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.
We understand the confidential nature of the information you provide to Marc Glassman, Inc.’s Pharmacy. Marc Glassman, Inc.’s Pharmacy is required by law to maintain the privacy of protected health information and provide this Notice of its legal duties and privacy practices with respect to protected health information. Marc Glassman, Inc.’s Pharmacy is also required to notify affected individuals following a breach of unsecured protected health information. We want you to understand how Marc Glassman, Inc.’s Pharmacy may use and disclose certain information you provide us, and what rights you have concerning that information. This privacy policy will tell you:
- What information is protected;
- How Marc Glassman, Inc.’s Pharmacy may use and disclose your protected information; and
- Your rights concerning your protected information.
What Information is Protected
Information protected by this privacy policy includes information Marc’s Glassman, Inc.’s Pharmacy receives or creates that identifies you and concerns:
- Your past, present or future medical health or condition,
- Medical care that is provided to you, or
- The past, present or future payment for medical care provided to you.
How We May Use or Disclose Protected Information
Marc Glassman Inc.’s Pharmacy may use or disclose your protected information to provide you with treatment, obtain payment for your treatment, or perform health care operations. Some examples of how we may use or disclose your protected information for these reasons are:
Treatment. We may use or disclose your protected information to dispense prescription medications or devices to you, provide you with information and counseling on your drug therapy, and communicate with your physician, your physician's staff, emergency treatment personnel or other health care professionals to ensure you receive appropriate treatment.
Payment. We may use or disclose your protected information to determine the amount of your co–payment responsibility and to obtain payment for your treatment from your insurer or pharmacy benefit manager.
Health Care Operations. We may use your protected information to review the performance of our pharmacists, to prevent fraud and to develop compliance programs in order to offer more effective and comprehensive treatment to you.
Marc Glassman, Inc.’s Pharmacy may also use or disclose your protected information for other reasons. Those reasons and some examples of how we may use or disclose your protected information for those reasons are:
Communications with you. We may use your protected information to contact you. We may contact you to ensure that your prescription is working effectively, or to provide you with refill reminders or information about treatment alternatives.
Health oversight agencies. We may disclose your protected information to agencies authorized by law to perform audits, investigations or inspections for the oversight of the health care system, government benefit programs, government regulatory programs or civil rights laws.
Judicial and administrative proceedings. We may disclose your protected information in response to a court order, administrative order, subpoena, warrant, or other lawful process.
Law enforcement. We may disclose your protected information as required by law in response to requests from law enforcement.
Services. We may hire third parties to perform certain services for us. We may disclose your protected information to these third parties so that they can perform the services we requested. These third parties will be required to protect your information and will not be allowed to use your information for any purpose other than to provide the services we requested.
Friends and/or Family Members. Under limited circumstances, we may disclose your protected information to a person who, in our pharmacist’s professional judgment, is involved with your health care where we determine that the disclosure is in your best interest.
Special Circumstances. We may disclose your protected information in certain special circumstances. Such circumstances include disclosures to agencies authorized by law to collect information for national security and intelligence activities, for specialized government functions in the event you are a veteran or are in the military, for investigation of a death or identification of a deceased person, for review of product quality and safety, to avert a threat to health or safety of an individual or the public, or to comply with requirements for worker's compensation programs.
The examples given above are for illustration only. They may not be all–inclusive and Marc Glassman, Inc.’s Pharmacy may also use or disclose your protected information as otherwise required by law. Marc Glassman, Inc.’s Pharmacy will obtain your written authorization before using or disclosing your protected information whenever the law requires us to do so. You may revoke your authorization in writing at any time. Upon receipt of your written revocation, we will stop using or disclosing your protected information, except to the extent that we have already taken action in reliance on the authorization. Other uses and disclosures not described in this notice will be made only with your written authorization.
The following is a description of the types of uses and disclosures that require authorization:
Psychotherapy Notes. Marc Glassman, Inc.’s Pharmacy must obtain authorization for any use or disclosure of psychotherapy notes except to carry out the following treatment, payment or health care operations: use by the originator of the notes for treatment; use or disclosure by Marc Glassman, Inc.’s Pharmacy for its own training programs; or use by Marc Glassman, Inc.’s Pharmacy to defend itself in a legal action brought by you.
Marketing. Marc Glassman, Inc.’s Pharmacy must obtain authorization for any use or disclosure of protected health information for marketing, except if the information is in the form of face-to-face communication made by Marc Glassman, Inc.’s Pharmacy to you or a promotional gift of nominal value provided by Marc Glassman, Inc.’s Pharmacy.
Sale of Protected Health Information. Marc Glassman, Inc.’s Pharmacy must obtain authorization for any disclosure of protected health information which is a sale of protected health information as defined by law.
Your Rights
You have certain rights concerning your protected information and concerning this Notice. These rights include:
- You have the right to request a copy of the Notice at any time.
- You have the right to inspect and receive a copy of the protected information we maintain about you. To do so, contact your local Marc Glassman, Inc.’s Pharmacy. Under limited circumstances, Marc Glassman, Inc.’s Pharmacy may deny such requests and you may request that such denial be reviewed.
- If you feel that the protected information we maintain about you is incomplete or incorrect, you have the right to request that we amend it. Marc Glassman, Inc.’s Pharmacy may deny such requests and you may request that such denial be reviewed.
- You have the right to request additional restrictions on our use or disclosure of your protected information. Marc Glassman, Inc.’s Pharmacy may deny such requests (except as described below) and you may request that such denial be reviewed. Marc Glassman, Inc.’s Pharmacy may not deny requests to restrict disclosure of your protected health information to a health plan if the disclosure is for payment or health care operations and pertains to a health care item or service for which you have paid out of pocket in full.
- You have the right to receive an accounting of the disclosures Marc Glassman, Inc.’s Pharmacy has made of your protected information. The accounting will not include disclosures made for treatment, payment or health care operations, disclosures made directly to you, your friends or family members involved in your care, or other disclosures authorized by you. The right to receive an accounting of disclosures is subject to certain other exceptions, restrictions, and limitations.
- You have the right to request that we contact you about your protected information by alternate means or at alternate locations (e.g., cellular telephone instead of home telephone). Marc Glassman, Inc.’s Pharmacy will attempt to accommodate all reasonable requests.
- You may request that we contact you about your protected information only in writing. We will accommodate reasonable requests. To make a request, you must submit your request in writing to your local Marc Glassman, Inc.’s Pharmacy. We may charge you a fee for the costs of copying and mailing your protected information.
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