Notice of Privacy Practices

THRIFTY DRUG STORES, INC.
d/b/a  THRIFTY WHITE DRUG / WHITE DRUG

NOTICE OF PRIVACY PRACTICES



THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

Thrifty White Drug (the “Pharmacy”) is required by law to maintain the privacy of your Protected Health Information ("PHI") and to provide individuals with notice of our legal duties and privacy practices with respect to PHI.  PHI is information about you, including basic demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.  This Notice of Privacy Practices ("Notice") describes how we may use and disclose PHI about you to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law.  The Notice also describes your rights with respect to PHI about you.

The Pharmacy is required to follow the terms of the Notice that is currently in effect.  We will not use or disclose PHI about you without your written authorization, except as described in this Notice.  We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain.  Upon request, we will provide a revised Notice to you, and we will post a revised notice at each Thrifty White Drug location  

Your Health Information Rights Under State Law


State laws that are more stringent than the federal HIPAA Privacy Regulations (that is, those state laws that provide you with greater protection for your information or greater access to your records than the federal law) supercede the federal rules.  HIPAA sets the floor for privacy standards and each state may create greater limitations and prohibitions on how PHI is used.  The Pharmacy will comply with the more stringent laws as they apply in the state where you obtain services from us, and in some cases may provide you with even greater protection than is required by state or federal law.  The more stringent laws and policies are described below.  As state law changes occur, the posted copy of this Notice will be updated periodically to reflect those changes.  


Your Health Information Rights Under HIPAA

You have the following rights with respect to PHI about you:

•    Obtain a paper copy of the Notice upon request.  You may request a copy of the Notice at any time.  Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy.  To obtain a paper copy, contact your nearest Thrifty White Drug location.

•    Request a restriction on certain uses and disclosures of PHI.  You have the right to request additional restrictions on our use or disclosure of PHI about you by sending a written request to Privacy Officer, Thrifty White Drug, 6055 Nathan Lane N. Suite #200, Plymouth, MN 55442.  We are not required to agree to the requested restrictions.

•    Inspect and obtain a copy of PHI.  You have the right to access and copy PHI about you contained in a designated record set for as long as the Pharmacy maintains the PHI.  The designated record set usually will include prescription and billing records.  To inspect or copy PHI about you, you must send a written request to the Pharmacy where you had prescriptions filled. We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request, to the extent permitted by applicable state and federal law.  We may deny your request to inspect and copy PHI in certain limited circumstances.  If you are denied access to PHI about you, you may request that the denial be reviewed.  Each individual over the age of 18 must request a copy of his or her own records in writing.  A spouse generally is not able to obtain the records of the other spouse without the authorization of the spouse who is the subject of the records.  State law may give minors control of their health records, although in most cases, a parent has access to the records of that parent’s minor child.

  • State laws allow minors to keep some records confidential from parents or guardians in certain cases.  In most of these cases, minors are responsible for payment for the services and products related to those records.  If a minor chooses to use his or her parents’ insurance or payment information, the Pharmacy cannot assure that the records will be kept confidential.  In addition, we are permitted in some cases to inform the parent of legal guardian of the minor patient of any treatment given or needed where, in the judgment of the pharmacist, failure to inform the parent or guardian would seriously jeopardize the health of the minor patient.  Minors must notify the Pharmacy in situations where the minor believes the information should be kept confidential so that the Pharmacy can make a determination about whether the information must be shared with a parent or guardian.


•    Request an amendment of PHI.  If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it.  You may request an amendment for as long as we maintain the PHI.  To request an amendment, you must send a written request to the Pharmacy where you obtained the information.  You must include a reason that supports your request.  In certain cases, we may deny your request for amendment.  If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may file a rebuttal to your statement.  Requests to change a billing address for charge accounts must be in writing and be mailed, faxed or e-mailed to the Accounts Receivable Department at the corporate office.

•    Receive an accounting of disclosures of PHI.  You have the right to receive an accounting of the disclosures we have made of your PHI after April 14, 2003 for most purposes other than treatment, payment, or health care operations.  The accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care that are permitted by state and federal law, disclosures for notification purposes and certain disclosures to state Boards of Pharmacy or other regulatory agencies responsible for auditing or licensing pharmacies.  The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations.  To request an accounting, you must submit a request in writing to Privacy Officer, Thrifty White Drug, 6055 Nathan Lane N. Suite #200, Plymouth, MN 55442.  Your request must specify the time period for which you would like to receive an accounting, but the time period may not be longer than six years from the date of the request, and must not go back further than April 14, 2003.  The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings.  We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.

  • Wisconsin law requires the Pharmacy to note the time and date of each request to inspect the health record, the name of the inspecting person, the time and date of the inspection, and the records released for inspection.


•    Request communications of PHI by alternative means or at alternative locations.  You may request that we communicate with you regarding PHI by an alternate method or using a different address.  For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box address.  To request confidential communication of PHI about you, you must submit a request in writing to the pharmacy where you have your prescriptions filled.  Your request must state how or where you would like to be contacted.  We will accommodate all reasonable requests, although we are permitted to require you to provide information about how payment will be handled.  

Examples of How We May Use and Disclose PHI

The following are descriptions and examples of ways we use and disclose your PHI:

•    We will use PHI for treatment.  Example:  Information obtained by the pharmacist will be used to dispense prescription medications to you, contact physicians and counsel you and other caregivers.  We will document in your record information related to the medications dispensed to you and services provided to you.  We may use PHI to coordinate care with other pharmacies and healthcare providers.  For example, we may use PHI to coordinate care with other pharmacies and healthcare providers if we have concerns regarding suspected prescription misuse or addiction.

•    We will use PHI for payment.  Example:  We will contact your insurer or pharmacy benefit manager to determine whether it will pay for your prescription and the amount of your co-payment.  We will bill you or a third-party payer for the cost of prescription medications dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the prescriptions you are taking. We will give the insurer the information they need to perform their duties under their contract with your plan sponsor.   

•    We will use PHI for health care operations.  Example:  The Pharmacy may use information in your health record to monitor the performance of the pharmacists providing treatment to you.  This information will be used in an effort to continually improve the quality and effectiveness of the health care and service we provide. Health care operations includes activities such as training, legal, auditing and compliance, customer service and other pharmacy management and administration.  PHI may be transferred to another pharmacy if they are buying a store from us.

We may also use or disclose PHI for the following purposes:

•    Business associates:  There are some services provided by us through contracts with business associates.  Examples include liability insurers, attorneys, data conversion processors, collection agencies, pharmacy software and systems providers, and data switches to relay data to your insurer and other similar associates.  When these services are provided through a contract, we may disclose PHI about you to our business associates so that they can perform the job we have asked them to do.  To protect PHI about you, we require the business associate to appropriately safeguard the PHI.

•    Communication with individuals involved in your care or payment for your care:  Health professionals such as pharmacists and other Thrifty White employees, using their professional judgment, may disclose PHI to a person that has been designated by you and/or is acting as your “agent” or authorized representative, as permitted under state law.  We may disclose PHI relevant to that person's involvement in your care or payment related to your care.  For example, we may disclose PHI to a person designated by you to pick up your prescription.

•    Health-related communications:  We may contact you to provide refill reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.  This communication may be via phone, mail, e-mail or other form of communication.

•    Food and Drug Administration (FDA):  We may disclose to the FDA, or persons under the jurisdiction of the FDA,  PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

•    Worker's compensation:  We may disclose PHI about you as authorized by and as necessary to comply with state laws relating to worker's compensation or similar programs.

•    Public health:  As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

  • Wisconsin law permits the release of records pursuant to a written request from a government agency.  Private pay patients may be able to opt out of this type of disclosure, unless the disclosure is required by law, by annually submitting to the Pharmacy a written request on a form provided by the state Department of Health


•    Law enforcement:  We may disclose PHI about you for law enforcement purposes as specifically required or permitted by law, including disclosures to an inspector or investigator whose duty it is to enforce the laws relating to drugs, and who is engaged in a specific investigation involving a designated person or drug, or for reporting suspected crimes such as child abuse.  

  • Minnesota law generally does not allow the release of information from a person’s health record to law enforcement without a valid court order or warrant, unless specifically required or authorized by law.


•    As required by law:  We must disclose PHI about you when required to do so by law.  

•    Health oversight activities:  We may disclose PHI about you to an oversight agency for activities authorized by law.  These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws. 

  • Minnesota law requires that patient-identifying information (such as name and address) be removed from most disclosures for health oversight activities, unless you have provided written consent for access to your protected health information.
  • Wisconsin law permits the release of records pursuant to a written request from a government agency.  Private pay patients may be able to opt out of this type of disclosure, unless the disclosure is required by law, by annually submitting to the Pharmacy a written request on a form provided by the state Department of Health.


•    Judicial and administrative proceedings:  If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a valid court or administrative order or warrant or grand jury subpoena.

We are permitted to use or disclose PHI about you for the following purposes:

•    Research:  We may disclose PHI about you to researchers when their research has been approved by an institutional review board or a privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

  • Minnesota law generally requires a written consent before we can disclose any medical information about you for medical research to an outside researcher.  We will obtain your consent or refusal to participate in any research study, or we will make a good faith effort to obtain your consent or refusal, prior to releasing any identifiable information about you for research purposes.
  • Wisconsin law generally requires a written consent before we may release medical information about you for research purposes to an outside researcher.  In some situations, we may release information for research purposes to a researcher who agrees to protect the privacy of your medical information.  Private pay patients may be able to opt out of this type of disclosure, unless the disclosure is required by law, by annually submitting to the Pharmacy a written request on a form provided by the state Department of Health.  


•    Coroners, medical examiners, and funeral directors:  We may release PHI about you to a coroner or medical examiner.  This may be necessary, for example, to identify a deceased person or determine the cause of death.  We may also disclose PHI to funeral directors consistent with applicable law to carry out their duties.

  • Minnesota law requires written authorization signed by a family member or legal representative to release medical information to funeral directors.  Minnesota law requires reports of certain types of death to a coroner or medical examiner, and in those cases, we must disclose health records upon the request of the coroner or medical examiner.  Funeral directors are required to collect fact of death and certain demographic information.  Thrifty will disclose this information to those in charge of the disposition of a body, as required.  Any additional disclosures of PHI will require consent from a surviving spouse, parent, person appointed by the patient in writing, or the patient’s legally authorized representative.


•    Organ or tissue procurement organizations:  Consistent with applicable law, we may disclose PHI about you to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

•    Fundraising:  We may contact you as part of a fundraising effort on behalf of the Pharmacy.

•    Correctional institution:  If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others.  

  • In most situations, Minnesota law will require the Pharmacy to get your written consent prior to making such disclosures.  Minnesota law allows certain persons acting on your behalf (as your “agent”) to have access to your prescription information.  When the correctional institution acts as your agent, we will provide the correctional institution with your prescription information.


•    To avert a serious threat to health or safety:  We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person, but generally will do so only with your written consent unless we are authorized by law to make the disclosure.  For example, we will disclose the information in situations where state law provides that the pharmacist has a “duty to warn” about a specific threat or danger.

•    Military and veterans:  If you are a member of the armed forces, we will release PHI about you as required by military command authorities if required to do so by law.  We may also release PHI about foreign military personnel to the appropriate military authority, if required to do so by law.  If not required to do so by law, we will obtain your written consent prior to making such disclosures.

  • Minnesota law generally does not permit this type of disclosure without written consent, or unless otherwise required by federal law.
  • Wisconsin law permits the release of records pursuant to a written request from a government agency.  Private pay patients may be able to opt out of this type of disclosure, unless the disclosure is required by law, by annually submitting to the Pharmacy a written request on a form provided by the state Department of Health.


•    National security and intelligence activities:  We may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.  

  • Minnesota law generally does not permit this type of disclosure without written consent, or unless otherwise required by federal law.

 

  • Wisconsin law permits the release of records pursuant to a written request from a government agency.  Private pay patients may be able to opt out of this type of disclosure, unless the disclosure is required by law, by annually submitting to the Pharmacy a written request on a form provided by the state Department of Health.


•    Protective services for the President and others:  We may disclose PHI about you to authorized federal official so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

  • Minnesota law generally does not permit this type of disclosure without written consent, or unless otherwise required by federal law.
  • Wisconsin law permits the release of records pursuant to a written request from a government agency.  Private pay patients may be able to opt out of this type of disclosure, unless the disclosure is required by law, by annually submitting to the Pharmacy a written request on a form provided by the state Department of Health.


•    Victims of abuse, neglect, or domestic violence:  We may disclose PHI about you to a government authority, such as a social service or protective services agency, if we reasonably believe you are a victim of abuse, neglect, or domestic violence.  We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.

  • Minnesota law requires us to report information about child abuse and maltreatment of vulnerable adults.  Other reports of violence or neglect that involve disclosures from your health record will not be made without your consent, unless the report is required by law.

 

  • Wisconsin law requires us to report information about threatened or suspected child abuse or neglect or suspected unborn child abuse.  Other reports of violence or neglect that involve disclosures from your health record will not be made without your consent, unless the report is required by law.


•    Sexually transmitted diseases:  

  • Under Iowa law, we will not disclose any HIV/AIDS-related information without your written consent, except in limited situations where we are required by law to disclose such information.  For example, we are required to disclose HIV/AIDS-related information to health care providers who have a medical need to know the information and to the Department of Public Health.
  • Under Montana law, we will not disclose information concerning persons infected or reasonably suspected to be infected with a sexually transmitted disease without written consent, except in limited situations where we are required to disclose such information.  For example, we are required to disclose such information to local health officers and to the Department of Public Health.
  • Wisconsin law generally requires your written consent to disclose information from your HIV test results, except under limited circumstances when the disclosure is required or permitted by state law.


•    Medicaid programs:  

  • Under Montana and South Dakota law, we will disclose PHI of Medicaid/CHIP participants only for purposes related to the administration of these programs, or as otherwise required by law, or with the participant’s written consent.


Other Uses and Disclosures of PHI

The Pharmacy will obtain your written authorization before using or disclosing PHI about you for purposes other than those provided for above (or as otherwise permitted or required by law).  You may revoke an this authorization in writing at any time.  Upon receipt of the written revocation, we will stop using or disclosing PHI about you, except to the extent that we have already taken action in reliance on the authorization.  

For More Information or to Report a Problem

If you have questions or would like additional information about the Pharmacy's privacy practices, you may contact the Privacy Officer, Thrifty White Drug, 6055 Nathan Lane N. Suite #200, Plymouth, MN 55442.  The e-mail address is privacyoffice@thriftywhite.com.   

If you believe your privacy rights have been violated, you can file a complaint by writing to:  Privacy Officer, Thrifty White Drug, 6055 Nathan Lane N. Suite 200, Plymouth, MN 55442.  You may also file a complaint with the Secretary of Health and Human Services.  There will be no retaliation against you for filing a complaint.  

Effective Date
This Notice is effective as of April 14, 2003, and was updated on December 1, 2006 and April 10, 2013.