Notice of Privacy Practices

Our Commitment

Okuley's Pharmacy Inc. (“Okuley's Pharmacy”) is required by law to maintain the privacy of your protected health information (“PHI”), to provide you this Notice of our legal duties and privacy practices, to notify you following a breach of unsecured PHI, and to abide by the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

For Treatment

We may use and disclose your PHI to provide, coordinate, or manage your pharmacy care. For example, we may contact your prescriber about a drug interaction, or share your medication history with another pharmacy or your physician.

For Payment

We may use and disclose your PHI to obtain payment. For example, we may submit claims to your insurance plan or pharmacy benefit manager, or verify coverage and eligibility.

For Health Care Operations

We may use and disclose your PHI for our business operations. For example, quality assessment, staff training and competency review, business planning, and compliance activities.

Appointment and Refill Reminders

We may contact you by phone, mail, email, or text message to tell you a prescription is ready, that a refill is due, or about an appointment.

Treatment Alternatives and Health-Related Benefits

We may tell you about alternative treatments, health-related products, or services that may be of interest to you.

Individuals Involved in Your Care

We may disclose PHI to a family member, friend, or other person you identify who is involved in your care or payment for your care, to the extent relevant to that involvement. If you are not present or are unable to agree or object, we will use professional judgment to determine whether disclosure is in your best interest.

As Required by Law

We will disclose PHI when required by federal, state, or local law.

Other Permitted Uses and Disclosures

We may use or disclose your PHI without your authorization in the following circumstances, subject to applicable legal requirements:

• Public health activities, including reporting to the Ohio Automated Rx Reporting System (OARRS) as required by state law, reporting adverse events or product defects to the FDA, and disease prevention or control
• Victims of abuse, neglect, or domestic violence
• Health oversight activities by agencies such as the Ohio State Board of Pharmacy
• Judicial and administrative proceedings, in response to a court order, subpoena, or other lawful process
• Law enforcement purposes, as permitted by law
• Coroners, medical examiners, and funeral directors
• Organ and tissue donation
• Research, where approved by an institutional review board or privacy board
• To avert a serious threat to health or safety
• Specialized government functions, including military and national security activities
• Workers' compensation, as authorized by law

Uses and Disclosures Requiring Your Written Authorization

The following require your written authorization:

• Most uses and disclosures of psychotherapy notes
• Uses and disclosures for marketing purposes
• Disclosures that constitute a sale of PHI
• Any other use or disclosure not described in this Notice

You may revoke an authorization in writing at any time. Revocation does not affect disclosures already made in reliance on it.

Your Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your PHI in our designated record set. If we maintain your records electronically, you have the right to receive an electronic copy and to direct us to transmit it to a third party you designate. Submit your request in writing to our Privacy Officer. We may charge a reasonable, cost-based fee.

Right to Amend

If you believe PHI we hold is incorrect or incomplete, you may request in writing that we amend it, including your reason for the request. We may deny your request in certain circumstances, and you may submit a statement of disagreement.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your PHI. This does not include disclosures for treatment, payment, or health care operations, or certain other disclosures. Your request must state a time period, which may not exceed six years.

Right to Request Restrictions

You have the right to request a restriction on our use or disclosure of your PHI for treatment, payment, or health care operations, or to a person involved in your care. We are generally not required to agree to a requested restriction, with one exception: we must agree to your request to restrict disclosure of PHI to a health plan if the disclosure is for payment or health care operations, is not otherwise required by law, and you have paid for the item or service in full out of pocket.

Right to Request Confidential Communications

You may request that we communicate with you about your health matters in a certain way or at a certain location — for example, only by mail to a specific address. We will accommodate reasonable requests.

Right to Notification of a Breach

You have the right to be notified in the event of a breach of your unsecured PHI.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you agreed to receive it electronically. Ask any staff member at any of our locations or contact our Privacy Officer.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services.

You will not be retaliated against for filing a complaint.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. The current Notice will be posted in each of our pharmacies and on our website with its effective date.

Questions

Contact our Privacy Officer at (419) 784-4800 or qokuley@okuleypharmacy.com.