Pharmacy Notice of Privacy Practices
WE ARE NOT A PHARMACY HOWEVER, WE TAKE YOUR PRIVACY SERIOUSLY !!!
PLEASE take the time to read carefully and complete electronic signature at end of page.
You will be unable to schedule an appointment with the Physician nor complete any transactions unless you have electronically signed the HIPPA form after reading.
We will use and disclose your PHI to carry out the healthcare related activities as necessary or required, and especially to monitor and improve the quality of the health care, products, and services that are provided to you by us and other health care professionals.
In addition to treatment, payment and health care operations as described above, we may use and disclose your PHI for the following purposes:
Business associates: The health care system is very complex and as such we may not be able to provide health care products and services to you without the involvement of other businesses or persons. Depending on what these other businesses or persons do for us, they may become “business associates” as defined by HIPAA. In many situations it will be necessary for us to provide your PHI to these business associates so that they can carry out the activities that we need to have performed in order to provide you health care products and services. For patients that have health insurance that includes a pharmacy benefit, one of our most common business associates is a health insurance company, your Primary Care Physician, or a insurance benefits company that processes claims we may submit for payment for health care products and services on your behalf. We have written contracts with all of our business associates to whom we provide your PHI so that they can carry out their activities on our behalf. In an effort to provide you a level of comfort, you should know, these contracts require our business associates to give us their assurance that they, like us, will protect the privacy of your PHI.
Communications with you concerning your health and treatment: We want to do whatever we can to assist you with maintaining your health and obtaining the most benefit from your treatment. We routinely monitor your health care internally with the Medical Director at Anti-Aging Medical HGH Institute, your Primary Care Provider, prescription medications for appropriateness and take other steps to help you use your medication properly and make healthy life style changes. For example, if you forget to obtain a refill of your medication, we may contact you to remind you to obtain the refill. We may also call you or send you materials regarding products and services that we believe may be of benefit to you and your health. In the event that a pharmaceutical manufacturer or the Food and Drug Administration (FDA) is to issue a medication recall, we may contact you if you are taking the medication subject to the recall.
Federal and state government agencies: We may disclose your PHI to federal and state government agencies for a variety of purposes, most of which are directed at monitoring health care quality and safety, government programs related to health care and our compliance with laws applicable to health care. For example, the United State Drug Enforcement Administration (DEA) monitors the distribution and use of controlled substances, while the FDA monitors adverse drug events. We may disclose your PHI to such agencies where required by the agency so that the agency can carry out its required activities. Related to this, some private businesses, such as the manufacturers of medications and medical devices, are legally required to conduct post marketing surveillance in order to ensure the safety of their products. Disclosing your PHI for such surveillance may be necessary. A number of state agencies also conduct health care quality and safety activities, for which we may disclose your PHI. For example, some states maintain a controlled substance monitoring program and require that we report to the state the prescriptions for controlled substances that we dispense to you.
Federal and state government health care insurance programs: If you apply for and receive benefits from federal and state health care programs, such as Medicare or Medicaid, your PHI may be disclosed to the agency granting these benefits. If you are employed by a business that is required to carry workers’ compensation insurance, and you are injured in such a way that the workers’ compensation plan covers your health care, it may be necessary to disclose you PHI to the workers’ compensation plan. Such plans have a right to conduct audits, inspections and investigations of our activities and your activities, and where required, we will disclose your PHI for these activities.
Public health and safety: There are several federal and state laws that require health care providers to report to various government agencies matters related to public health. If your physical or mental health condition and illness is of a nature that requires that it be reported, then we will disclose your PHI to the appropriate government agency in order to comply with these laws. In addition to reporting about physical and mental health conditions and illnesses, we may also disclose your PHI to government agencies in other situations where we are required to submit reports, such as suspected domestic, child or elder abuse or neglect.
Law enforcement activities: A number of federal, state and local government agencies are charged with enforcing the health care and drug laws, and other laws in relations to the health care products and services that we may provide to you. In addition, as a state licensed pharmacy, a variety of federal, state and local health care agencies, such as the state board of pharmacy, regulate our activities. These agencies may engage in a number of activities designed to monitor and improve federal and state health care programs and systems, including conducting of inspections and investigations of our activities and the health care products and services that we provide to our patients. At any time we are required by federal or state laws, or by court order, subpoena of other legal mandate, to disclose your PHI we will do so as necessary.
Legal disputes: Lawsuits and other legal disputes are common today, and depending on the issues, may involve your PHI that we possess. In the event that you are involved in a lawsuit or other legal proceeding, whether as a plaintiff or a defendant, and without regard to the basis for the lawsuit, such as medical malpractice or divorce, we will disclose your PHI when required to comply with a court order, subpoena, discovery proceeding, such as a deposition, or other legal mandate served upon us. We will attempt to notify you prior to the disclosure if you are not the party to the legal dispute requesting your PHI so that you and your attorney can determine whether you want to take legal actions to prevent disclosure of your PHI.
Disclosures for the benefit of you and others: Events can occur where we would use and disclosure your PHI for your benefit and to prevent or reduce the risk of harm to you. For example, if you are in a car accident and are unconscious in a hospital emergency room and the emergency room medical staff calls us with a request for your PHI, we may disclose it for the purpose of assisting in your prompt medical treatment. The same is true if a family member, friend or caregiver contacts us in an emergency situation, or where an emergency situation is not present, but we have reason to believe you are at risk of harm or serious injury and we believe that disclosing your PHI will assist them in caring for you. We may also disclose your PHI upon your death to a funeral director, embalmer, medical examiner or coroner’s office to assist them in carrying out their legal responsibilities related to your death. Finally, we may disclose your PHI where necessary to protect the health and safety of others.
Disclosures for national security and intelligence: We are legally required to disclose your PHI when necessary to national security and intelligence and counter-intelligence activities. Any disclosure for these purposes would be made only to authorized government officials.
Disclosures if you are in the military or a veteran: We may disclose your PHI, if you are a member of any branch of the armed services, whether on active or reserve status. If you are a veteran, we may release your PHI. Particularly if you are receiving health care products and services from the Veterans Services. Any disclosure for these purposes would be made only to authorized government officials.
Disclosures of a miscellaneous nature: We may be required to disclose your PHI if you are placed into custody of a federal or state correctional system if necessary to protect the health and safety of you and others. Health care is an area where much research is being conducted, and we may disclose your PHI for purposes of a research project, but only if we are satisfied that the research project has been approved by a responsible institutional review board and the research project has established adequate methods to protect your privacy. Much health care research is sponsored through organizations that conduct fundraising activities, and we may inquire with you using your PHI to determine your interest in participating in or otherwise supporting a fundraising activity. Finally, given the national need for organ donations, we may, with your written permission disclose your PHI to organizations that manage organ transplantation programs.
If you have any questions about any of the uses and disclosures of your PHI as described above, Please contact our Privacy Officer at the address or telephone number listed at the beginning of this document.
Uses and Disclosures not Contained in this Notice
If a use and disclosure of your PHI is not contained in this Notice, we will obtain your written authorization before the use and disclosure. You may have the right to refuse to authorize the use and disclosure, or if you grant the authorization, to revoke the authorization at any time. If such authorization is requested, we will provide you with a form that describes the proposed use and disclosure and your rights related to the requested authorization.
HIPAA requires that we give you this “Notice of Privacy Practices” and make a good faith effort to obtain your written acknowledgement that you were given this notice. Upon giving you this Notice, you will be asked to sign a document acknowledging that you received this notice. We appreciate your cooperation in reviewing this notice and in giving us your written acknowledgment.
HIPAA also requires that this Notice, at a minimum, cover the following three areas.
– How we will use and disclose your personally identifiable health information.
– Your rights with respect to your personally identifiable health information.
– Our legal duties to protect the confidentiality of your personally identifiable health information.
In preparing this Notice, we made every effort to comply with this HIPAA requirement. Also, you should be aware that the Federal regulation HIPAA does not take precedence over State Law when the State Law is more strict. You may have additional protections under State Law.
Please consult our Privacy Officer if you have any questions or want more information concerning your health care and privacy rights under HIPAA or the laws of our state, or our privacy practices. Also, you should consult our Privacy Officer if you wish to file a complaint about our privacy practices or if you believe we have violated any of your rights as described in this Notice.
Thank you for allowing us the privilege of being your Anti-aging / Longevity choice, we look forward to providing you with high quality health care assessments, information, and products and services that will help to keep you healthy.
MORE HIPAA INFORMATION
The protection of your private information is very important to us. We will continue to make every effort to ensure your personal health information is protected. The Health Insurance Portability and Accountability Act (HIPAA) created national standards to further ensure this protection. As of April 14, 2003, all accredited retail pharmacies are required to provide you with this Notice of Privacy Policies.
Effective Date: December 03, 2005
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 May Use or Disclose Your PHI
We protect the privacy of your health information. For some activities, we must have your written authorization to use or disclose your PHI. However, the law permits us to use or disclose your health information for the following purposes without your authorization:
• For Treatment We may use your PHI to treat you. For example, if you are being treated for an injury, we may share your PHI with your primary physician so they can provide proper care. We may also use it to send you information about products or new services that we offer that may be of interest to you.
• For Payment We may use and disclose your PHI to collect payment for products and services. For example, we may contact your third party payer (i.e. insurer) to determine whether your program will pay for your MD Visit / Consultation.
For Health Care Operations We will use and disclose PHI to carry out health care operations. These activities include, but are not limited to, quality assessment activities, investigations, licensing, and conducting or arranging for other health care related activities. For example, we may use your information to monitor the performance of Physicians providing treatment to you. This information will be used in an effort to continually improve the quality and effectiveness of health care services we provide to our customers.
• As Required by Law We will disclose your PHI when required to do so by local, state or federal law, including workers’ compensation laws.
• Public Health and Safety Risks We may use and disclose your PHI to an authorized public health authority or individual to (1) protect public health and safety; (2) prevent or control disease, injury, or disability; (3) report vital statistics such as births or deaths; (4) investigate or track problems with prescription drugs, foods, supplements and other health products; (5) post marketing surveillance to enable product recalls, repairs or replacements; and (6) to government entities authorized to receive reports regarding abuse, neglect, or domestic violence.
• Oversight Agencies We may use and disclose your PHI to health oversight agencies for certain activities such as audits, investigations, inspections, and licensures.
• Legal Proceedings We may disclose your PHI in the course of any legal proceeding in response to an order of a court or administrative agency and, in certain cases, in response to a subpoena, discovery request, or other lawful process.
• Law Enforcement To law enforcement officials in limited circumstances for law enforcement purposes. For example, disclosures may be made to identify or locate a suspect, witness, or missing person; to report a crime; or to provide information concerning victims of crimes.
• Military Activity and National Security To the military as required by military command authorities when the patient is a member of the armed forces; to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law; and to authorized federal officials so they may provide protection to the president, other authorized persons, or foreign heads of state or conduct special investigations.
• We may share your protected health information with our business associates, certain individuals or companies providing services for us or on our behalf. We require business associates to appropriately safeguard your protected health information. We may contact you to tell you about possible treatment alternatives, health related benefits or services. For example, your name and address may be used to send you a newsletter about the services we offer. We may also send you information about products or services we believe might benefit you. We may disclose information about you to a family member or friends, who is involved in your medical care or helps pay for your care. We may disclose your information to an entity assisting in disaster relief effort, notify a family member, or another person responsible for your care about your condition, status and location. For example, your PHI may be shared with a local or out-of-state compounding or retail Pharmacy to fulfill prescription medicine orders. HIPAA requires us to enter into Business Associate contracts to safeguard your PHI as required by Anti-aging Medical HGH Institute and by law.
When We May Not Use or Disclose Your PHI
Except as described in this Notice or as permitted by law, we will obtain your written authorization before using or disclosing PHI about you. You may revoke an authorization in writing at any time. Forms for making revocations are available by calling our customer service phone number and may be submitted electronically or mailed to: Anti Aging Medical HGH Institute, 2800 W. State Rd 84, Suite 118, Fort Lauderdale, FL 33312. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the authorization.
You Have the Following Rights With Respect to Your Health Information
• You have the right to request that we restrict how your PHI is used or disclosed in carrying out treatment, payment, or health care operations. We are not required to agree to the requested restrictions, but will accommodate reasonable requests. If we do agree to the requested restrictions, that agreement will be binding on us. If we agree, we will comply with your request unless the information is needed to provide your emergency treatment. You may revoke a previously agreed upon restriction, at any time, in writing.
• You have the right to inspect and copy your PHI for as long as we maintain the health information. A designated record set contains MD Visits, MD Consultations, MD and PCP conversations as it relates to your initial and continuing health care, prescription and billing
records that may be used to make decisions about your health care. We may charge a reasonable fee for the costs of copying, mailing, or other supplies that are necessary to grant your request. In certain situations we may deny your request and will tell you why we are denying it.
In some cases you may have the right to ask for a review of our denial.
• If you feel that the PHI we maintain about you is incomplete or incorrect, you may request that we amend it. You may request an amendment for as long as we maintain the PHI. You must include a reason that supports your request. In certain cases, we may deny the request. If the request for amendment is denied, you have the right to file a statement of disagreement with the decision, and we may give a rebuttal to your statement. We will include a copy of both statements in your file.
• You have the right to receive an accounting of disclosures of your PHI that we have made after February 01, 2010 for purposes other than (1) for Anti-Aging Medical HGH Institute treatment plan, payment, or health care operations, (2) to you or based upon your authorization and (3) for certain government functions. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. The time period for the requested accounting must be specified and it may not be longer than six years. The first accounting you request within a 12-month period will be provided free of charge, but you may be charged for the cost of additional accountings within that period. We will notify you of the cost involved and you may choose to withdraw or modify the request at that time.
• You have the right to request that our communications to you concerning your PHI be made by alternative means or to alternative locations. For example, you may wish us to communicate in some way other than calling your home telephone number. We will comply with a reasonable request for such an alternative.
You may obtain a Notice of Privacy Practices by calling us and requesting a copy be mailed to
you, or you can ask for a copy next time you visit the MD at our office. If you would like to exercise one or more of these rights, you must send a written request to:
Changes to this Notice of Privacy Practices
Anti-Aging Medical HGH Institue reserves the right to change this Notice at any time. We reserve the right to apply the revised Notice to all PHI we already maintain, as well as any information we receive in the future. If we change any of the practices described in this Notice, we will post the revised Notice at: _____________________________
For More Information or to Report a Problem
This Notice describes how we will treat your personal health information pursuant to the requirements of the Federal HIPAA privacy rules. State privacy laws may impose certain additional requirements. For a more complete description of state privacy issues, please go to the Notice posted at http://www.BuyPhentermineDirect.com/npp. If you have questions or would like additional information about our privacy practices, you may contact the Privacy Office by writing to: Privacy Dept.,_______________________________________________________________. If you believe your privacy rights have been violated, you can file a complaint with Anti-Aging Medical HGH Institute Privacy Dept or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint and Anti-Aging Medical HGH Institute will maintain information in a manner consistent with company policies.
ANTI-AGING MEDICAL INSTITUTE:
State Laws More Stringent
ALABAMA We will not disclose your personal health records to anyone without your authorization, except where it is in your best interest or where the law requires the disclosure.
ARIZONA We will not disclose any confidential communicable disease related information unless the subject of that information has authorized us in writing to do so or unless state or federal law authorizes or requires the disclosure.
CALIFORNIA We may disclose your medical information as follows:
(a) to providers of health care, health care service plans, contractors or other health care professionals or facilities for purposes of diagnosis or treatment of the patient. This includes, in an emergency situation, the communication of patient information by radio transmission or other means between licensed emergency medical personnel at the scene of an emergency, or in an emergency medical transport vehicle, and licensed emergency medical personnel at a health facility;
(b) to an insurer, employer, health care service plan, hospital service plan, employee benefit plan, governmental authority, contractor or any other person or entity responsible for paying for health care services rendered to the patient to the extent necessary to allow responsibility for payment to be determined and payment to be made. If the patient is, by reason of a comatose or other disabling medical condition, unable to consent to the disclosure or medical information and no other arrangements have been made to pay for the health care services being rendered to the patient, the information may also be disclosed to a governmental authority to the extent necessary to determine the patient’s eligibility for, and to obtain, payment under a governmental program for health care services provided to the patient. The information may also be disclosed to another provider of health care or health care service plan as necessary to assist the other provider or health care service plan in obtaining payment for health care services rendered by that provider of health care or health care service plan to the patient;
(c) to any person or entity that provides billing, claims management, medical data processing, or other administrative services for providers of health care or health care service plans or for any of the persons or entities specified above in paragraph (b). However, no information so disclosed may be further disclosed by the recipient in any way that would be violative of California laws governing the use and disclosure of medical information without authorization from the patient;
(d) to organized committees and agents of professional societies or of medical staffs of licensed hospitals, licensed health care service plans, professional standards review organizations, independent medical review organizations and their selected reviewers, utilization and quality control peer review organizations, contractor’s or persons or organizations insuring, responsible for, or defending professional liability that a provider may incur, if the committees, agents, health care service plans, organizations, reviewers, contractors or persons are engaged in reviewing the competence or qualifications of health care professionals or in reviewing health care services with respect to medical necessity, level of care, quality of care, or justification of charges;
(e) a provider of health care or health care service plan that has created medical information as a result of employment-related health care services to an employee conducted at the specific prior written request and expense of the employer may disclose to the employee’s employer that:
i. is relevant in a law suit, arbitration, grievance, or other claim or challenge to which the employer and the employee are parties and in which the patient has placed in issue his or her medical history, mental or physical condition, or treatment, provided that information may only be used or disclosed in connection with that proceeding;
ii. describes functional limitations of the patient that may entitle the patient to leave from work for medical reasons or limit the patient’s fitness to perform his or her present employment, provided that no statement of medical cause is included in the information disclosed;
(f) unless the provider of health care or health care service plan is notified in writing of an agreement by the sponsor, insurer, or administrator to the contrary, the information may be disclosed to a sponsor, insurer, or administrator of a group or individual insured or uninsured plan or policy that the patient seeks coverage by or benefits from, if the information was created by the provider of health care or health care service plan as the result of services conducted at the specific prior written request and expense of the sponsor, insurer, or administrator for the purpose of evaluating the application for coverage or benefits;
(g) to a health care service plan by providers of health care that contract with the health care service plan and may be transferred among providers of health care that contract with the health care service plan, for the purpose of administering the health care service plan. Medical information may not otherwise be disclosed by a health care service plan except in accordance with the provisions of this part;
(h) to an insurance institution, agent or support organization of medical information if the insurance institution, agent, or support organization has complied with all requirements for obtaining the information pursuant to the requirements of the California Insurance Code provisions;
(i) to an organ procurement organization or a tissue bank processing the tissue of a decedent for transplantation into the body of another person, but only with respect to the donating decedent for the purpose of aiding the transplant;
(j) to a third party for purposes of encoding, encrypting, or otherwise anonymizing data. However, no information may be further disclosed by the recipient in any way that would be unauthorized manipulation of coded or encrypted medical information that reveals individually identifiable medical information;
(k) for purposes of disease management programs and services, information may be disclosed to any entity contracting with a health care service plan or the health care service plan’s contractors to monitor or administer care of enrollees for a covered benefit, provided that the disease management services and care are authorized by a treating physician or to any disease management organization that complies fully with the physician authorization requirements, provided that the health care service plan or its contractor provides or has provided a description of the disease management services to a treating physician or to the health care service plan’s or contractor’s network of physicians.
CONNECTICUT We will not sell your individually identifiable medical record information. We will not disclose information about pharmaceutical services rendered to you to third parties without your consent, except to the following persons:
(a) the prescribing practitioner or a pharmacist or another prescribing practitioner presently treating you when deemed medically appropriate;
(b) a nurse who is acting as an agent for a prescribing practitioner that is presently treating you or a nurse providing care to you in a hospital;
(c) third party payors who pay claims for pharmaceutical services rendered to you or who have a formal agreement or contract to audit any records or information in connection with such claims;
(d) any governmental agency with statutory authority to review or obtain such information;
(e) any individual, the state or federal government or any agency thereof or court pursuant to a subpoena; and
(f) any individual, corporation, partnership or other legal entity which has a written agreement with the pharmacy to access the pharmacy’s database provided the information accessed is limited to data which does not identify specific individuals.
FLORIDA We will not disclose your pharmacy records without your written authorization, except to:
(b) your legal representative;
(c) the Department of Health pursuant to existing law;
(d) in the event that you are incapacitated or unable to request your records, your spouse; and
(e) in any civil or criminal proceeding, upon the issuance of a subpoena from a court of competent jurisdiction and proper notice to you or your legal representative, by the party seeking the records.
GEORGIA Unless authorized by you, we will not disclose your confidential information to anyone other than you or your authorized representative, except to the following persons or entities:
(a) the prescriber, or other licensed health care practitioners caring for you;
(b) another licensed pharmacist for purposes of transferring a prescription or as part of a patient’s drug utilization review, or other patient counseling requirements;
(c) the Board of Pharmacy, or its representative; or
(d) any law enforcement personnel duly authorized to receive such information.
We may also disclose your confidential information without your consent pursuant to a subpoena issued and signed by an authorized government official or a court order issued and signed by a judge of an appropriate court. We will not disclose AIDS confidential information, except in situations where the subject of the information has provided us with a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure.
HAWAII We will not disclose any HIV/AIDS/ARC-related information, except in situations where the subject of the information has provided us with prior written consent allowing the release or where we are authorized or required by state or federal law to make the disclosure.
IOWA We will not disclose any HIV/AIDS-related information, except in situations where the subject of the information has provided us with a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure.
IDAHO We will not release your identifiable prescription information to anyone other than you or your designee, unless requested by any of the following persons or entities:
(a) the Board of Pharmacy, or its representatives, acting in their official capacity;
(b) the practitioner, or the practitioner’s designee, who issued your prescription;
(c) other licensed health care professionals who are responsible for the your care;
(d) agents of the Department of Health and Welfare when acting in their official capacity with reference to issues related to the practice of pharmacy;
(e) agents of any board whose practitioners have prescriptive authority, when the board is enforcing laws governing that practitioner;
(f) an agency of government charged with the responsibility for providing medical care for you;
(g) the federal Food and Drug Administration, for purposes relating to monitoring of adverse drug events in compliance with the requirements of federal law, rules or regulations adopted by the FDA; and
(h) the authorized insurance benefit provider or health plan that provides your health care coverage or pharmacy benefits.
INDIANA We will disclose your confidential information only when it is in your best interests, when the information is requested by the Board of Pharmacy or its representatives or by a law enforcement officer charged with the enforcement of laws pertaining to drugs or devices or the practice of pharmacy, or when disclosure is essential to our business operations.
KENTUCKY We will only use your information to provide pharmacy care. We will not disclose your patient information or the nature of professional services rendered to you without your express consent or without a court order, except to the following authorized persons:
(a) members, inspectors, or agents of the Board of Pharmacy;
(b) you, your agent, or another pharmacist acting on your behalf;
(c) another person, upon your request;
(d) licensed health care personnel who are responsible for your care;
(e) certain state government agents charged with enforcing the controlled substances laws;
(f) federal, state, or municipal government officers who are investigating a specific person regarding drug charges; and
(g) a government agency that may be providing medical care to you, upon that agency’s written request for information.
MAINE We will not disclose your health care information for fundraising purposes or to coroners or funeral directors, without your authorization. We will only disclose patient identifiable communicable disease information to Department of Human Services for adult or child protection purposes or to other public health officials, agents or agencies or to officials of a school where a child is enrolled, for public health purposes. In a public health emergency, as declared by the state health officer, we may also release your information to private health care providers and agencies for the purpose of preventing further disease transmission.
MICHIGAN Unless authorized by you, we will not disclose your prescription or equivalent record on file, except to the following persons:
(a) you, or another pharmacist acting on your behalf;
(b) the authorized prescribed who issued the prescription, or a licensed health professional who is currently treating you;
(c) an agency or agent of government responsible for the enforcement of laws relating to drugs and devices; or
(d) a person authorized by a court order.
We will not disclose AIDS-related information about an individual except in situations where the subject of the information has provided us with a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure.
MINNESOTA We will not disclose your prescription orders or the contents thereof, except to:
(a) you, your agent, or another pharmacist acting on your behalf or your agent’s behalf;
(b) the licensed practitioner who issued the prescription;
(c) the licensed practitioner who is currently treating you;
(d) a member, inspector, or investigator of the board or any federal, state, county, or municipal officer whose duty it is to enforce the laws of this state or the United States relating to drugs and who is engaged in a specific investigation involving a designated person or drug;
(e) an agency of government charged with the responsibility of providing medical care for you;
(f) an insurance carrier or attorney on receipt of written authorization signed by you or your legal representative, authorizing the release of such information; and
(g) any person duly authorized by a court order.
Unless we have obtained your oral or written consent, we will not disclose the nature of pharmaceutical services rendered to you, except as follows:
(a) pursuant to an order or direction of a court;
(b) to other pharmacies;
(c) to you; or
(d) drug therapy information to your physician.
MISSOURI Unless specifically authorized by you, we will not release your pharmacy records to anyone other than:
(a) you or any other person authorized by you to receive the information;
(b) the authorized prescriber who issued the prescription order, or a licensed health professional who is currently treating you;
(c) in response to lawful requests from a court or grand jury;
(d) a person authorized by a court order;
(e) to transfer medical or prescription information between pharmacists as provided by law; or
(f) government agencies acting within the scope of their statutory authority.
We will not disclose any HIV/AIDS-related information, except in situations where the subject of the information has provided us with a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure.
MONTANA We will not disclose information concerning persons infected, or reasonably suspected to be infected with a sexually transmitted disease, except to:
(a) personnel of the Department of Public Health and Human Services;
(b) a physician who has obtained the written consent of the person whose record is requested; or
(c) a local health officer.
NEVADA We will not disclose the contents of your prescriptions or disclose any copies of your prescriptions, other than to you, except to:
(a) the practitioner who issued the prescription;
(b) the practitioner who is currently treating you;
(c) a member, inspector or investigator of the Board of Pharmacy, an inspector of the FDA, or an agent of the investigation division of the department of public safety;
(d) an agency of state government charged with the responsibility of providing medical care for you;
(e) an insurance carrier, on receipt of your written authorization or your legal guardian authorizing the release of information;
(f) any person authorized by an order of a district court;
(g) a member, inspector, or investigator of a professional licensing board that licenses the practitioner who orders the prescriptions filled at the pharmacy; and
(h) other registered pharmacists for the limited purpose of and to the extent necessary for the exchange of information regarding persons suspected of misusing prescriptions to obtain excessive amounts of drugs or failing to use a drug in conformity with the directions for its use, or taking a drug in combination with other drugs in a manner that could result in injury to that person.
We will not disclose any personal information about an individual who has, or is suspected of having, a communicable disease, without the individual’s written consent, except as follows:
(a) for statistical purposes, as long as the identity of the person is not discernible from the information disclosed;
(b) in a prosecution for a violation or a proceeding for an injunction brought pursuant to the communicable disease laws;
(c) neglect of a child or elderly person;
(d) to any person who has a medical need to know the information for his own protection or for in reporting the actual or suspected abuse or the well-being of a patient or dependent person, as determined by the health authority in accordance with regulations of the state board of health;
(e) pursuant to specified statutes that require the reporting of certain test results;
(f) if the disclosure is made to the department of human resources and the person about whom the disclosure is made has been diagnosed as having AIDS or an illness related to HIV and is a recipient of or an applicant for Medicaid;
(g) to a fireman, police officer or person providing emergency medical services if the board has determined that the information relates to a communicable disease significantly related to that occupation and the information is disclosed in the manner prescribed by the state board of health; and
(h) if the disclosure is authorized or required by specific statute.
NEW HAMPSHIRE We will not use, release, or sell your identifiable medical information for the purpose of sales or marketing of services or products unless you have provided us with a written authorization permitting such activity. We will only disclose your professional records if:
(a) we have obtained your permission to do so;
(b) it is an emergency situation and it is in your best interest for us to disclose the information; or
(c) the law requires us to disclose the information.
NEW MEXICO Unless we receive a written consent from you, we will not disclose your confidential information to anyone other than you or your authorized representative, except to the following persons or entities:
(a) pursuant to the order or direction of a court;
(b) to the prescriber or other licensed practitioner caring for you;
(c) to another licensed pharmacist where it is in your best interest;
(d) to the Board of Pharmacy or its representative or to such other persons or governmental agencies duly authorized by law to receive such information;
(e) to transfer a prescription to another pharmacy as required by the provisions of patient counseling;
(f) to provide a copy of a nonrefillable prescription to you;
(g) to provide drug therapy information to physicians or other authorized prescribers for their patients; or
(h) as required by the provisions of the patient counseling regulations.
NEW YORK We may not give a patient a copy of a prescription for a controlled substance, and for copies of other types of prescriptions, we must indicate that the copy is for informational purposes only.
NORTH CAROLINA We will not disclose or provide a copy of your prescription orders on file, except to:
(b) your parent or guardian or other person acting in loco parentis if you are a minor and have not lawfully consented to the treatment of the condition for which the prescription was issued;
(c) the licensed practitioner who issued the prescription or who is treating you;
(d) a pharmacist who is providing pharmacy services to you;
(e) anyone who presents a written authorization for the release of pharmacy information signed by you or your legal representative;
(f) any person authorized by subpoena, court order or statute;
(g) any firm, company, association, partnership, business trust, or corporation who by law or by contract is responsible for providing or paying for medical care for you;
(h) any member or designated employee of the Board of Pharmacy;
(i) the executor, administrator or spouse of a deceased patient;
(j) Board-approved researchers, if there are adequate safeguards to protect the confidential information; and
(k) the person who owns the pharmacy or his licensed agent.
NORTH DAKOTA We will not disclose the nature of the services we provide to you to anyone other than you, without first obtaining your oral or written consent, except that we may disclose such information:
(a) to other pharmacies;
(b) to your physician; or
(c) as ordered or directed by a court.
OHIO Unless we have obtained your written consent, we will only disclose your pharmacy records to:
(b) the prescriber who issued the prescription or medication order
(c) certified/licensed health care personnel who are responsible for your care;
(d) a member, inspector, agent, or investigator of the state board of pharmacy or any federal, state, county, or municipal officer whose duty is to enforce the laws of this state or the United States relating to drugs and who is engaged in a specific investigation involving a designated person or drug;
(e) an agent of the state medical board when enforcing the statutes governing physicians and limited practitioners;
(f) an agency of government charged with the responsibility of providing medical care for you, upon a written request by an authorized representative of the agency requesting such information;
(g) an agent of a medical insurance company who provides prescription insurance coverage to you, upon authorization and proof of insurance by you or proof of payment by the insurance company for those medications whose information is requested;
(h) an agent who contracts with the pharmacy as a “business associate” in accordance with the regulations promulgated by the secretary of the United States department of health and human services pursuant to the federal standards for privacy of individually identifiable health information; or
(i) in emergency situations, when it is in your best interest.
OKLAHOMA We will not divulge the nature of your problems or ailments or any confidence you have entrusted to the pharmacist in his professional capacity, except in response to legal requirements or where its in your best interest. We will not disclose information which identifies any person who has or may have a communicable or venereal disease, unless authorized by the individual or as otherwise permitted under state law. Whenever possible, we will de-identify such information prior to disclosure.
PENNSYLVANIA We will not disclose any HIV-related information, except in situations where the subject of the information has provided us with a written consent allowing the release or where we are authorized or required by state or federal law to make the disclosure.
RHODE ISLAND We will only disclose your prescription information to our agents and persons directly involved in your care. We will not disclose your confidential health care information without your consent, except in certain limited situations, as permitted under R.I. Gen. Laws § 5-37.3-4(b). Such situations may include:
(a) to medical personnel who believe in good faith that the information is necessary for diagnosis or treatment 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 shall not identify, directly or indirectly, any individual patient in any report of that research, audit, or evaluation, or otherwise disclose patient identities in any manner;
(c) to appropriate law enforcement personnel, or to a person if the health care provider believes that person or his or her family to be in danger from a patient; or to appropriate law enforcement personnel if the patient has or is attempting to obtain narcotic drugs from the health care provider illegally;
(d) to the state medical examiner in the event of a fatality that comes under his or her jurisdiction; or e) to the attorneys for a health care provider whenever that provider considers that release of information to be necessary in order to receive adequate legal representation;
(e) 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 the patient to whom that information pertains;
(f) to the state board of elections pursuant to a subpoena or subpoena duces tecum when that information is required to determine the eligibility of a person to vote by mail ballot and/or the legitimacy of a certification by a physician attesting to a voter’s illness or disability; or
(g) 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.
SOUTH CAROLINA We will not disclose your prescription drug information without first obtaining your 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;
(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.
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:
(a) you, or your agent, or another pharmacist acting on your behalf;
(b) the practitioner who issued the prescription drug order;
(c) certified/licensed health care personnel who are responsible for your care;
(d) 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
(e) 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.
TENNESSEE We will obtain your authorization before we disclose your patient records for any reason, except where:
(a) the disclosure is in your best interest;
(b) the law requires the disclosure; or
(c) the disclosure is to an authorized prescriber or to communicate a prescription order where necessary to:
i. carry out prospective drug use review as required by law;
ii. assist prescribers in obtaining a comprehensive drug history on you; or
iii. prevent abuse or misuse of a drug or device and the diversion of controlled substances.
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 for the purpose of utilization review, case management, peer reviews, or other administrative functions; or
(c) in response to a subpoena issued by a court of competent jurisdiction. We will not sell your name and address or other identifying information for any purpose.
TEXAS We will only release your confidential record to you, your agent, or to:
(a) a practitioner or another pharmacist if, in the pharmacist’s professional judgment, the release is necessary to protect your health and well-being;
(b) the pharmacy board or another state or federal agency authorized by law to receive the record;
(c) a law enforcement agency engaged in investigation of a suspected violation of the controlled substances laws, or the Comprehensive Drug Abuse Prevent Control Act of 1970;
(d) a person employed by a state agency that licenses a practitioner, if the person is performing the person’s official duties; or
(e) an insurance carrier or other third party payor authorized by the patient to receive the information.
UTAH We will not release or discuss information in your prescription or medication profile to anyone except:
(a) you or your legal guardian or designee;
(b) a lawfully authorized federal, state, or local drug enforcement officer; a third party payment program authorized by you;
(c) another pharmacist, pharmacy intern, pharmacy technician, or prescribing practitioner providing services to you or to whom you have requested us transfer a prescription; and
(d) your attorney, with a written authorization signed by:
i. you before a notary public;
ii. your parent or lawful guardian, if you are a minor;
iii. your lawful guardian, if you are incompetent; or
iv. your personal representative, in the case of deceased patients.
WASHINGTON We will not disclose any information regarding an individual’s treatment for a sexually transmitted diseases, except in situations where the subject of the information has provided us with a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure. Unless authorized by you, we will not disclose your health care information except in limited circumstances permitted by law. Such permitted disclosures may include:
(a) To a person who the provider reasonably believes is providing health care to the patient;
(b) 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 health care provider; or for assisting the health care provider in the delivery of health care and the health care provider reasonably believes that the person:
i. Will not use or disclose the health care information for any other purpose; and
ii. Will take appropriate steps to protect the health care information;
(c) To any other health care provider reasonably believed to have previously provided health care to the patient, to the extent necessary to provide health care to the patient, unless the patient has instructed the health care provider in writing not to make the disclosure;
(d) To any person if the health care provider reasonably believes that disclosure will avoid or minimize an imminent danger to the health or safety of the patient or any other individual, however there is no obligation under this chapter on the part of the provider to so disclose;
(e) Oral, made to immediate family members of the patient, or any other individual with whom the patient is known to have a close personal relationship, if made in accordance with good medical or other professional practice, unless the patient has instructed the health care provider in writing not to make the disclosure;
(f) To a health care provider who is the successor in interest to the health care provider maintaining the health care information;
(g) To a person who obtains information for purposes of an audit, if that person agrees in writing to certain restrictions.
(h) To an official of a penal or other custodial institution in which the patient is detained; or
(i) To provide directory information, unless the patient has instructed the health care provider not to make the disclosure.
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 his 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 protect against clear and substantial danger of imminent injury by the individual to himself or another; or
(e) 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.
We will not disclose your prescription records to anyone other than you or someone authorized by you without first obtaining your written informed consent.
Unless we have received an authorization from you, we will only disclose your confidential information to:
(a) you, or as you direct;
(b) 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;
(c) to such other persons or governmental agencies authorized by law to investigate controlled substance law violations;
(d) a minor’s parent or guardian;
(e) your third party payor; or
(f) your agent.
Information on this site is provided for informational purposes and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. You should read carefully all product packaging. If you have or suspect that you have a medical problem, promptly contact your health care provider. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. Customer reviews are provided for informational purposes only. Customer reviews reflect the individual reviewer’s results and experiences only and are not verified or endorsed by Anti-Aging Medical HGH Institute. Actual results may vary among users.
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