Simplex Pharmacy Privacy and Security Policy 

Under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), Simplex Pharmacy is required to provide you with a Notice of Privacy Practices that describes how we may use your information for treatment, payment and other purposes that details your rights regarding the privacy of your health and medical information.

It is the policy of Simplex Pharmacy to compliance with all federal and state regulations regarding the use and disclosure of PHI (Protected Health Information) and to allow disclosure of patient PHI without a patient authorization only for the purposes of treatment, payment and healthcare operations or as otherwise allowed by the Privacy Regulations or under other state and federal laws. 

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED

Simplex Pharmacy reserves the right to change the privacy and security practices outlined in this notice and make the new notice effective for PHI we maintain. Should we make such a change, we will display the revised notice to you online, and make it available to you upon request.

Protected Health Information (PHI)

The Privacy Rule protects all "individually identifiable health information" held or transmitted by Simplex Pharmacy or its business associates, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).” “Individually identifiable health information” is information, including demographic data, that relates to:

• the individual’s past, present or future physical or mental health or condition,

• the provision of health care to the individual, or

• the past, present, or future payment for the provision of health care to the individual,

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual. Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number). 

Permitted Uses and Disclosures

Simplex Pharmacy is permitted, but not required, to use and disclose protected health information, without an individual’s authorization, for the following purposes or situations: 

To the Individual; Simplex Pharmacy may disclose protected health information to the individual who is the subject of the information. 

Treatment; is the provision, coordination, or management of healthcare and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another. Simplex Pharmacy may disclose PHI to doctors, nurses, pharmacists, technicians, or other personnel, including people outside of Simplex Pharmacy, who are involved in your medical care and need the information to provide you with medical care. Treatment Alternatives and Health Related Benefits and Services. We may use and disclose PHI to contact you to remind you that you have a prescription with us. We also may use and disclose PHI to tell you or others that are involved in your treatment about alternatives or health-related benefits and services that may be of interest to you.

Payment; encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual. Simplex Pharmacy may use and disclose Protected Health Information so that we or others may bill and receive payment from you, your insurance company or a third party for the treatment and services you receive or have received. 

Health care operations are any of the following activities: (a) quality assessment and improvement activities, including case management and care coordination; (b) competency assurance activities, including provider or health plan performance evaluation, credentialing, and accreditation; (c) conducting or arranging for medical reviews, audits, or legal services, including fraud and abuse detection and compliance programs; (d) specified insurance functions, such as underwriting, risk rating, and reinsuring risk; (e) business planning, development, management, and administration; and (f) business management and general administrative activities of the entity, including but not limited to: de-identifying protected health information, creating a limited data set, and certain fundraising for the benefit of the covered entity. We may also use and disclose PHI for health care operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care based on our daily operations. We also may share information with other entities that are involved in your health care operation activities. Simplex Pharmacy may rely on its professional ethics and best judgments in deciding on these permissive uses and disclosures.

For Additional information regarding Incidents to an otherwise permitted use and disclosure, Public Interest and Benefit Activities, Limited Data Set for the purposes of research, public health or health care operations, please contact Simplex Pharmacy Compliance Team at 718-462-2029. Simplex Pharmacy may rely on professional ethics and judgments in deciding which of these permissive uses and disclosures to make.

HOW YOU CAN GET ACCESS TO THIS INFORMATION

YOUR RIGHTS:

You have the following rights regarding Health Information we have about you:

Right to Inspect and Copy. You have a right to inspect and copy PHI that may be used to make decisions about your care or payment for your care. This includes medical and billing records. We have up to 30 days to make your PHI available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state or federal needs-based benefit program. We may deny your request in certain limited circumstances. If we do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review. Please contact our compliance team with all inquiries at 718-462-2029 or email us at hello@simplexpharmacy.com

Right to an Electronic Copy of Electronic Medical Records. If your Protected Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. We will make every effort to provide access to your Protected Health Information in the form or format you request, if it is readily producible in such form or format. If the PHI is not readily producible in the form or format you request your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.

Right to Get Notice of a Breach. You have the right to be notified upon a breach of any of your unsecured Protected Health Information.

Right to Amend. If you feel that the PHI we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office.

Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of PHI for purposes other than treatment, payment and health care operations or for which you provided written authorization.

Right to Request Restrictions. You have the right to request a restriction or limitation on the Protected Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose to someone involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request unless you are asking us to restrict the use and disclosure of your PHI to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “out-of-pocket” in full. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Out-of-Pocket-Payments. If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Opportunity to Agree or Object. Simplex Pharmacy may disclose your PHI to a relative, family member, close friend, caretaker, provider or anyone that is involved in your healthcare. Simplex Pharmacy may rely on its professional ethics and judgments in deciding on these permissive uses and disclosures if you are unable to agree or object. You have the right to object to such disclosure or any other disclosures in writing or by contacting our compliance team at 644 Rogers Ave, Brooklyn, NY 11226. P: 718-462-2029 Attn: Compliance Team

Obtaining Forms for Submitting Written Requests. You may obtain forms for submitting written requests by contacting our Compliance Team at 644 Rogers Ave, Brooklyn, NY 11226 or by telephone at 718-462-2029.

Complaints and Additional Resources. 

If you need additional information, have more questions, believe your privacy has been violated, you may file a complaint with us, contact Simplex Pharmacy Attn: Compliance Team 644 Rogers Ave, Brooklyn, NY 11226 or by phone 718-462-2029

U.S. Department of Health & Human Services 

https://www.hhs.gov/hipaa Toll Free: 1-800-368-1019 TTD Number: 1-800-537-7697