Notice of Privacy Practices at A.S.A.P. PHARMACY

To our patients. This notice describes how health information about you, as a patient of this pharmacy, may be used and disclosed, and how you can get access to your health information. This is required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of1996 (HIPAA).

Our commitment to your privacy

Our pharmacy is dedicated to maintaining the privacy of your health information. We are required to maintain the confidentiality of your health information. We realize that these laws are complicated, but we must provide you with the following important information:  A.S.A.P. PHARMACY generally is required to obtain your written authorization before using your protected health information. This section explains those situations where, under federal law, A.S.A.P. PHARMACY may use or disclose your protected health information without your permission.

1. Treatment: We use and disclose your protected health information to provide health care services to you. This includes uses and disclosures

to: treat your illness or injury, or contact you to provide appointment or refill reminders, or give you information about treatment alternatives or other health related benefits and services that may interest you.

2. Payment:  We may use and disclose your protected health information to obtain payment for health care services that we or others provide.

This  includes uses and disclosures to: Submit and obtain payment from you health insurer, HMO, or other company that pays 

the cost of some or all of your health care (payor), or verify that your payor will pay for you health care.

3. Health Care Operations: We may use and disclose your protected health information for our health care operations, such as internal administration and planning that improve the quality and cost effectiveness of the care that we provide you. This also includes uses and disclosures to: evaluate the quality and competence of our health care providers, train students, residents, and fellows, or identify health related services and products that may be beneficial to your health and then contact you about the services and products.

We may also disclose your protected health information to third parties to assist us in these activities, but only if they agree in writing to maintain the confidentiality of your health information. We may also disclose your protected health information to your other health care providers, to enable them to conduct their own quality reviews, compliance activities and other health care operations.

Use and disclosure of your health information in certain special circumstances

The following circumstances may require us to use or disclose your health information:

1.       Under appropriate circumstances, including emergencies, we may disclose your protected health information to relatives, caregivers or personal including emergencies representatives who are with you or appear on your behalf (for example, to pick up a prescription). We may also need to notify such persons of your location in our facility and general conditions. If you object to such disclosures, please notify A.S.A.P. PHARMACY.

2.     To public health authorities and health oversight agencies that are authorized by law to collect information.

3.     Lawsuits and similar proceedings in response to a court or administrative order, or if required to do so by a law enforcement official.

4.     We may also disclose your protected health information to third parties to assist us in these activities, but only if they agree in writing to maintain the confidentiality of your health information. We may also disclose your protected health information to your other health care providers, to enable them to conduct their own quality reviews, compliance activities and other health care operations.

5.     When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. We will only make disclosures to a person or organization able to help prevent the threat.

6.      If you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate

authorities.

7.     To federal officials for intelligence and national security activities authorized by law.

8.     To correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official.

9.     For Workers Compensation and similar programs and similar programs.

Your rights regarding your health information:

1. Communications. You can request that our pharmacy communicate with you about your health and related issues in a particular

manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. We will accommodate  

          reasonable requests.

2.    We may disclose your protected health information for the following public health activities:

         To report to public health authorities for the purpose of preventing or controlling disease, injury or disability;

         To report information to the U.S. Food and Drug Administration (FDA) about products and services under its jurisdiction; or

         To alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease;

3.  You can request a restriction in our use or disclosure of your health information for treatment, payment, or health care operations.  Additionally, you have the right to request that we restrict our disclosure of your health information to only certain individuals involved in  your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.

4. You have the right to inspect and obtain a copy of the health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to 367 N. Chevy Chase Drive Unit B. Glendale,  CA 91206. If you request copies, we will charge you a reasonable fee for copies. We also will charge you for our postage costs, if you request that we mail the copies to you. If you are a parent or legal guardian of a minor, certain portions of the minor's medical record may not be accessible to you under California law. The period of your request cannot exceed six years and does not apply to disclosures that occurred prior to April 14, 2003. If you request an accounting more than once during a twelve (12) month period, we will charge you a reasonable fee.

5. You may ask us to amend your health information if you believe it is incorrect or incomplete, and as long as the information is kept by or for our pharmacy. To request an amendment, your request must be made in writing and submitted to 367 N. Chevy Chase Drive Unit B. Glendale, CA 91206. You must provide us with a reason that supports your request for amendment.

6.   Right to a copy of this notice. You are entitled to receive a copy of this Notice of Privacy Practices. You may ask us to give you a copy of this Notice at any . To obtain a copy of this notice, contact 367 N. Chevy Chase Drive Unit B Glendale, CA 91206. Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with our pharmacy or with the Secretary of the Department of Health and Human Services. To file a complaint with our pharmacy, contact 367 N. Chevy Chase Drive Unit B, Glendale, CA 91206. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

7.  If we reasonably believe that you are a victim of abuse, neglect or domestic violence, we may disclose your protected health information as required by law to social services or other governmental agency authorized by law to receive such reports.

8.  Right to provide an authorization for other uses and disclosures. Our pharmacy will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.

9.  We may disclose your protected health information to a health oversight agency that is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid (for example, for fraud and abuse investigations).

This notice is effective as of January 3, 2005