POLICIES

NARMC Notice of Privacy Practices

 

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND RELEASED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Who Will Follow this Notice


This notice describes our System’s practices and that of:

  • Any member of a volunteer group we allow to help you while you are in the hospital.

  • All employees, members of the Hospital Medical Staff and other System personnel.

  • Any healthcare professional authorized to enter information into your medical record.

 

Understanding Your Patient Information


Each time you visit a hospital, doctor, or other medical person, a record of your visit is made. Usually, this record contains your symptoms, examination and test results, conclusions, treatments, and a plan for future care or treatment. This information, often referred to as your medical record, serves as a:

 

  • Tool for planning your care and treatment

  • Means of communication among the many medical people who contribute to your care

  • Legal document describing the care you received

  • Means by which you or an insurance company can verify that services billed were actually provided

  • A tool in educating medical personnel

  • A source of data for medical research

  • A source of information for public health officials charged with improving the health of the nation

  • A source of data for facility planning and marketing

  • A tool with which we can assess and continually work to improve the care we render and the results of patients


Your hospital, doctor or medical person will also maintain information concerning the charges to your account for your medical attention, any insurance companies who may have a financial duty for payment of your bill and the status of your account.


Understanding what is in your record and how your patient information is used helps you to:

 

  • Check its accuracy

  • Better understand who, what, when, where, and why others may access your medical information

  • Make more informed decisions when allowing disclosure to others

  • Know your Medical Information rights


Although your medical record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:


Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or release about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we release about you to someone who is involved in your care or the payment of your care, like a family member or friend. For example, you could ask us not to leave test results on your answering machine.


We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing and forms are available from the Home Care department. In your request, you must tell us (1) what information you want to limit; (2) if you want to limit use, release or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.


Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy medical information that may be used to make decisions about you, you must fill out an authorization form available from any department. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another medical professional chosen by the hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.


Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend or change the information. You have the right to request an amendment for as long as the information is kept by the Home Care Department. To request an amendment, call the Home Care Department 870-414-4100 for a form, fill it out and return it to the Home Care Department or mail it to North Arkansas Regional Medical Center, Attn: Home Care, 620 North Main Street, Harrison, Arkansas 72601.


We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

 

  • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

  • Is not part of the medical information kept by NARMC;

  • Is not part of the information which you would be permitted to inspect and copy; orIs accurate and complete.

 

Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the releases we have made of your medical information. To request this list, call the Medical Records Department 870-414-4058 or stop by and ask for an “Accounting of Disclosures Form”. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a twelve (12) month period will be free. For additional lists, we will charge you for the costs of providing the list. We will notify you of the cost before payment so you may withdrawal or modify your 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. To request confidential communications, you may talk to the admissions department or the department where you are receiving your care. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
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. You may obtain a copy of this notice on our website, www.narmc.com or at the Admissions Department.

 

 


Our Responsibilities


This organization is required to:

  • Maintain the privacy of your medical information

  • Provide you with a Notice of Privacy Practices

  • Abide by the terms of the Notice of Privacy Practices currently in effect

  • Notify you if we are unable to agree to a requested restriction

  • Accommodate reasonable requests you may have to communicate medical information by alternative means or at alternative locations

 

We reserve the right to change our practices and to make the new provisions effective for all protected medical information we keep. If revised, copies of the revised "Notice of Privacy Policies" will be available via our web site www.narmc.com or by contacting either the NARMC's Admissions Department or NARMC Privacy Officer.


We will not use or release your medical information without your written authorization, except as described in this notice. If you provide us with permission to use or release medical information about you, you may revoke the permission, in writing, at any time and we will no longer use or release medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any releases we have already made with your permission and that we are required to retain our records of the care that we provided to you.
 

 


How We May Release Medical Information About You Treatment Purposes
 

We may use medical information about you to provide you with medical treatment or services. For example: Information obtained by a nurse or other member of your healthcare team will be recorded in your medical record and used to determine the course of treatment that should work best for you. Medical information from your medical record maybe released to your physician’s office for follow up care.


Payment Purposes: We may use and release medical information about you so that the treatment and services you receive at the NARMC may be billed to an insurance company or a third party and payment may be collected from you. For example: A bill will be sent to you or your insurance company.


Health Care Operations: We may use and release medical information about you for hospital operations. These uses and releases are necessary to run the hospital and make sure that all of our patients receive quality care. For example: members of the quality improvement team may use information in your medical record for quality improvement purposes.


Business Associates: There are some services provided in our organization through contract with outside companies called business associates. For example: the computer repairman that works on our billing software. We may release your medical information to our business associate so that they can perform their job and bill you or your insurance company for services. These business associates are required to safeguard your information.


Appointment Reminders: We may use and release medical information to contact you as a reminder that your have an appointment for treatment or medical care.


Treatment Alternatives: We may use and release medical information to tell you about or recommend possible alternative treatment options or alternatives that may be of interest to you.


Health Related Benefits and Services: We may use and release medical information to tell you about health related benefits or services that may be of interest to you. For example: medical equipment or supplies


Directory: Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes while you are a patient at the hospital. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name at our information desk.


Notification: We may use or release information to notify or assist in notifying a family member, personal representative, or another person responsible for your care of your location and general condition.


Communication with Family: Health professionals, using their best judgment, may release to a family member or any other person you identify, medical information relevant to that person's involvement in your care or payment related to your care.


Fund Raising: We may contact you as part of a fund-raising effort for the hospital or an organization related to the hospital. We will only release contact information, such as your name, address and phone number and the dates you received treatment or services. If you do not want the hospital to contact you for fund-raising efforts, you must notify North Arkansas Regional Medical Center in writing at


Attn: Foundation, 620 North Main, Harrison, Arkansas 72601.


Research: We may release information to researchers when their research has been approved by an institutional review board and privacy protocols have been established.


As Required By Law: We will release medical information about you when required to do so by federal, state or local law.


To Avert a Serious Threat to Health or Safety: We may use and release medial information about you when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person.


Coroners, Medical Examiners, and Funeral directors: We may release medical information to coroners, medical examiners or funeral directors when required by law to allow these individuals to carry out their duties.


Organ Procurement Organizations: When required by law, we may release medical information to organ procurement organizations for the purpose of tissue donation and transplant.


Food and Drug Administration (FDA): We may release to the FDA medical information related to accidental events relating to food, supplements, product and product defects, or to allow product recalls, repairs, or replacement.


Workers Compensation: We may release medical information to the limit allowed by law to workers compensation or other similar programs required by law.


Public Health: As required by law, we may release your medical information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.


Registry: As required by law, we may release your medical information to state and national registries. For example: If you are diagnosed with cancer we will send your medical information to the Arkansas Central Cancer Registry.


Correctional Institution: Should you be an inmate of a correctional institution, we may release to the institution or law officers medical information necessary for your health and the health and safety of other individuals.


Law Enforcement: We may release medical information for law enforcement purposes as required by law or in response to a valid subpoena.


Military and Veterans: If you are or have been a member of the armed forces, we may release medical information about you as required by military authorities.


Health Oversight Activities: We may release medical information to a health oversight agency for activities authorized by law, including, for example, hospital audits, investigations, inspections and licensure.


Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may release medical information about you in response to a court or administrative order. We may also release medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.


National Security and Intelligence Activities: We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.


Protective Services for the President and Others: We may release medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
 

 


For More Information or to Report a Problem
 

If you have questions and would like additional information, you may contact the NARMC Privacy Officer at 870-414-4052. If you believe your privacy rights have been violated, you can file a complaint with the Patient Hotline by calling 870-414-5020 or by submitting in writing your complaint to the U.S. Department of Health and Human
Services. You will not be penalized and no adverse actions will be taken against you for filing a complaint.
 
Effective Date: April 14, 2003

Notice of Privacy Practices for NARMC Home Care

 

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND RELEASED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Who Will Follow this Notice


This notice describes our System’s practices and that of:

  • Any member of a volunteer group we allow to help you while you are in the hospital.

  • All employees, members of the Hospital Medical Staff and other System personnel.

  • Any healthcare professional authorized to enter information into your medical record.

 

 

Understanding Your Patient Information


Each time you visit a hospital, doctor, or other medical person, a record of your visit is made. Usually, this record contains your symptoms, examination and test results, conclusions, treatments, and a plan for future care or treatment. This information, often referred to as your medical record, serves as a:

  • Tool for planning your care and treatment

  • Means of communication among the many medical people who contribute to your care

  • Legal document describing the care you received

  • Means by which you or an insurance company can verify that services billed were actually provided

  • A tool in educating medical personnel

  • A source of data for medical research

  • A source of information for public health officials charged with improving the health of the nation

  • A source of data for facility planning and marketing

  • A tool with which we can assess and continually work to improve the care we render and the results of patients

 

Your hospital, doctor or medical person will also maintain information concerning the charges to your account for your medical attention, any insurance companies who may have a financial duty for payment of your bill and the status of your account.


Understanding what is in your record and how your patient information is used helps you to:

 

  • Check its accuracy

  • Better understand who, what, when, where, and why others may access your medical information

  • Make more informed decisions when allowing disclosure to others

  • Know your Medical Information rights


Although your medical record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

 

  • Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or release about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we release about you to someone who is involved in your care or the payment of your care, like a family member or friend. For example, you could ask us not to leave test results on your answering machine.

  • We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing and forms are available from the Home Care department. In your request, you must tell us (1) what information you want to limit; (2) if you want to limit use, release or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

  • Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy medical information that may be used to make decisions about you, you must fill out an authorization form available from any department. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another medical professional chosen by the hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

  • Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend or change the information. You have the right to request an amendment for as long as the information is kept by the Home Care Department. To request an amendment, call the Home Care Department 365-2100 for a form, fill it out and return it to the Home Care Department or mail it to North Arkansas Regional Medical Center, Attn: Home Care, 825 North Spring, Harrison, Arkansas 72601.


We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

 

  • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

  • Is not part of the medical information kept by NARMC;

  • Is not part of the information which you would be permitted to inspect and copy; orIs accurate and complete.

 

Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the releases we have made of your medical information. To request this list, call the Home Care Department 365-2100 or stop by and ask for an “Accounting of Disclosures Form”. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a twelve (12) month period will be free. For additional lists, we will charge you for the costs of providing the list. We will notify you of the cost before payment so you may withdrawal or modify your 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. To request confidential communications, you may talk to the admissions department or the department where you are receiving your care. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.


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. You may obtain a copy of this notice on our website, www.narmc.com or at the Home Care Department.
 

 


Our Responsibilities


This organization is required to:

 

  • Maintain the privacy of your medical information

  • Provide you with a Notice of Privacy Practices

  • Abide by the terms of the Notice of Privacy Practices currently in effect

  • Notify you if we are unable to agree to a requested restriction

  • Accommodate reasonable requests you may have to communicate medical information by alternative means or at alternative locations


We reserve the right to change our practices and to make the new provisions effective for all protected medical information we keep. If revised, copies of the revised "Notice of Privacy Policies" will be available via our web site www.narmc.com or by contacting either the NARMC's Home Care Department or NARMC Privacy Officer.


We will not use or release your medical information without your written authorization, except as described in this notice. If you provide us with permission to use or release medical information about you, you may revoke the permission, in writing, at any time and we will no longer use or release medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any releases we have already made with your permission and that we are required to retain our records of the care that we provided to you.
 

 


How We May Release Medical Information About You Treatment Purposes
 

We may use medical information about you to provide you with medical treatment or services. For example: Information obtained by a nurse or other member of your healthcare team will be recorded in your medical record and used to determine the course of treatment that should work best for you. Medical information from your medical record maybe released to your physician’s office for follow up care.


Payment Purposes: We may use and release medical information about you so that the treatment and services you receive at the NARMC may be billed to an insurance company or a third party and payment may be collected from you. For example: A bill will be sent to you or your insurance company.


Health Care Operations: We may use and release medical information about you for hospital operations. These uses and releases are necessary to run the hospital and make sure that all of our patients receive quality care. For example: members of the quality improvement team may use information in your medical record for quality improvement purposes.


Business Associates: There are some services provided in our organization through contract with outside companies called business associates. For example: the computer repairman that works on our billing software. We may release your medical information to our business associate so that they can perform their job and bill you or your insurance company for services. These business associates are required to safeguard your information.


Appointment Reminders: We may use and release medical information to contact you as a reminder that your have an appointment for treatment or medical care.


Treatment Alternatives: We may use and release medical information to tell you about or recommend possible alternative treatment options or alternatives that may be of interest to you.


Health Related Benefits and Services: We may use and release medical information to tell you about health related benefits or services that may be of interest to you. For example: medical equipment or supplies


Directory: Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes while you are a patient at the hospital. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name at our information desk.


Notification: We may use or release information to notify or assist in notifying a family member, personal representative, or another person responsible for your care of your location and general condition.


Communication with Family: Health professionals, using their best judgment, may release to a family member or any other person you identify, medical information relevant to that person's involvement in your care or payment related to your care.


Fund Raising: We may contact you as part of a fund-raising effort for the hospital or an organization related to the hospital. We will only release contact information, such as your name, address and phone number and the dates you received treatment or services. If you do not want the hospital to contact you for fund-raising efforts, you must notify North Arkansas Regional Medical Center in writing at


Attn: Hospice of the Hills Inc., PO Box1927, Harrison, Arkansas 72601.


Research: We may release information to researchers when their research has been approved by an institutional review board and privacy protocols have been established.


As Required By Law: We will release medical information about you when required to do so by federal, state or local law.


To Avert a Serious Threat to Health or Safety: We may use and release medial information about you when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person.


Coroners, Medical Examiners, and Funeral directors: We may release medical information to coroners, medical examiners or funeral directors when required by law to allow these individuals to carry out their duties.


Organ Procurement Organizations: When required by law, we may release medical information to organ procurement organizations for the purpose of tissue donation and transplant.
Food and Drug Administration (FDA): We may release to the FDA medical information related to accidental events relating to food, supplements, product and product defects, or to allow product recalls, repairs, or replacement.


Workers Compensation: We may release medical information to the limit allowed by law to workers compensation or other similar programs required by law.


Public Health: As required by law, we may release your medical information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.


Registry: As required by law, we may release your medical information to state and national registries. For example: If you are diagnosed with cancer we will send your medical information to the Arkansas Central Cancer Registry.


Correctional Institution: Should you be an inmate of a correctional institution, we may release to the institution or law officers medical information necessary for your health and the health and safety of other individuals.


Law Enforcement: We may release medical information for law enforcement purposes as required by law or in response to a valid subpoena.


Military and Veterans: If you are or have been a member of the armed forces, we may release medical information about you as required by military authorities.


Health Oversight Activities: We may release medical information to a health oversight agency for activities authorized by law, including, for example, hospital audits, investigations, inspections and licensure.


Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may release medical information about you in response to a court or administrative order. We may also release medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.


National Security and Intelligence Activities: We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.


Protective Services for the President and Others: We may release medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
 


For More Information or to Report a Problem


If you have questions and would like additional information, you may contact the NARMC Privacy Officer at 870-414-5020. If you believe your privacy rights have been violated, you can file a complaint with the Home Care Department by calling 870-414-5020 or by submitting in writing your complaint to the U.S. Department of Health and Human Services. You will not be penalized and no adverse actions will be taken against you for filing a complaint.
 
Effective Date: April 14, 2003 Copyright 2003, North Arkansas Regional Medical Center

NARMC Pharmacy Notice of Privacy Practices

 

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.


NARMC Pharmacy is required by law to maintain the privacy of Protected Health Information ("PHI") and to provide you with notice of our legal duties and privacy practices with respect to PHI. PHI is 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 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 your PHI.


We are required to provide this notice to you by the Health Insurance Portability and Accountability Act ("HIPAA"). NARMC Pharmacy is required to follow the terms of the Notice currently in effect. We will not use or disclose your PHI without your written authorization, except as described or otherwise permitted by 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 any revised Notice to you.
 

 


Examples of How We Use and Disclose Protected Health Information About You


The following categories describe different ways that we use and disclose your protected health information. We have provided you with examples in certain categories; however, not every use or disclosure in a category will be listed.

 

Treatment. We may use your health information to provide and coordinate the treatment, medications and services you receive. For example, we may contact you regarding compliance programs such as drug recommendations, therapeutic substitution, refill reminders, other product recommendations, counseling and drug utilization review (DUR), product recalls or disease state management.
 
Payment. We may use your health information for various payment-related functions. Example: We may contact your insurer, pharmacy benefit manager or other health care payor to determine whether it will pay for your medication and the amount of your co-payment. We will bill you or a third-party payor for the cost of medications dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the medications you are taking.
 
Health Care Operations. We may use your health information for certain operational, administrative and quality assurance activities. Example: We 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. We may disclose health information to business associates if they need to receive this information to provide a service to us and will agree to abide by specific HIPAA rules relating to the protection of health information.

 

We are permitted to use or disclose your PHI for the following purposes. However, NARMC Pharmacy may never have reason to make some of these disclosures.
 

 


Disclosures


To Communicate with Individuals Involved in Your Care or Payment for Your Care: We may disclose to a family member, other relative, close personal friend or any other person you identify, PHI directly relevant to that person's involvement in your care or payment related to your care.


Business Associates: There are some services provided in our Pharmacy through contract with outside companies called business associates. For example: fill in example here. We may release your medical information to our business associate so that they can perform their job and bill you or your insurance company for services. These business associates are required to safeguard your information.


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 your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker's compensation or other similar programs established by law.


Public Health: As required by law, we may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability. Law Enforcement. We may disclose your PHI for law enforcement purposes as required by law or in response to a subpoena or court order.


As Required by Law: We will disclose your PHI when required to do so by federal, state, or local law.


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


Judicial and Administrative Proceedings:. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to tell you about the request or to obtain an order protecting the information requested.


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


Coroners, Medical Examiners, and Funeral Directors: We may release your PHI 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 enable them to carry out their duties.


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


Notification: We may use or disclose your PHI to notify or assist in notifying a family member, personal representative, or another person responsible for your care, regarding your location and general condition.


Correctional Institution: If you are or become an inmate of a correctional institution, we may disclose to the institution or its agents PHI necessary for your health and the health and safety of other individuals.
To Avert a Serious Threat to Health or Safety:. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.


Military and Veterans: If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.


National Security, Intelligence Activities, and Protective Services for the President and Others: We may release PHI about you to federal officials for intelligence, counterintelligence, protection to the President and other authorized persons or foreign heads of state, and other national security activities authorized by law.


Victims of Abuse or Neglect: We may disclose PHI about you to a government authority if we reasonably believe you are a victim of abuse or neglect. 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.


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

 


Your Health Information Rights


Obtain a paper copy of the Notice upon request. You may request a copy of our current Notice at any time. You may obtain a copy of this notice on our website, www.narmc.com. Request a restriction on certain uses and disclosures of PHI. You have the right to request additional restrictions on our use or disclosure of your PHI by sending a written request to NARMC Pharmacy. We are not required to agree to those restrictions. We cannot agree to restrictions on uses or disclosures that are legally required, or which are necessary to administer our business.


For example: It may be necessary for NARMC Pharmacy to necessary information to third party carriers so that we can be reimbursed. Inspect and obtain a copy of PHI. In most cases, you have the right to access and copy the PHI that we maintain about you. To inspect or copy your PHI, you must fill out a Authorization to Release Medical Information form and send it to NARMC Pharmacy.


We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request. We may deny your request to inspect and copy in certain limited circumstances. 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. To request an amendment, you must send a written request to NARMC Pharmacy. Amendment forms are available at the Pharmacy.


You must include a reason that supports your request. In certain cases, we may deny your request for amendment. 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 right to receive an accounting is subject to certain exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to NARMC Pharmacy.
Accounting of Disclosure forms are available at the Pharmacy.


Your request must specify the time period. The time period may not be longer than six years and may not include dates before April 14, 2003. Request communications of PHI by alternative means or at alternative locations. For instance, you may request that we contact you at a different residence or post office box. To request confidential communication of your PHI, you must submit a request in writing to NARMC Pharmacy. Your request must tell us how or where you would like to be contacted. We will accommodate all reasonable requests.

 


 
Incidental Disclosures

 

NARMC Pharmacy will make reasonable efforts to avoid incidental disclosures of protected health information. An example of an incidental disclosure is conversations that may be overheard between the pharmacy staff and the patient at the drive-thru, as a result of the speaker system. To reduce the likelihood of this happening, we recommend that you go inside the store to the pharmacy for any consultations.


Minors. If you are a minor who has lawfully provided consent for treatment and you wish for NARMC Pharmacy to treat you as an adult for purposes of access to and disclosure of records related to such treatment, please notify a pharmacist or NARMC Pharmacy.

For More Information or To Report a Problem


If you have questions and would like additional information, you may contact the NARMC Privacy Officer at 870-414-5020. If you believe your privacy rights have been violated, you can file a complaint on the NARMC Patient Hotline by calling 870-414-5020 or by submitting in writing your complaint to the U.S. Department of Health and Human Services. You will not be penalized and no adverse actions will be taken against you for filing a complaint.
 

Effective Date This Notice is effective as of April 13, 2003.

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