Privacy Policy

Wellcare Pharmacy NOTICE OF PRIVACY PRACTICES

As part of the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, the Facility has created this Notice of Privacy Practices (Notice). ThisNotice describes the Facility’s privacy practices and the rights you, the individual, have as they relate to the privacy of your Protected Health Information (PHI). Your PHI isinformation about you, or that could be used to identify you, as it relates to your past and present physical and mental health care services. The HIPAA regulations requirethatthe Facility protect the privacy of your PHI that the Facility has received or created.

This Facility will abide by the terms presented within this Notice. For any uses or disclosures that are not listed below (Including Marketing and Selling of PHI), the Facilitywill obtain a written authorization from you for that use or disclosure, which you will have the right to revoke at any time, as explained in more detail below. The Facility reservestheright to change the Facility’s privacy practices and this Notice.

HOW THE FACILITY MAY USE AND DISCLOSE YOUR PHI

The following is an accounting of the ways that the Facility is permitted, by law, to use and disclose your PHI.

Uses and disclosures of PHI for Treatment: We will use the PHI that we receive from you to fill your prescription and coordinate or manage your health care.

Uses and disclosures of PHI for Payment: The Facility will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.

Uses and disclosures of PHI for Health Care Operations: The Facility may use the minimum necessary amount of your PHI to conduct quality assessments, improvement activities, and evaluate the Facility workforce.

The following is an accounting of additional ways in which the Facility is permitted or required to use or disclose PHI about you without your written authorization

Uses and disclosures as required by law: The Facility is required to use or disclose PHI about you as required and as limited by law.

Uses and disclosure for Public Health Activities: The Facility may use or disclose PHI about you to a public health authority that is authorized by law to collect for thepurposeofpreventing or controlling disease, injury, or disability. This includes the FDA so that it may monitor any adverse effects of drugs, foods, nutritional supplements and other products as required by law.

Uses and disclosure about victims of abuse, neglect or domestic violence: The Facility may use or disclose PHI about you to a government authority if it is reasonablybelievedyou are a victim of abuse, neglect or domestic violence.

Uses and disclosures for health oversight activities: The Facility may use or disclose PHI about you to a health oversight agency for oversight activities which may includeaudits, investigations, inspections as necessary for licensure, compliance with civil laws, or other activities the health oversight agency is authorized by law to conduct.

Disclosures to Individuals Involved in your Care: The Facility may disclose PHI about you to individuals involved in your care

Disclosures for judicial and administrative proceedings: The Facility may disclose PHI about you in the course of any judicial or administrative proceedings, providedthat properdocumentation is presented to the Facility

Disclosures for law enforcement purposes: The Facility may disclose PHI about you to law enforcement officials for authorized purposes as required by law or in responsetoacourt order or subpoena.

Uses and disclosures about the deceased: The Facility may disclose PHI about a deceased, or prior to, and in reasonable anticipation of an individual’s death, to coroners, medical examiners, and funeral directors.

Uses and disclosures for cadaveric organ, eye or tissue donation purposes: The Facility may use and disclose PHI for the purpose of procurement, banking, or transplantationof cadaveric organs, eyes, or tissues for donation purposes.

Uses and disclosures for research purposes: The Facility may use and disclose PHI about you for research purposes with a valid waiver of authorization approved byaninstitutional review board or a privacy board. Otherwise, the Facility will request a signed authorization by the individual for all other research purposes.

Uses and disclosures to avert a serious threat to health or safety: The Facility may use or disclose PHI about you, if it believed in good faith, and is consistent with anyapplicable law and standards of ethical conduct, to avert a serious threat to health or safety.

Uses and disclosures for specialized government functions: The Facility may use or disclose PHI about you for specialized government functions including; military andveteran’s activities, national security and intelligence, protective services, department of state functions, and correctional institutions and law enforcement custodial situations.

Disclosure for workers’ compensation: The Facility may disclose PHI about you as authorized by and to the extent necessary to comply with workers’ compensationlawsor programs established by law.

Disclosures for disaster relief purposes: The Facility may disclose PHI about you as authorized by law to a public or private entity to assist in disaster relief efforts andfor familyand personal representative notification.

Disclosures to business associates: The Facility may disclose PHI about you to the Facility’s business associates for services that they may provide to or for the Facilitytoassist the Facility to provide quality health care. To ensure the privacy of your PHI, we require all business

The Facility may contact you for the following purposes:

Information about treatment alternatives: The Facility may contact you to notify you of alternative treatments and/or

Health related benefits or services: The Facility may use your PHI to notify you of benefits and services the Facility provides.

Fundraising: If the Facility participates in a fundraising activity, the Facility may use demographic PHI to send you a fundraising packet, or the Facility may disclosedemographic PHI about you to its business associate or an institutionally related foundation to send you a fundraising packet. No further disclosure associates to applyappropriate safeguards to any PHI they receive or create.

FOR ALL OTHER USES AND DISCLOSURES

The Facility will obtain a written authorization from you for all other uses and disclosures of PHI, and the Facility will only use or disclose pursuant to such an authorization. Inaddition, you may revoke such an authorization in writing at any time. To revoke a previously authorized use or disclosure, please contact authorized Privacy Officer of Wellcare Pharmacy, to obtain a Request for Restriction of Uses and Disclosures.

YOUR HEALTH INFORMATION RIGHTS

The following are a list of your rights in respect to your PHI. Please contact the Privacy Officer, for more information about the below.

Request restrictions on certain uses and disclosures of your PHI: You have the right to request additional restrictions of the Facility’s uses and disclosures of your PHI; however,the Facility is not required to accommodate a request. This includes the right to restrict disclosures to Insurances for those products and services you pay out‐of‐pocket for

The right to have your PHI communicated to you by alternate means or locations: You have the right to request that the Facility communicate confidentially with youusinganaddress or phone number other than your residence. However, state and federal laws require the Facility to have an accurate address and home phone number in caseof emergencies. The Facility will consider all reasonable requests.

The right to inspect and/or obtain a copy your PHI: You have the right to request access and/or obtain a copy of your PHI that is contained in the Facility for the durationtheFacility maintains PHI about you. There may be a reasonable cost‐based charge for photocopying documents.

You will be notified in advance of incurring such charges, if any

The right to amend your PHI: You have the right to request an amendment of the PHI the Facility maintains about you, if you feel that the PHI the Facility has maintainedaboutyou is incorrect or otherwise incomplete. Under certain circumstances we may deny your request for amendment. If we do deny the request, you will have the right tohavethedenial reviewed by someone we designate who was not involved in the initial review. You may also ask the Secretary, United States Department of Health and HumanServices(“HHS”), or their appropriate designee, to review such a denial.

The right to receive an accounting of disclosures of your PHI: You have the right to receive an accounting of certain disclosures of your PHI made by the Facility.

The right to receive additional copies of the Facility’s Notice of Privacy Practices: You have the right to receive additional paper copies of this Notice, upon request, evenif youinitially agreed to receive the Notice electronically

Notification of Breaches: You will be notified of any breaches that have compromised the privacy of your PHI.

REVISIONS TO THE NOTICE OF PRIVACY PRACTICES

The Facility reserves the right to change and/or revise this Notice and make the new revised version applicable to all PHI received prior to its effective date. The Facilitywill alsopost the revised version of the Notice in the Facility

Notification of Breaches: You will be notified of any breaches that have compromised the privacy of your PHI.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Facility and/or to the Secretary of HHS, or his designee. If you wish to file a complaint with the Facility, please contact Wellcare Pharmacy if you wish to file a complaint with the Secretary, please write to:

http://www.hhs.gov/ocr/office/about/rgn‐hqaddresses.html

The Facility will not take any adverse action against you as a result of your filing of a complaint

CONTACT INFORMATION

If you have any questions on the Facility’s privacy practices or for clarification on anything contained within the Notice, please contact:

Privacy Office

Wellcare Pharmacy at 3078 W 7800 S Ste# 9 West Jordan, Utah - 84088