Notice of Privacy Practices

Effective February 21, 2017

This notice applies to all Sterling pharmacies, and any other Astrup Drug, Inc., pharmacies.

As part of the federal Health Insurance Portability and Accountability Act (HIPAA), this notice describes how Protected Health Information (PHI) about you may be used and disclosed and how you can get access to this information. Please review it carefully.

YOUR RIGHTS

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
You can ask us to correct health information about you that you think is incorrect or incomplete. Contact the privacy officer, below, to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within twelve months.
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action.
You can complain if you feel we have violated your rights by contacting the privacy officer, below. You can also 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 www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

YOUR CHOICES

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care; or
- Share information in a disaster relief situation.

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

We do not share your information for the following purposes unless we have your written permission:
- Marketing purposes;
- Sale of your information; and
- Most sharing of psychotherapy notes.
We may contact you for fundraising efforts, but you can tell us not to contact you again.

OUR USES & DISCLOSURES

We typically use or share your health information in the following ways:

We can use your health information and share it with other professionals who are treating you.
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
We can use and share your health information to bill and get payment from health plans or other entities.

How else can we use or share your health information?

We are allowed or required to share your information in other ways:

For certain public health and safety situations such as:
- Preventing disease;
- Helping with product recalls;
- Reporting adverse reactions to medications;
- Reporting suspected abuse, neglect, or domestic violence; and/or
- Preventing or reducing a serious threat to anyone’s health or safety.
For health research.
As required by state or federal laws, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
For the purpose of procurement, banking, or transplantation of organs, eyes, or tissue for donation purposes.
With a coroner, medical examiner, or funeral director when an individual dies.
For workers’ compensation claims.
For law enforcement purposes or with a law enforcement official.
With health oversight agencies for activities authorized by law.
For special government functions such as military, national security, and presidential protective services.
In response to a court or administrative order, or in response to a subpoena.

OUR RESPONSIBILITIES

We are required by law to maintain the privacy and security of your PHI.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it upon request.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by notifying the privacy officer, below, in writing.

For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Contact Information

If you have any questions on our privacy practices or for clarification on anything contained within this notice, please contact:

Sterling Pharmacy, c/o Astrup Drug, Inc.
Attn: Dave Brooks, Privacy Officer
905 N Main St
Austin, MN 55912
(507) 433-7447