PERMITTED USES AND DISCLOSURES
We, COPE, are required by law to maintain the privacy of your protected health information.
Protected health information is information that could allow someone to identify
you as the subject of the health information. We will not use or disclose your health
information without your written authorization, except as explained in this Notice
or as required by law. Certain laws may require that we disclose your health information
without your written authorization and we are obligated to follow those laws. “Your
information” means your protected health information. The term “disclose” means
use and disclose.
HOW WE MAY DISCLOSE YOUR HEALTH CARE INFORMATION
Treatment: We may disclose your information for the purpose of your medical
treatment such as to provide and coordinate the delivery of prescription drug products
and services. Your pharmacist will obtain information necessary to safely you’re
your prescription. Also, COPE may communicate with your health care providers about
your prescription drugs.
Payment: Your information may be used to bill or receive payment for your
prescriptions. This may include communication with credit card companies.
Health Care Operations: We may disclose your information to support administrative
and business activities necessary to operate COPE and to help pharmacies provide
your prescriptions. For example, we may use your information when we perform quality
and financial audits of prescription claims.
Individuals Involved in Your Care or Payment for Care: We may disclose your
information to your family, friends or other persons identified by you when they
are involved in your care or payment for your care. We may also disclose your information
to notify or assist in notifying a family member or another person responsible for
your care, of your location, general condition, or death.
If you are available, we will give you an opportunity to object to these disclosures,
and we will not make the disclosures if you object. If you are not available, we
will determine whether a disclosure to family or friends is in your best interest.
We will only disclose health information directly related to a person’s involvement
in your care or payment. When permitted by law, we may coordinate our uses and disclosures
of your information with public or authorized private entities in disaster relief
efforts.
Prescription Reminders: We may use your information to remind you prescriptions
are ready to be filled. We may leave a reminder on your answering machine or voicemail
unless you tell us not to.
Treatment Alternatives and Health-Related Benefits and Services: We may disclose
your information to tell you about new treatment alternatives or other health-related
services that may be of interest to you.
Research: We may disclose your information for research purposes for projects
approved by an Institutional Review Board or Privacy Board. We may disclose your
information to people preparing for a research project; for example, to help them
find patients with specific health needs, so long as the health information they
review does not leave our control.
As Required by Law: We will disclose your information as required by law.
Public Health Activities: We may disclose your information to public health
officials charged with preventing or controlling disease, injury, or disability.
Food and Drug Administration or Drug Manufacturers: We may disclose your
information to the FDA relative to adverse drug, supplement, food, or product events
or defects, or post-marketing surveillance information to enable product recalls,
repairs, or replacement.
To a Government Authority: We can disclose your information if you are the
victim of abuse, neglect, or domestic violence under certain circumstances.
To Avert a Serious Threat to Health or Safety: We may disclose your information
as necessary to prevent a serious threat to your health and safety or the health
and safety of anyone else.
Workers’ Compensation: We may release your information for workers’ compensation
or programs that provide benefits for work-related injuries or illness.
Health Oversight Activities: We may disclose health information to a government
health oversight agency for activities authorized by law such as audits, investigations,
inspections, and licensure. We can make these disclosures when necessary for the
government to monitor the health care system, government programs, licensing, and
civil rights compliance.
Judicial and Administrative Proceedings: We may disclose your information
in response to a court or administrative order or in response to a subpoena, discovery
request during litigation, or lawful process.
Law Enforcement: We may release health information if asked by a law enforcement
official: (i) in response to a court order, subpoena, warrant, summons or similar
process; (ii) to identify or locate a suspect, fugitive, witness, or missing person;
(iii) about the victim of a crime under certain circumstances; (iv) about a death
we believe may be the result of criminal conduct; (v) about criminal conduct on
our premises; and (vi) to report a crime in an emergency.
National Security and Intelligence Activities: We may release your information
to federal officials for intelligence, counterintelligence and other authorized
national security activities.
Protective Services for the President and Others: We may disclose your information
to authorized federal officials so they may provide protection to the President,
other persons, foreign heads of state, or to conduct special investigations.
Coroner and Medical Examiners: We may disclose your information to a coroner
or medical examiner for discovering the cause of death or other legal duties.
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Organ Donations: We may disclose health information to facilitate organ donation.
Inmates: If you are an inmate, we may release your information to the correctional
institution or the custodial law enforcement official for: (i) the institution to
provide you with health care; (ii) protecting your health and safety or that of
others; or (iii) the institution’s safety and security.
OTHER USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION
Other uses and disclosures of your information not covered in the previous sections
of this Notice will only be made with your written authorization. If you permit
us to disclose your information, you may revoke the authorization any time in writing.
After you revoke your authorization, we will not disclose the information under
the terms of the authorization. We cannot retrieve information disclosed with your
permission.
YOUR RIGHTS
You have the following rights regarding your information:
Restrictions: You have the right to request a restriction on your information
we disclose for treatment, payment, or healthcare operations. Your request must
be in writing to COPE’s Privacy Officer. We are not required to agree to your request.
If we do agree, we will notify you in writing and comply with your request unless
the information is needed to provide you emergency treatment or is required by law.
Alternative Communications: You have the right to request that we communicate
with you about medical or billing information in a certain way (phone, fax, mail,
etc.) or at a specific location (home, office, etc.). You must specify, in writing,
how or where to contact you, and give it to COPE’s Privacy Officer at the address
below. We may ask for clarification if the request is based on a danger to you.
We will accommodate your request if it is reasonable.
Inspect and Copy: You have the right to inspect and obtain a copy of your
information. Usually, this includes prescription and billing records. To inspect
and obtain a copy of your records you must submit your request in writing to COPE’s
Privacy Officer. We may charge a fee for the cost of copying and/or mailing the
records. We may deny your request to inspect or copy your records in certain, limited
circumstances and you may obtain a review of the denial in some cases.
Amend (Change) Your Records: If you believe health information we have about
you is incorrect or incomplete, you may ask us to change the information. You have
the right to request a change as long as we keep the information. To request a change,
you must submit the request in writing to COPE’s Privacy Officer for review. You
must state specifically the basis for your request. We may deny your request if
certain criteria are not met. We may deny your request if you ask us to amend information
that is: (i) not created by us, unless the person or entity that created the it
is no longer available to make the change; (ii) not part of the information COPE
keeps; (iii) not part of the information that you would be permitted to inspect
and copy; or (iv) is accurate and complete.
Disclosures: You have the right to request, in certain situations, a list
of disclosures of your information for purposes other than treatment, payment and
health care operations. You must submit your written request to COPE’s Privacy Officer
for review. You may be charged the cost of providing the list. Once notified of
the cost, you may withdraw or modify your request before costs are incurred.
Paper Copy of This Notice: Even if you have agreed to receive this Notice
electronically, you are entitled to a paper copy of this Notice any time upon request.
To obtain a paper copy, you may call or write to COPE’s Privacy Officer or visit
our website at www.COPE.com.
COMPLAINTS
If you believe that your privacy rights have been violated, you may call COPE’s
Privacy Officer at the phone number below or file a written complaint with COPE’s
Privacy Officer. You may also send your complaint to the Secretary of the U.S. Department
of Health and Human Services at the Office of Civil Rights. You will not be penalized
for filing a complaint.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice and to make the revised Notice effective
for health information we already have about you as well as information we will
receive. We will inform you of a change in this Notice by posting the changes on
our website.
PRIVACY OFFICER INFORMATION
If you have any questions or would like additional information about COPE’s privacy
practices, you may contact:
COPE’s Privacy Officer
Tania Malik
COPE, Inc.
1318 Dale St. Suite 100
Raleigh, NC 27605
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