Notice of Privacy Practices

Effective date: March 30, 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.

Our Responsibilities
At Bartell Drugs, we value our relationship with every patient and know that respect for your privacy is an important part of that relationship. We are committed to protecting the privacy of your protected health information.

Protected health information (PHI) is any information about you that we create or collect that relates to your past, present or future health care or payment for your care. PHI is information that identifies you or it is reasonable to believe that it can be used to identify you. In this notice, we will refer to PHI as your health information.

We are required by state and federal law to maintain the privacy and security of your health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your health information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record	You can ask to see or get an electronic or paper copy of your pharmacy records and other health information we have about you. Please make your request in writing. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 15 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record	You can ask us to correct health information about you that you think is incorrect or incomplete. Please make your request in writing. Ask us how to do this. We may say “no” to your request, but we will tell you why in writing within 10 days.
Request confidential communications	You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. Please make your request in writing. We will say “yes” to all reasonable requests.
Ask us to limit what we use or share	You can ask us not to use or share certain health information for treatment, payment, or our operations. Please make your request in writing. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a prescription, service, or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we have shared information	You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. Please make your request in writing. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice	You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. Ask at your neighborhood pharmacy or use the contact information on the last page of this notice.
Choose someone to act for you	If you have given someone authorization or medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. Please provide your authorization in writing. We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated	You can complain if you feel we have violated your rights by contacting us using the contact information on the last page of this notice. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Access to a Minor’s Health Information

Before responding to a request regarding health records of another, we generally require written authorization from the patient. Parents may exercise rights related to health records on behalf of their minor children, except in certain circumstances. In accordance with applicable law, only a minor may exercise their rights regarding health records that are related to care for which the minor patient can legally consent without parental involvement and has consented. In Washington, a minor of any age may consent to reproductive care; a minor who is thirteen years of age or older may consent to mental health or substance abuse treatment, and a minor who fourteen years of age or older may consent to diagnosis and treatment related to sexually transmitted disease.

Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care, often referred to as caregivers
Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In this case, you have the right and choice to opt out:

Fundraising purposes

We may send you fundraising communications for a related foundation or charitable organization. You have the right to tell us not to contact you for this purpose.

In these cases we never share your information unless you give us written permission:

Marketing purposes
Sale or lease of your information

Our Uses and Disclosures

How do we typically use or share your health information? We keep records of your health information, including prescriptions and typically use or share your health information in the following ways.
Treat you	We can use your health information and share it with other professionals who are treating you. We may contact you to remind you about your prescription refill.		Example: We may use and disclose your health information in dispensing prescription medicines and related products and services, including counseling you and your caregivers, friends or family involved in your care about proper use of your medications.
Run our company	We can use and share your health information to run our pharmacies, improve your care, and contact you when necessary.		Example: We use health information about you to manage your treatment and coordinate dispensing of your medication.
Bill for prescriptions and services	We can use and share your health information to bill and get payment from health plans or other entities.		Example: We give information about you to your health insurance plan so it will pay for your prescriptions, including Medicare and Medicaid if you receive these benefits.
How else can we use or share your health information? We are allowed or required to share your health information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your health information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues		We can share health information about you for certain situations such as: Preventing disease Helping with medication or product recalls Reporting adverse reactions to medications Reporting suspected abuse, neglect, or domestic violence Preventing or reducing a serious threat to anyone’s health or safety Assisting in disaster relief efforts
Do research		We can use or share your information for health research in certain cases.
Comply with the law		We will share health information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests		We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director		We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests		We can use or share health information about you: For workers’ compensation claims For law enforcement purposes or with a law enforcement official With the custodial agency if you are placed in custody of a corrections system With health oversight agencies for activities authorized by law For special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions		We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Work with business associates		We can share health information with our business associates performing services on our behalf if they sign a business associate agreement ensuring that they will take appropriate steps to protect your health information. We may notify you if your health information is disclosed in error to a third party or organization.

If a use or disclosure of your health information is not described in this Notice or otherwise permitted or required by law, we will obtain your written authorization before using or disclosing your information. You have the right to refuse to authorize use or disclosure. If you grant the authorization, you may revoke the authorization at any time by letting us know in writing.

Changes to the Terms of This Notice
We may change the terms of this notice, and changes will apply to all health information we have about you. The new notice will be available on request in our pharmacies, and on our web site at www.bartelldrugs.com.

Contact
If you have questions about this notice, need more information about your privacy rights, or would like to file a complaint about our privacy practices, please contact the Privacy Officer at Bartell Drugs, 4025 Delridge Way SW, Seattle WA 98106, phone 206-767-1345, fax 206-762-3764, or email privacy@bartelldrugs.com.

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Notice of Privacy Practices

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