Privacy Policy

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATIONABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THISINFORMATION. PLEASE REVIEW IT CAREFULLY

When this Notice of Privacy Practices (“Notice”) refers to “we” or “us,” itis referring to New Body Rx and all the pharmacists who provide health careservices and the employees of our pharmacy. We are required by law to maintainthe privacy of your protected health information (“PHI”), to follow the termsof the Notice currently in effect, to give you this Notice setting forth ourlegal duties and privacy practices concerning your PHI and to notify affectedindividuals following a breach of unsecured PHI. This Notice describes how wemay use and disclose your PHI. Additionally, this Notice explains the rightsyou have with respect to your PHI, and certain obligations we must abide by inaccordance with the law. We reserve the right to amend this Notice. If we makeany material revisions to this Notice, we will post a copy of the revisedNotice in the pharmacy, on our website and will offer you a copy of the revisedNotice.

I. USE AND DISCLOSURE OF YOUR PHI

We will use and disclose your PHI for treatment, payment and health careoperations. We may also use your PHI for other purposes that are permittedand/or required by law and pursuant to your written authorization. Thefollowing lists examples of how we may use and/or disclose your PHI. Any otheruses not described in this Notice will only be made with your explicit writtenauthorization, which you may revoke at any time by providing us with writtennotice of your revocation.

A. Treatment – We may use and disclose your PHI in order to provide you withprescription and supply services. We may disclose your PHI to otherpharmacists, pharmacy technicians and health care providers that are involvedin your care. You will receive an individual notice and have the opportunity toopt out of any subsidized treatment communications.

B. Payment – We will use and disclose your PHI in order to obtain paymentfor the health care services we provide to you. We may also need to discloseyour PHI to receive prior approval from your health plan or to determine ifyour health plan will cover a certain prescription or service.

C. Health Care Operations – We may use and disclose your PHI in connectionwith the management of our pharmacy. For example, this may include: qualityassessment and improvement, internal compliance audits, and performanceevaluations.

Additionally, we may use your PHI for our business management and generaladministrative activities.

D. Prescription Refill Reminders, Treatment Alternatives or Health-RelatedBenefits – We may use and disclose your PHI to contact you to remind you aboutprescription refills, to tell you about treatment options or alternatives, orto inform you about health-related benefits or services that may be of interestto you.

E. Family Members, Relatives or Close Friends – Unless you object to suchdisclosure, we may disclose your PHI to your family members, relatives or closepersonal friends, or any other persons identified by you as being involved inthe treatment or payment for your medical care. If you are not present to agreeor object to our disclosure of your PHI to a family member, relative or friend,we may exercise our professional judgment to determine whether the disclosureis in your best interest. If we decide to disclose your PHI, we will onlydisclose the PHI that is relevant to your treatment or payment.

F. Other Permitted and Required Uses and Disclosures – We may use your PHIwithout obtaining your authorization and without offering you the opportunityto agree or object as follows: as required by law, provided however, that theuse or disclosure will be made in compliance with applicable law; to a publichealth authority that is authorized by law to collect or receive suchinformation, or to a foreign government agency that is acting in collaborationwith a public health authority and these health activities generally includepreventing or controlling disease, reporting deaths, reporting adverse effectsof medications or problems with products, notification of communicable disease,and reporting abuse or neglect under certain circumstances; to a health oversightagency for oversight activities authorized by law, including audits andinspections, and civil, administrative or criminal investigations, proceedingsor actions; for judicial or administrative proceedings purposes in response toa subpoena, court order, discovery request, etc. but only if efforts have beenmade to inform you about the request or to obtain an order protecting theinformation requested; to law enforcement to report certain injuries, complywith court orders or warrants or similar process, to identify a suspect,fugitive, missing person, or victi,m or to report a crime; to a coroner ormedical examiner to perform duties authorized by law, such as identification ofa deceased person or determining the cause of death; to funeral directors,consistent with applicable law, as necessary to carry out their duties; toorgan procurement organizations or similar entities for the purpose offacilitating organ, eye or tissue donation and transplantation; for researchpurposes provided that certain approvals take place and assurances are given;to avert a serious threat to health or safety, so long as the disclosure isonly to a person who is reasonably able to prevent or lessen such threat; formilitary and veterans activities (including foreign military personnel) toassure the proper execution of a military mission and to determine eligibilityfor benefits; for national security and intelligence activities for the purposeof conducting lawful intelligence, counter-intelligence and other nationalsecurity activities; for protection of the President and other authorizedpersons or foreign heads of state or to conduct authorized investigations; to acorrectional institution or law enforcement custodian if you are an inmate orunder custody; and to the extent necessary to comply with laws relating toworkers’ compensation and work-related injuries.

II. YOUR RIGHTS AS OUR PATIENT

As our patient, you have a number of rights associated with your PHI. Thefollowing describes your specific rights.

A. You have the right to request restrictions or limitations on how we useand/or disclose your PHI, however, we do not have to agree to your requestedrestriction or limitation (except for transactions you paid for in fullout-of-pocket). Your written request must specify: (1) if you would like torestrict or limit our use and/or disclosure; (2) what information you wantrestricted or limited; and (3) to whom the restriction or limitation applies(e.g., spouse).

If we agree to your request, it will not prevent us from disclosing your PHIas follows: (1) to you if you request access or an accounting of disclosures;(2) for purposes required or permitted by law; or (3) in case of an emergency.

B. You have the right to receive confidential communications concerning yourPHI by alternative means or via alternative locations. For example, you maywant to receive communications related to your prescriptions at a differentaddress other than your home address. If you wish to receive confidentialcommunications via alternative means or locations, please submit your requestin writing to the Privacy Officer and set forth the alternative means by whichyou wish to receive communications or the alternative location at which youwish to receive such communications. We will accommodate all reasonablerequests.

C. You have the right to access, inspect and obtain a copy of your PHI,including any electronic PHI; provided, however, you are not entitled to accesscertain PHI exempted under HIPAA. To the extent we maintain electronic PHI,upon request we will provide you with a copy of your PHI in the formatrequested. If we do not have your PHI in our possession, we will provide youwith the appropriate contact information when your request is received. If yourequest a copy of your PHI, you will receive a response to your request in atimely fashion but may be charged a reasonable, cost-based fee to cover copycosts and postage. In some limited circumstances, we may deny your request foraccess to PHI in which case you may request for the denial to be reviewed. If accessis ultimately denied, you are entitled to a written explanation with thereason(s) for the denial.

D. You have the right to receive an accounting of disclosures of your PHImade by us, including disclosures to or by our business associate(s), for aperiod of six (6) years prior to the date on which you request an accounting ofdisclosures, or such lesser period as you indicate. You will receive onerequest annually free of charge and, thereafter, we may charge you areasonable, cost-based fee for each subsequent request for an accounting ofdisclosures within the same twelve-month period. We will notify you of the costfor an accounting of disclosures and you may choose to withdraw or modify yourrequest before we charge you.

E. If you believe we have PHI about you that is incorrect or incomplete, youmay make a written request to us stating the reasons to support any requestedamendment. You have the right to request an amendment to your PHI for so longas we maintain your PHI. If we do not have your PHI in our possession, we willprovide you with the appropriate contact information when we receive yourrequest. We will respond to your request for an amendment after we receive yourrequest. However, we may deny your request for amendment if, for example, wedetermine that the PHI you requested was not created by us or is alreadyaccurate and complete. You may respond to our denial by filing a writtenstatement of disagreement, but we have the right to rebut your disagreement. Ifthis occurs, you have the right to request that your original request, ourdenial, your statement of disagreement, and our rebuttal be included in futuredisclosures of your PHI.

F. You have the right at any time to obtain a paper copy of this Notice,even if you receive this Notice electronically. If you have received anelectronic copy of this Notice but wish to obtain a paper copy of this Notice,please send your request in writing to the Privacy Officer at the addresslisted below.

G. You have the right to opt-out of fundraising and your PHI will not beused for fundraising purposes or sold without your prior authorization.

III. Additional Information/Questions or Complaints

A. If you need any additional information about this Notice or wish toexercise any of your rights set forth in this Notice, please contact thePrivacy Officer at the following address: New Body Rx 8525 E Pinnacle PeakRoad, Suite 101 Scottsdale, AZ 85255

If you believe your privacy rights have been violated, you may file acomplaint without retaliation with the Privacy Officer of the pharmacy or with:

Secretary of the Department of Health and Human Services

200 Independence Avenue SW

Washington D.C. 20201

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