We will not disclose any HIV-related information to anyone but you, except in situations where the subject of the information has provided us with a written consent to disclose the information or where we are authorized or required by state or federal law to make the disclosure
When a parent or legal guardian has consented to treatment of a minor fourteen (14) years of age or older, the parent or legal guardian may consent to release of the minor's medical records and information to the minor's current mental health treatment provider. Under some circumstances and to the extent that we maintain such information, we may also release information related to mental health treatment for which a minor has provided consent, if it is deemed pertinent and requested or authorized for disclosure by the minor's current mental health provider. Otherwise, the minor shall control the release of the minor's mental health treatment records and information to the extent allowed by law
Disclosure - Pharmacist-Specific
We will only disclose your prescription information to our agents, agents of other properly licensed pharmacies, and persons directly involved in your care, to the extent such disclosure is consistent with state and federal laws, and to researchers to the extent consistent with federal policy for the protection of human subjects.
Disclosure - Health Care Providers Generally
We will not disclose your confidential health care information without your written consent, except in the following situations:
(a) to a physician, dentist, or other medical personnel who believe in good faith that the information is necessary to diagnose or treat you in a medical or dental emergency;
(b) to qualified personnel for the purpose of conducting scientific research, management audits, financial audits, program evaluations, actuarial, insurance underwriting, or similar studies, provided that personnel does not identify, directly or indirectly, you in any report of that research, audit, or evaluation, or otherwise disclose your identity in any manner;
(c) to appropriate law enforcement personnel, or to a person if the pharmacist believes that you may pose a danger to that person or his or her family; or to appropriate law enforcement personnel if you have attempted or are attempting to obtain narcotic drugs from the pharmacy illegally; or to appropriate law enforcement personnel or appropriate child protective agencies if you are a minor child who the pharmacist believes, after providing services to you, to have been physically or psychologically abused;
(d) between or among qualified personnel and health care providers within the health care system for purposes of coordination of health care services given to you and for purposes of education and training within the same health care facility;
(e) to third party health insurers, third party administrators and other entities that provide operational support to such entities for the purpose of adjudicating health insurance claims or administering health benefits, including to utilization review agents;
(f) to a malpractice insurance carrier or lawyer if we have reason to anticipate a medical liability action or if you initiate a medical liability action against our pharmacy;
(g) to public health authorities in order to carry out their designated functions. These functions include, but are not restricted to, investigations into the causes of disease, the control of public health hazards, enforcement of sanitary laws, investigation of reportable diseases, certification and licensure of health professionals and facilities, and review of health care such as that required by the federal government and other governmental agencies;
(h) to the state medical examiner in the event of a fatality that comes under his or her jurisdiction;
(i) in relation to information that is directly related to a current claim for workers' compensation benefits or to any proceeding before the workers' compensation commission or before any court proceeding relating to workers' compensation;
(j) to our attorneys whenever we consider the release of information to be necessary in order to receive adequate legal representation;
(k) to provide appropriate school authorities with disease, health screening and/or immunization information required by the school; or when a school age child transfers from one school or school district to another school or school district;
(l) to a law enforcement authority to protect the legal interest of an insurance institution, agent, or insurance-support organization in preventing and prosecuting the perpetration of fraud upon them;
(m) to a grand jury or to a court of competent jurisdiction pursuant to a subpoena or subpoena duces tecum when that information is required for the investigation or prosecution of criminal wrongdoing by a health care provider relating to his or her or its provisions of health care services and that information is unavailable from any other source; provided, that any information so obtained is not admissible in any criminal proceeding against you;
(n) to the state board of elections pursuant to a subpoena or subpoena duces tecum when the information is required to determine your eligibility to vote by mail ballot and/or the legitimacy of a certification by a physician attesting to a voter's illness or disability;
(o) to certify the nature and permanency of your illness or disability, the date when you were last examined and that it would be an undue hardship for you to vote at the polls so that you may obtain a mail ballot;
(p) to the Medicaid fraud control unit of the attorney general's office for the investigation or prosecution of criminal or civil wrongdoing by a health care provider relating to his or her or its provision of health care services to then Medicaid eligible recipients or patients, residents, or former patients or residents of long term residential care facilities; provided, that any information obtained is not admissible in any criminal proceeding against you;
(q) to the state department of children, youth, and families pertaining to the disclosure of health care records of children in the custody of the department;
(r) to the foster parent or parents pertaining to the disclosure of health care records of children in the custody of the foster parent or parents; provided, that the foster parent or parents receive appropriate training and have ongoing availability of supervisory assistance in the use of sensitive information that may be the source of distress to these children; or
(s) to the workers' compensation fraud prevention unit for purposes of investigation.
Except as specifically provided above or by federal law, we will not give, sell, transfer, or relay your confidential health care information to any other person not specified in a written consent form or notice that meets state law requirements without obtaining your additional written consent on a form stating the need for the proposed new use of this information or the need for its transfer to another person.
Disclosure-Prescription Information Privacy Act
We will not disclose your prescription drug information without first obtaining your written consent, except in the following circumstances:
(a) the lawful transmission of a prescription drug order in accordance with state and federal laws pertaining to the practice of pharmacy;
(b) communications among licensed practitioners, pharmacists and other health care professionals who are providing or have provided services to you;
(c) information gained as a result of a person requesting informational material from a prescription drug or device manufacturer or vendor;
(d) information necessary to effect the recall of a defective drug or device or protect the health and welfare of an individual or the public;
(e) information whereby the release is mandated by other state or federal laws, court order, or subpoena or regulations (e.g., accreditation or licensure requirements);
(f) information necessary to adjudicate or process payment claims for health care, if the recipient makes no further use or disclosure of the information;
(g) information voluntarily disclosed by you to entities outside of the provider-patient relationship;
(h) information used in clinical research monitored by an institutional review board, with your written authorization;
(i) information which does not identify you by name, or that is encoded so that identifying you by name or address is generally not possible, and that is used for epidemiological studies, research, statistical analysis, medical outcomes, or pharmacoeconomic research;
(j) information transferred in connection with the sale of a business to a successor in interest;
(k) information necessary to disclose to third parties in order to perform quality assurance programs, medical records review, internal audits or similar programs, if the third party makes no other use or disclosure of the information;
(l) information that may be revealed to a party who obtains a dispensed prescription on your behalf; or
(m) information necessary in order for a health plan licensed by the South Carolina Department of Insurance to perform case management, utilization management, and disease management for individuals enrolled in the health plan, if the third party makes no other use or disclosure of the information.
Disclosure - Pharmacist-Specific
We will not disclose information maintained in your patient records or information communicated to you as part of patient counseling, to anyone other than you, to those practitioners and pharmacists where, in the pharmacist's professional judgment, release is necessary to protect the your health and well-being, and to other persons or governmental agencies authorized by law to receive such confidential information. Additionally, we will not disclose your information or the nature of professional pharmacy services rendered to you, without your express consent or the order or direction of a court, except to:
(n) you, or your agent, or another pharmacist acting on your behalf;
(o) the practitioner who issued the prescription drug order;
(p) certified/licensed health care personnel who are responsible for your care;
(q) an inspector, agent or investigator from the Board of Pharmacy or any federal, state, county, or municipal officer whose duty is to enforce the laws of South Carolina or the United States relating to drugs or devices and who is engaged in a specific investigation involving a designated person or drug; and
(r) a government agency charged with the responsibility of providing medical care for you upon written request by an authorized representative of the agency requesting the information.
Without your express written consent or a written order or direction of a court, we will not divulge or reveal the following information to anyone but you, your authorized representative, the prescriber of your drug, another licensed practitioner caring for you, or another licensed pharmacist or other person authorized by law to receive such information:
(1) the contents of any prescription drug order or medication, the therapeutic effect thereof, or the nature of professional pharmaceutical services rendered to you;
(2) the nature, extent, or degree of your illness; or
(3) any medical information furnished by your prescriber.
We will only release your patient information under the following circumstances:
(1) with your authorization;
(2) if the board of pharmacy requests it as part of an inspection or investigation of a pharmacy or pharmacist;
(3) if, in the pharmacist's professional judgment, releasing your patient information to practitioners and other pharmacists is necessary to protect the your health and well-being; and
(4) if other persons are authorized or required by law to obtain access to patient information.
For Participants in State Medical Assistance Programs:
We will only use your Protected Health Information for purposes directly related to the administration of the South Dakota medical assistance program. We will not disclose your Protected Health Information without your authorization.
Disclosure - Health Care Provider
We will not disclose your name and address or other identifying information, except to:
(a) a health or government authority pursuant to any reporting required by law;
(b) an interested third-party payor or its designee for the purpose of utilization review, case management, peer reviews, or other administrative functions; or
(c) another health care provider from whom you receive or seek care; or
(d) in response to a request by the office of inspector general or the medicaid control fraud unit with respect to an ongoing investigation or to a subpoena issued by a court of competent jurisdiction.
Disclosure - Pharmacist-Specific
We will obtain your authorization before we disclose your patient records for any reason, except where:
(e) the disclosure is in your best interest;
(f) the law requires the disclosure; or
(g) the disclosure is to an authorized prescriber or to communicate a prescription order where necessary to:
(1) carry out prospective drug use review as required by law;
(2) assist prescribers in obtaining a comprehensive drug history on you;
(3) prevent abuse or misuse of a drug or device and the diversion of controlled substances;
(4) provide a medication therapy management program or quality assurance program.
Sale of Information
We will not sell your name and address or other identifying information for any purpose.
Disclosures - Generally
We will not electronically disclose your protected health information to any person without a separate written or electronic authorization from you or your legally authorized representative for each disclosure, except when we make disclosures to:
(a) another covered entity, as that term is defined under Texas state law, for the purpose of treatment, payment, healthcare operations;
(b) to perform an insurance or health maintenance organization function as defined in the Texas insurance laws;
(c) or as otherwise authorized or required by federal or state law.
Disclosures - Pharmacist Specific
We will only release your patient medication records, prescription drug orders, medication orders or other health-related records containing your information that is maintained by us to the following individuals and entities:
(a) you or to your agent;
(b) a practitioner or another pharmacist if, in the pharmacist's professional judgment, the release is necessary to protect your health and well-being;
(c) the Texas State Board of Pharmacy or another state or federal agency authorized by law to receive the record;
(d) a law enforcement agency engaged in investigation of a suspected violation of the Texas controlled substances laws, or the Comprehensive Drug Abuse Prevent Control Act of 1970;
(e) a person employed by a state agency that licenses a practitioner, if the person is performing the person's official duties; or
(f) an insurance carrier or other third party payor authorized by the patient to receive the information.
Sale of Protected Health Information
We will not disclose your protected health information to any other person in exchange for direct or indirect remuneration, except for treatment, payment, health care operations, in the performance of an insurance or health maintenance organization functions allowed under the insurance laws, and as otherwise authorized under state law. If we disclose it in the performance of an insurance or health maintenance organization function authorized by state law, the remuneration will not exceed our reasonable costs of preparing or transmitting your protected health information for such disclosure.
We will obtain your clear and unambiguous permission in written or electronic form to use or disclose protected health information for any of our marketing communications, except if the communication is in the following forms:
(a) a face-to-face communication made directly to you;
(b) a promotional gift of nominal value;
(c) necessary for administration of a patient assistance program or other prescription drug savings or discount program; or
(d) made at your oral request.
We will not discuss information in your prescription or medication profile with release such information to anyone except:
(a) you or your legal guardian or designee;
(b) a lawfully authorized federal, state, or local drug enforcement officer;
(c) a third party payment program authorized by you;
(d) another pharmacist, pharmacy intern, pharmacy technician, or prescribing practitioner providing services to you or to whom you have requested us to transfer a prescription;
(e) your attorney, if we receive a written authorization signed by:
(1) you before a notary public;
(2) your parent or lawful guardian, if you are a minor;
(3) your lawful guardian, if you are incompetent; or
(4) your personal representative, in the case of deceased patients.
State law requires the pharmacy to disclose your health care information for the following purposes:
(a) to federal, state, or local health care authorities, to the extent the pharmacist is required by law to report health care information;
(b) when needed to determine compliance with state or federal licensure, certification or registration rules or laws;
(c) to investigate unprofessional conduct or ability to practice a health profession with reasonable skill and safety;
(d) when needed to protect the public health; or
(e) pursuant to compulsory process or discovery notices that meet state law requirements.
In the event we disclose your health care information without your written authorization, we will limit the disclosed information to the extent needed by the following recipients:
(a) to a person who the pharmacist reasonably believes is providing health care to you;
(b) to a person who the pharmacist reasonably believes previously provided health care to you to provide for additional health care, unless you have instructed the pharmacist or pharmacy in writing not to the make the disclosure;
(c) to any other person who requires health care information for health care education, or to provide planning, quality assurance, peer review, or administrative, legal, financial, or actuarial services to the pharmacy; or for assisting the pharmacy in the delivery of health care and the pharmacist reasonably believes that the person will not use or disclose the health care information for any other purpose and will take appropriate steps to protect the health care information;
(d) to any person if the pharmacist reasonably believes that disclosure will avoid or minimize an imminent danger to your or another individual's health or safety; however, there is no obligation on the part of the pharmacist to so disclose;
(e) to an official of a penal or other custodial institution in which you are detained;
(f) for payment, including information necessary for a recipient to make a claim, or for a claim to be made on behalf of a recipient for aid, insurance or medical assistance; or
(g) for use in a research project where an institutional review board has determined that such disclosure meets statutory requirements regarding the necessity of the information to the research project's aims and safeguards used to protect the information from being used to identify you or from being subsequently disclosed to other parties.
(b) We may also provide health care information (excluding information related to sexually transmitted diseases and mental health services) to the following parties without your authorization:
(h) to your immediate family members, including a state-registered domestic partner or other individual with whom the patient is known to have a close personal relationship, unless you have instructed the pharmacist or pharmacy in writing not to make the disclosure;
(i) to a health care provider who is the successor in interest to the pharmacy maintaining the information;
(j) to a person who obtains information for purposes of an audit, if that person agrees in writing to remove or destroy, at the earliest opportunity consistent with the purpose of the audit, information that would enable you to be identified and not to disclose the information further, except to accomplish the audit or report unlawful or improper conduct involving fraud in payment for health care by a health care provider or patient, or other unlawful conduct by the pharmacy;
(k) to provide directory information, unless you have instructed the pharmacy not to make the disclosure;
(l) to federal, state, or local law enforcement authorities and the health care provider, health care facility, or third-party payor if any of these parties believes in good faith that the health care information disclosed constitutes evidence of criminal conduct that occurred on the premises of the health care provider, health care facility, or third-party payor or third-party payor;
(m) to another health care provider, health care facility, or third-party payor, provided that the information relates to the relationship that the provider, facility, or payor has or had with you regarding your care and the disclosure is for health care operations functions defined in state law;
(n) to county coroners an medical examiners for death investigations; or
(o) to procurement organizations or person to whom your body part passes for purposes of examination necessary to assure the medical suitability of the body part; or to a person subject to the jurisdiction of the U.S. Food and Drug Administration in regards to a product it regulates or activity for which the agency has responsibilities regarding the activity's quality, safety, or effectiveness.
Sexually Transmitted Diseases
We will not disclose any information or records related to sexually transmitted diseases, for reasons other than those permitted by state law without your patient authorization. Additionally, as provided under the law, we will limit the information disclosed to the extent necessary for the permitted recipients' use(s) of that information allowed under the law.
Mental Health Services
We will not disclose mental health records as they relate to the your admission to a provider of mental health services and all information and records complied, obtained or maintained in the course of providing such services except to the extent provided by law.
We will not disclose confidential information relating to an individual who is obtaining or has obtained treatment for a mental illness, without the individual's written consent, except in the following circumstances:
(a) with the signed, written consent of the individual or the individuals legal guardian;
(b) in certain proceedings involving involuntary examinations;
(c) pursuant to a court order in which the court found the relevance of the information to outweigh the importance of maintaining the confidentiality of the information;
(d) to provide notice to the federal National Instant Criminal Background Check System;
(e) to protect against clear and substantial danger of imminent injury by the individual to himself, herself, or another; or
(f) to staff of the mental health facility where the individual is being cared for or to other health professionals involved in treatment of the individual, for treatment or internal review purposes.
Under HIPAA, we are permitted to disclose confidential information without your consent, for thirty days from the date of your admission to a mental health facility if we make a good faith effort to obtain consent from you or your legal representative prior to disclosure, only provide the minimum information necessary is released for a specifically stated purpose; and promptly notify you or your legal representative of the disclosure, its purpose, and to whom the information was disclosed.
We are not required to disclose confidential information relating to receipt of diagnoses, treatment, or provision of birth control, prenatal care, drug rehabilitation and related services or venereal disease-related health care services provided to a minor to his or her parent or guardian without the minor's written consent.
We will not disclose your confidential health care information to anyone but you without your informed consent, except in the following situations
(a) to heath care facility staff committees, or accreditation or heath care services review organizations for the purposes of conducting management audits, financial audits, program monitoring and evaluation, and health care service review or accreditation.
(b) to a health care provider or any person acting under the supervision of a health care provider or to licensed emergency personnel, and only to the extent that performance of their duties requires access to the records, if the person (i) is rendering assistance to the patient, (ii) is being consulted regarding the health of the patient, (iii) the life or health of the patient appears to be in danger and the information contained in the patient health care records may aid the person in rendering assistance, or (iv) the person prepares or stores records for the purposes of the preparation or storage of those records.
(c) to the extent that the records are needed for billing, collection or payment of claims.
(d) under a lawful order of a court of record.
Unless we have received an authorization from you, we will only disclose your information maintained in our records or communicated to you as part of patient counseling to:
(a) you, or as you direct, to those practitioners and other pharmacists where, in the pharmacist's professional judgment such release is necessary for treatment or to protect your health and well-being;
(b) to other licensed professionals treating you; and
(c) to such other persons or governmental agencies authorized by law to investigate controlled substance law violations.
This addendum is effective on June 2, 2016.