about the request or to obtain a court order that will protect the PHI
requested.
6. To Law Enforcement. We may use and disclose PHI
if asked to do so by a law enforcement official, in the following
circumstances: (a) in response to a court order, subpoena, warrant, summons or
similar process; (b) to identify or locate a suspect, fugitive, material
witness or missing person; (c) to provide information about the victim of a
crime if, under certain limited circumstances, we are unable to obtain the
person's agreement; (d) about a death we believe may be due to criminal
conduct; (e) about criminal conduct at our facility; and (f) in emergency
circumstances, to report a crime, its location or victims, or the identity,
description or location of the person who committed the crime.
7. To Coroners, Medical Examiners and Funeral Directors.
We may use and disclose PHI to facilitate the duties of coroners, medical
examiners and funeral directors.
8. To Organ Procurement Organizations. We may use
and disclose PHI to facilitate organ donation and transplantation.
9. For Medical Research. We may use and disclose
your PHI to medical researchers who request it for approved medical research
projects; however, with very limited exceptions such uses and disclosures must
be cleared through a special approval process before any PHI is used and
disclosed to the researchers, who will be required to safeguard the PHI they
receive.
10. To Avert a Serious Threat to Health or Safety. We
may use and disclose your PHI to someone who can help prevent a serious threat
to your health and safety or the health and safety of another person or the
public.
11. For Specialized Government Functions. We may
use and disclose your PHI for specialized government functions. For
example, we may use and disclose your PHI to authorized federal officials for
intelligence and national security activities that are authorized by law, or so
that they may provide protective services to the President or foreign heads of
state or conduct special investigations authorized by law.
12. To Workers' Compensation or Similar Programs. We
may use and disclose your PHI to workers' compensation or similar programs in
order for you to obtain benefits for work-related injuries or illness.
IV. Other Uses and Disclosures of Your Protected Health Information.
Other uses and disclosures of your PHI that are not covered by this
Notice or permitted by the laws that apply to us will be made only with your
written authorization. If you give us written authorization for a use or
disclosure of your PHI, you may revoke that authorization, in writing, at any
time. If you revoke your authorization, we will no longer use or disclose
your PHI for the purposes specified in the written authorization, except that
we are unable to take back any disclosures we have already made with your
permission. In addition, we can use or disclose your PHI after you have
revoked your authorization for actions we have already taken in reliance upon
your authorization. We are also required to retain certain records of the
uses and disclosures made when the authorization was in effect.
V. More Restrictive Law. In the event that state law or other
applicable law prohibits or materially limits our uses and disclosures of your
PHI as set forth above, we will restrict our uses and disclosures of you PHI in
accordance with the more restrictive standard.
VI. Your Rights Related to Your Protected Health Information. You
have the following rights:
A. The Right to Request Limits on Uses and Disclosures of Your PHI.
You have the right to ask us to limit how we use and
disclose your PHI, as long as you are not asking us to limit uses and
disclosures that we are required or authorized to make by the Secretary of the
U.S. Department of Health and Human Services, related to any of the disclosures
described in Section III above. Any such request must be submitted in
writing to our Privacy Officer at the address shown in Section VII, below.
We are not required to agree to your request. If we do agree, we
will put it in writing and will abide by the agreement except when you require
emergency treatment.
B. The Right to Choose How We Communicate With You. You
have the right to ask that we send information to you at a specific address
(for example, at work rather than at home) or in a specific manner (for
example, by e-mail rather than by regular mail, or never by telephone).
We must agree to your request as long as it would not be disruptive to
our operations to do so. You must make any such request in writing,
addressed to our Privacy Officer at the address shown in Section VII, below.
C. The Right to See and Copy Your PHI. Except for
limited circumstances, you may look at and copy your PHI if you ask in writing
to do so. Any such request must be addressed to our Privacy Officer at
the address shown in Section VII, below, who will respond to your request
within 30 days (or 60 days if the extra time is needed). In certain
situations we may deny your request, but if we do, we will tell you in writing
of the reasons for the denial and explain your rights with regard to having the
denial reviewed.
If you ask us to copy your PHI, we may charge you a reasonable amount as
allowed by law. Alternatively, we may provide you with a summary or
explanation of your PHI, as long as you agree to that and to the cost, in
advance.
D. The Right to Correct or Update Your PHI. If you
believe that the PHI we have about you is incomplete or incorrect, you may ask
us to amend it. Any such request must be made in writing and must be
addressed to our Privacy Officer at the address shown in Section VII, below,
and must tell us why you think the amendment is appropriate. We will not
process your request if it is not in writing or does not tell us why you think
the amendment is appropriate. We will act on your request within 60 days
(or 90 days if the extra time is needed), and will inform you in writing as to
whether the amendment will be made or denied. If we agree to make the
amendment, we will ask you to tell us who else you would like us to notify of
the amendment.
We may deny your request if you ask us to amend information that:
1. was not created by us, unless the person who created the information
is no longer available to make the amendment;
2. is not part of the PHI we keep about you;
3. is not part of the PHI that you would be allowed to see or copy; or
4. is determined by us to be accurate and complete.
If we deny the requested amendment, we will tell you in writing how to submit a
statement of disagreement or complaint, or to request inclusion of your
original amendment request in your PHI.
E. The Right to Receive a List of the Disclosures We Have Made.
You have the right to receive a list of instances in which
we have disclosed your PHI. The list will not include disclosures we have
made for treatment, payment, and healthcare operations purposes described in
Section III, those made directly to you or your family or friends, for disaster
notification purposes, or those that were made per an authorization from you.
Nor will the list include disclosures we have made for national security
purposes or to law enforcement personnel, or disclosures made before April 14,
2003.
Your request for a list of disclosures must be made in writing and be addressed
to our Privacy Office at the address shown in Section VII, below.
We will respond to your request within 60 days (or 90 days if the extra
time is needed). The list we provide will include disclosures made within
the last six years unless you specify a shorter period. The first list
you request within a 12-month period will be free. You will be
charged our costs for providing any additional lists within the same 12-month
period.
F. The Right to Receive a Paper Copy of This Notice. Even
if you have agreed to receive the Notice by e-mail, you have the right to
request a paper copy as well. You may obtain a paper copy of this Notice
by contacting our Privacy Officer at the address shown in Section VII, below.
VII. For More Information or Complaints. If you
want more information about your privacy rights, do not understand your privacy
rights, are concerned that we have violated your privacy rights or disagree
with a decision that we have made about access to your PHI, you may contact our
Privacy Officer. You may also file a written complaint with the Secretary
of the U.S. Department of Health and Human Services. You may call our
Privacy Officer to obtain the correct address for the Secretary. We will
not retaliate against you for filing a complaint with the Secretary or with us.
You may contact our Privacy Officer at:
NationsHealth
Attn: Privacy Office
13630 N.W. 8th Street, Suite 210
Sunrise, Florida 33325
Telephone: (800) 246-2195
Effective Date: February 21, 2007
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