Privacy Policy
NOTICE OF PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
Raff and Hall Pharmacy is required by law to maintain the privacy of Protected Health Information (PHI) and provide you with a notice of our legal duties and privacy practices.
References to “Raff and Hall Pharmacy,” “we,” “us,” and “our” include Raff and Hall Pharmacy and the members of its affiliated covered entity.
An affiliated covered entity is a group of organizations under common ownership or control, designating themselves as a single entity for HIPAA compliance purposes.
Raff and Hall Pharmacy, its employees, workforce members, and affiliated entity members involved in providing and coordinating health care are bound by the terms of this notice.
Members of Raff and Hall Pharmacy‘s affiliated covered entity share PHI for treatment, payment, and health care operations, as permitted by HIPAA and this notice.
PHI refers to information that identifies you and relates to your physical or mental health, the provision of health care products and services, or payment for services.
This notice explains how we may use and disclose your PHI and your rights regarding it. We are required by HIPAA to provide this notice to you.
How We May Use and Disclose Your PHI
Treatment
We may use and disclose PHI to provide and coordinate the treatment, medications, and services you receive. This includes sharing PHI with pharmacists, doctors, hospitals, and other health care providers.
Payment
PHI may be used and disclosed to obtain payment for the health care products and services provided. For example, we may contact your insurer
or third-party payor for payment purposes.Health Care Operations
We may use and disclose PHI for activities necessary to operate our business, such as monitoring staff performance, improving the quality of
services, and analyzing data for better health outcomes.Business Associates
We may share PHI with third-party service providers, referred to as Business Associates, who assist in services like billing or consulting.
Communication with Individuals Involved in Your Care
We may disclose PHI to family members, friends, or personal representatives involved in your care or payment for care.
FDA
PHI may be disclosed to the FDA for adverse event reporting, product recalls, and other safety-related purposes.
Worker’s Compensation
PHI may be disclosed to worker’s compensation or similar programs as required by law.
Public Health
We may disclose PHI to public health authorities to control disease, injury, or disability.
Law Enforcement
PHI may be disclosed for law enforcement purposes as required by law, including in response to subpoenas or court orders.
Health Oversight Activities
PHI may be disclosed to oversight agencies for audits, inspections, and other activities related to licensure and compliance.
Judicial and Administrative Proceedings
PHI may be disclosed in response to a court order or lawful requests related to legal disputes.
Research
PHI may be used or disclosed for research purposes when authorized by law.
Coroners, Medical Examiners, and Funeral Directors
PHI may be disclosed to these entities to carry out their duties.
Organ or Tissue Procurement
PHI may be disclosed to facilitate organ or tissue donation.
Notification
PHI may be used to notify family or others responsible for your care of your location and general condition.
Disaster Relief
PHI may be used or disclosed for disaster relief purposes.
Fundraising
PHI may be used for fundraising purposes unless you opt out.
Correctional Institutions
PHI may be disclosed to correctional institutions for health and safety reasons.
Military and National Security
PHI may be disclosed for military or national security purposes as authorized by law.
Uses and Disclosures Requiring Authorization
Psychotherapy Notes, Marketing, and Sale of PHI
Your written authorization is required for these specific uses and disclosures.
Other Uses and Disclosures
Any other use or disclosure not covered by this notice will require your written authorization.
Your Health Information Rights
Right to Request Restrictions
You can request restrictions on certain uses and disclosures of your PHI.
Right to Access and Copy PHI
You have the right to inspect and obtain a copy of your PHI.
Right to Request Amendments
You may request amendments to your PHI if it is incomplete or incorrect.
Right to an Accounting of Disclosures
You can request a list of disclosures of your PHI.
Right to Confidential Communications
You may request that we communicate with you by alternative means or at alternative locations.
Right to Be Notified of a Breach
You have the right to be notified if there is a breach of your unsecured PHI.
Where to Submit Requests
Forms for submitting requests can be obtained by contacting the Privacy Office at Raff and Hall Pharmacy.
For More Information or to Report a Problem
For further details or to report a privacy concern, contact Raff and Hall Pharmacy at the provided address or toll-free at (806) 744-8477.
Model Notices of Privacy Practices
The HIPAA Privacy Rule requires health plans and covered health care providers to develop and distribute a notice that provides a clear, user friendly explanation of individuals rights with respect to their personal health information and the privacy practices of health plans and health care providers. This page provides options for meeting the requirement to create notices of privacy practices (NPP).
HHS developed the model NPPs you see on this site to help improve patient experience and understanding. These models use plain language and approachable designs.
The options below are separated into two sets, for health plans and health care providers. Each set contains three formatted options and a text only option, in both English and Spanish. They are:
- Notice in the form of a booklet (preferred by consumers in focus testing);
- A layered notice that presents a summary of the information on the first page, followed by the full content on the following pages;
- A notice with the design elements found in the booklet, but formatted for full page presentation.
- A text only version of the notice.
The models reflect the regulatory changes of the Omnibus Rule (2013). In particular, the models highlight the new patient right to access their electronic information held in an electronic health record, if their provider has an EHR in their practice. Covered entities may use these models by entering their specific information. Please review Questions and Instructions documents before personalizing the notice.
For more information about the HIPAA Privacy Rule and the Notice requirements, see: http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/notice.html
Instructions –
- Health Plan Instructions – PDF
- HC Provider Instructions – PDF
- Questions and Instructions for using the Model Notices – PDF
NPP Provider Files –
English
- NPP Booklet – HC Provider – PDF
- NPP Layered – HC Provider – PDF
- NPP Full Page – HC Provider – PDF
- NPP HC Provider – Text Version
Spanish
- NPP Booklet – HC Provider – PDF
- NPP Layered – HC Provider – PDF
- NPP Full Page – HC Provider – PDF
- NPP HC Provider – Text Version
NPP Health Plan Files –
English
- NPP Booklet – Health Plan – PDF
- NPP Full Page – Health Plan – PDF
- NPP Layered – Health Plan – PDF
- NPP Health Plan – Text Version
Spanish
- NPP Booklet – Health Plan – PDF
- NPP Full Page – Health Plan – PDF
- NPP Layered – Health Plan – PDF
- NPP Health Plan – Text Version
- A covered entity must make its notice available to any person who asks for it.
- A covered entity must prominently post and make available its notice on any web site it maintains that provides information about its customer services or benefits.
The Office for Civil Rights and Office of the National Coordinator for Health Information Technology collaborated to develop these model Notices of Privacy Practices.
Covered entities that are subject to both the HIPAA Privacy Rule and Section 1557 of the Affordable Care Act (ACA) should visit the FAQs at http://www.hhs.gov/civil-rights/for-individuals/section-1557/1557faqs/index.html for more information about providing taglines, which alert individuals with limited English proficiency (LEP) to the availability of language assistance services, and notices of nondiscrimination on entities’ Notices of Privacy Practices. OCR provides more information about Section 1557 and makes available translated resources for use by covered entities at:http://www.hhs.gov/civil-rights/for-individuals/section-1557.
Revised February 2014Model Notices of Privacy Practices
Privacy Policy
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.
As part of the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, the healthcare provider has created this Notice of Privacy Practices (Notice). This Notice describes the healthcare provider’s privacy practices and the rights you, the individual, have as they relate to the privacy of your Protected Health Information (PHI). Your PHI is information about you, or that could be used to identify you, as it relates to your past and present physical and mental health care services. The HIPAA regulations require that the healthcare provider protect the privacy of your PHI that the healthcare provider has received or created.
This healthcare provider will abide by the terms presented within this Notice. For any uses or disclosures that are not listed below, the healthcare provider will obtain a written authorization from you for that use or disclosure, which you will have the right to revoke at any time, as explained in more detail below. The healthcare provider reserves the right to change the healthcare provider’s privacy practices and this Notice. Revisions to the Notice will be posted in the healthcare provider and upon your request, provided to you in a paper format.
HOW THE HEALTHCARE PROVIDER MAY USE AND DISCLOSE YOUR PHI
The following is an accounting of additional ways in which the healthcare provider is permitted or required to use or disclose PHI about you without your written authorization. All uses and disclosures will be to the minimum necessary amount of your PHI. Many of these uses and disclosures will never be made by the healthcare provider; however, we are required by law to notify you of them as a health care provider.
Uses and disclosures as required by law: The healthcare provider is required to use or disclose PHI about you as required and as limited by law.
Uses and disclosure for Public Health Activities: The healthcare provider may use or disclose PHI about you to a public health authority that is authorized by law to collect for the purpose of preventing or controlling disease, injury, or disability. This includes the FDA so that it may monitor any adverse effects of drugs, foods, nutritional supplements and other products as required by law.
Uses and disclosure about victims of abuse, neglect or domestic violence: The healthcare provider may use or disclose PHI about you to a government authority if it is reasonably believed you are a victim of abuse, neglect or domestic violence.
Uses and disclosures for health oversight activities: The healthcare provider may use or disclose PHI about you to a health oversight agency for oversight activities which may include audits, investigations, inspections as necessary for licensure, compliance with civil laws, or other activities the health oversight agency is authorized by law to conduct.
Disclosures for judicial and administrative proceedings: The healthcare provider may disclose PHI about you in the course of any judicial or administrative proceedings, provided that proper documentation is presented to the healthcare provider.
Disclosures for law enforcement purposes: The healthcare provider may disclose PHI about you to law enforcement officials for authorized purposes as required by law or in response to a court order or subpoena.
Uses and disclosures about the deceased: The healthcare provider may disclose PHI about a deceased, or prior to, and in reasonable anticipation of an individual’s death, to coroners, medical examiners, and funeral directors.
Uses and disclosures for cadaveric organ, eye or tissue donation purposes: The healthcare provider may use and disclose PHI for the purpose of procurement, banking, or transplantation of cadaveric organs, eyes, or tissues for donation purposes.
Uses and disclosures for research purposes: The healthcare provider may use and disclose PHI about you for research purposes with a valid waiver of authorization approved by an institutional review board or a privacy board. Otherwise, the healthcare provider will request a signed authorization by the individual for all other research purposes.
Uses and disclosures to avert a serious threat to health or safety: The healthcare provider may use or disclose PHI about you, if it believed in good faith, and is consistent with any applicable law and standards of ethical conduct, to avert a serious threat to health or safety.
Uses and disclosures for specialized government functions: The healthcare provider may use or disclose PHI about you for specialized government functions including; military and veteran’s activities, national security and intelligence, protective services, department of state functions, and correctional institutions and law enforcement custodial situations.
Disclosure for workers’ compensation: The healthcare provider may disclose PHI about you as authorized by and to the extent necessary to comply with workers’ compensation laws or programs established by law.
Disclosures for disaster relief purposes: The healthcare provider may disclose PHI about you as authorized by law to a public or private entity to assist in disaster relief efforts.
Disclosures to business associates: The healthcare provider may disclose PHI about you to the healthcare provider’s business associates for services that they may provide to or for the healthcare provider to assist the healthcare provider to provide quality health care. To ensure the privacy of your PHI, we require all business associates to apply appropriate safeguards to any PHI they receive or create
OTHER USES AND DISCLOSURES
The healthcare provider may contact you for the following purposes:
Refill reminders: The healthcare provider may contact you to remind you of your prescription upon such time they are ready to be refilled.
Information about treatment alternatives: The healthcare provider may contact you to notify you of alternative treatments and/or products.
Health related benefits or services: The healthcare provider may use your PHI to notify you of benefits and services the healthcare provider provides.
Fundraising: If the healthcare provider participates in a fundraising activity, the healthcare provider may use demographic PHI to send you a fundraising packet, or the healthcare provider may disclose demographic PHI about you to its business associate or an institutionally related foundation to send you a fundraising packet. No further disclosure will be allowed by the business associates or an institutionally related foundation without your written authorization
FOR ALL OTHER USES AND DISCLOSURES
The healthcare provider will obtain a written authorization from you for all other uses and disclosures of PHI, and the healthcare provider will only use or disclose pursuant to such an authorization. In addition, you may revoke such an authorization in writing at any time. To revoke a previously authorized use or disclosure, please contant Tarun Patel, PRh. to obtain a Request for Restriction of Uses and Disclosures.
YOUR HEALTH INFORMATION RIGHTS
The following are a list of your rights in respect to your PHI.
Request restrictions on certain uses and disclosures of your PHI: You have the right to request additional restrictions of the healthcare provider’s uses and disclosures of your PHI; however, the healthcare provider is not required to accommodate a request. If you wish to request additional restrictions, please obtain the form, Request for Restriction of Uses & Disclosures, from the healthcare provider and return the completed form to the healthcare provider or return to contact Tarun Patel, RPh.
The right to have your PHI communicated to you by alternate means or locations: You have the right to request that the healthcare provider communicate confidentially with you using an address or phone number other than your residence. However, state and federal laws require the healthcare provider to have an accurate address and home phone number in case of emergencies. The healthcare provider will consider all reasonable requests. If you wish to request a change in your communicating address and/or phone number, please obtain a form, Request for Alternative Arrangements for Confidential Communication, from the healthcare provider and return the completed form to the healthcare provider or return to contact Tarun Patel, RPh.
The right to inspect and/or obtain a copy your PHI: You have the right to request access and/or obtain a copy of your PHI that is contained in the healthcare provider for the duration the healthcare provider maintains PHI about you. If you wish to inspect or obtain a copy of your PHI, please obtain a form, Request for Access to Records, from the healthcare provider and return the completed form to the healthcare provider or return to contact Tarun Patel, RPh. There may be a reasonable cost-based charge for photocopying documents. You will be notified in advance of incurring such charges, if any.
The right to amend your PHI: You have the right to request an amendment of the PHI the healthcare provider maintains about you, if you feel that the PHI the healthcare provider has maintained about you is incorrect or otherwise incomplete. Under certain circumstances we may deny your request for amendment. If we do deny the request, you will have the right to have the denial reviewed by someone we designate who was not involved in the initial review. You may also ask the Secretary, United States Department of Health and Human Services (“HHS”), or their appropriate designee, to review such a denial. If you wish to amend your PHI files, please obtain a form, Request for Amendment to PHI, from the healthcare provider and return the completed form to the healthcare provider or return to contact Tarun Patel, RPh.
The right to receive an accounting of disclosures of your PHI: [PC 16 (c)] You have the right to receive an accounting of certain disclosures of your PHI made by the healthcare provider. If you wish to receive an accounting of disclosures of your PHI, please obtain a form, Request for Accounting of Disclosures, from the healthcare provider and return the completed form to the healthcare provider or return to the contact Tarun Patel, RPh. You should be aware, however, that such an accounting excludes uses and disclosures made for treatment, payment, or health care operations purposes.
The right to receive additional copies of the Healthcare Provider’s Notice of Privacy Practices: You have the right to receive additional paper copies of this Notice, upon request, even if you initially agreed to receive the Notice electronically. If you wish to receive a paper copy of this request, please ask a healthcare provider workforce member and they will provide you with a copy.
REVISIONS TO THE NOTICE OF PRIVACY PRACTICES
The healthcare provider reserves the right to change and/or revise this Notice and make the new revised version applicable to all PHI received prior to its effective date. The revised Notice will be available, upon request, to all individuals. The healthcare provider will also post the revised version of the Notice in the healthcare provider.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with the healthcare provider and/or to the Secretary of HHS, or his/her designee. If you wish to file a complaint with the healthcare provider, please contact Tarun Patel, RPh. If you wish to file a complaint with the Secretary, please write to:
Texas Health and Human Services Commission
701 W. 51st Street,
MC W206
Austin, Texas 78751
Phone: 1-888-388-6332 or 512-438-4313
Email: HHSCivilRightsOffice@hhsc.state.tx.us
The healthcare provider will not take any adverse action against you as a result of your filing of a complaint.
CONTACT INFORMATION
If you have any questions on the healthcare provider’s privacy practices or for clarification on anything contained within the Notice, please contact: Raff and Hall Pharmacy 3404 I-27 Frontage Rd, Lubbock, TX 79404
Phone: (806) 744-8477