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NOTICE OF PRIVACY PRACTICES

04/01/2024

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.

Introduction

As part of the Federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, University Pharmacy has created this Notice of Privacy Practices (Notice). This describes University Pharmacy’s privacy practices and the rights you, the individual have as they relate to your past and present physical and mental health care services. The HIPAA regulations require that University Pharmacy protect the privacy of your PHI that the Facility has received or created.

University Pharmacy will abide by the terms presented within this Notice. For any uses or disclosures that are not listed below (including marketing and selling of PHI), University Pharmacy 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. University Pharmacy reserves the right to change our privacy practices this Notice.

HOW WE MAY USE AND DISCLOSE YOUR PHI

The following is an accounting of the ways that University Pharmacy is permitted, by law, to use and disclose your PHI.

Uses and disclosures of PHI for Treatment: We will use the PHI that we receive from you to fill your prescription and coordinate or manage your health care.

Uses and disclosures of PHI for Payment: University Pharmacy will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.

Uses and disclosures of PHI for Health Care Operations: University Pharmacy may use the minimum necessary amount of your PHI to conduct quality assessments, improvement activities, and evaluate our workforce.

The following is an accounting of additional ways in which University Pharmacy is permitted or required to use or disclose PHI about you without your written authorization.

Uses and disclosures as required by law: University Pharmacy is required to use or disclose PHI about you as required and as limited by law.

Uses and disclosure for Public Health Activities: University Pharmacy 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: University Pharmacy 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: University Pharmacy 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 to individuals involved in your care: University Pharmacy may disclose PHI about you to individuals involved in your care.

Disclosures for judicial and administrative proceedings: University Pharmacy may disclose PHI about you in the course of any judicial or administrative proceedings, provided that proper documentation is presented to the pharmacy.

Disclosures for law enforcement purposes: University Pharmacy 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: University Pharmacy 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 research purposes: University Pharmacy 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, our pharmacy 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: University Pharmacy 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 advert a serious threat to health or safety.

Uses and disclosures for specialized government functions: University Pharmacy 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: University Pharmacy 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: University Pharmacy may disclose PHI about you as authorized by law to a public or private entity to assist in disaster relief efforts and for family and personal representative notification.

Disclosures to business associates: University Pharmacy may disclose PHI about you to pharmacy business associates for services that they may provide to or for our pharmacy to assist us in providing 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

University Pharmacy may contact you for the following purposes:

Information about treatment alternatives: University Pharmacy may contact you to notify you of alternative treatments and/or products. Health related benefits or services: University Pharmacy may use your PHI to notify you of benefits and services that we provide.

YOUR HEALTH INFORMATION RIGHTS

The following are a list of your rights in respect to your PHI. Please contact Richard Rasmuson for more information about the below.

Request restrictions on certain uses and disclosures of your PHI: You have the right to request additional restrictions of University Pharmacy’s uses and disclosures of your PHI; however, the pharmacy is not required to accommodate a request. This includes the right to restrict disclosures to Insurances for those products and services you pay out-of-pocket for.

The right to have your PHI communicated to you by alternate means or locations: You have the right to request that University Pharmacy communicate confidentially with you using an address or phone number other than your residence. However, state and federal laws require University Pharmacy to have an accurate address and home phone number in case of emergencies. The pharmacy will consider all reasonable requests.

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 University Pharmacy for the duration the pharmacy maintains PHI about you. 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 University Pharmacy maintains about you, if you feel that the PHI the pharmacy 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.

The right to receive an accounting of disclosures of your PHI: You have the right to receive an accounting of certain disclosures of your PHI made by University Pharmacy.

The right to receive an accounting of disclosures of your PHI: You have the right to receive an accounting of certain disclosures of your PHI made by University Pharmacy.

The right to receive additional copies of the Facility’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.

Notification of Breaches: You will be notified of any breaches that have compromised the privacy of your PHI.

REVISIONS TO THE NOTICE OF PRIVACY PRACTICES

University Pharmacy 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. University Pharmacy will also post the revised version of the Notice in the Facility.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the pharmacy and/or to the Secretary of HHS, or his designee. If you wish to file a complaint with University Pharmacy, please contact Richard Rasmuson. If you wish to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200
Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting:

https://www.hhs.gov/hipaa/filing-a-complaint/what-to-expect/index.html

University Pharmacy will not take any adverse action against you as a result of your filling of a complaint.

CONTACT INFORMATION

If you have any questions on University Pharmacy’s privacy practices or for clarification on anything contained within the Notice, please contact:

University Pharmacy

Richard Rasmuson

1320 E 200 S

Salt Lake City, UT 84102

(801) 582-7624

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