HIPAA Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

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.

This notice applies to protected health information maintained by Lake Buena Vista Pharmacy LLC, including prescription records, medication histories, insurance information, and information related to pharmacy care.

Your Rights

You have the right to:

  • Inspect or obtain a copy of your paper or electronic pharmacy records.
  • Request corrections to your health information.
  • Request confidential communications.
  • Ask us to limit certain uses or disclosures.
  • Receive an accounting of certain disclosures.
  • Obtain a copy of this notice.
  • Have an authorized personal representative act for you.
  • File a complaint without retaliation.

Get a paper or electronic copy of your records

You may ask to inspect or receive a copy of prescription records and other health information in our designated record set.

We generally respond within 30 days. If a legally permitted extension is necessary, we will explain the reason and expected completion date in writing. We may charge a reasonable, cost-based fee as permitted by law.

If access is denied, we will provide a written explanation and explain any applicable review rights.

Ask us to correct your records

You may request an amendment if you believe information in your records is incorrect or incomplete.

We generally respond within 60 days. If a legally permitted extension is needed, we will notify you in writing. If we deny your request, we will explain why and how you may submit a statement of disagreement.

Request confidential communications

You may ask us to contact you in a specific way or at a different location—for example, using a particular telephone number or mailing address.

We will accommodate reasonable requests. Tell us if a communication method could reveal information you wish to keep private.

Ask us to limit what we use or share

You may request restrictions on how we use or disclose information for treatment, payment, or health care operations, or to people involved in your care.

We are generally not required to agree, except where the law requires us to do so.

If you pay for a health care item or service out-of-pocket in full, you may request that we not disclose information about that item or service to your health plan for payment or health care operations. We will honor this request unless disclosure is required by law. Please make the request before an insurance claim is submitted.

Get a list of certain disclosures

You may request an accounting of certain disclosures made during the six years before your request.

The accounting generally excludes disclosures for treatment, payment, and health care operations, disclosures made with your authorization, and other disclosures excluded by law.

The first accounting in a 12-month period is free. We may charge a reasonable fee for additional requests during that period after notifying you of the fee and giving you an opportunity to withdraw or modify your request.

Get a copy of this notice

You may request a paper copy at any time, even if you previously agreed to receive it electronically. A copy is also available on our website.

Choose someone to act for you

A legally authorized personal representative may exercise your privacy rights, subject to applicable law.

We will verify the person's identity and authority before providing access or accepting instructions.

File a complaint

If you believe your privacy rights have been violated, contact our Privacy Contact using the information below.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, Phone: 1-877-696-6775, Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html

We will not retaliate against you for filing a complaint.

Your Choices

Family, friends, and others involved in your care

When permitted by law, we may share information directly relevant to a family member's, friend's, caregiver's, or other person's involvement in your care or payment for your care.

For example, we may provide information needed by someone you have authorized to pick up your prescription.

You may tell us your preferences or object to these disclosures. If you cannot express your preferences, we may use professional judgment to make a limited disclosure in your best interest.

Disaster relief

We may share limited information with authorized disaster relief organizations to help notify people about your location, condition, or safety, as permitted by law.

Uses requiring written authorization

We will obtain your written authorization before:

Using or disclosing protected health information for marketing when authorization is required by law.

Selling protected health information when authorization is required by law.

Disclosing psychotherapy notes, if we maintain them, except for limited legally permitted situations.

Making other uses or disclosures not permitted by law or described in this notice.

You may revoke an authorization in writing at any time. Revocation does not affect actions already taken in reliance on your authorization.

Fundraising

If we contact you for fundraising, you may opt out of future fundraising communications. Your decision will not affect your treatment or payment.

If fundraising involves substance use disorder records protected by 42 CFR Part 2, we will provide clear advance notice and an opportunity to choose whether to receive those communications.

Our Uses and Disclosures

Treatment

We may use and disclose your information to provide pharmacy care and coordinate treatment with other health care professionals.

Example: A pharmacist contacts your prescriber to clarify a prescription, discuss a possible interaction, or recommend an appropriate medication change.

We may contact you about refills, medication safety, treatment alternatives, or health-related services, as permitted by law.

Payment

We may use and disclose information to obtain payment for prescriptions and pharmacy services.

Example: We submit prescription and insurance information to your health plan or pharmacy benefit manager to process a claim.

Health care operations

We may use and disclose information to operate the pharmacy, improve services, review quality, train authorized personnel, conduct audits, and meet compliance requirements.

Example: We review dispensing records to evaluate medication safety and improve pharmacy procedures.

Service providers

We may share information with service providers acting on our behalf, such as pharmacy technology providers, billing services, or secure record-storage providers.

When required, these providers must enter into agreements protecting your health information and limiting its use and disclosure.

Other Permitted or Required Disclosures

The following disclosures are subject to applicable legal conditions. Where another law provides greater protection, we follow that law.

Public health and safety

We may disclose information for legally permitted public health purposes, including reporting adverse medication reactions, supporting product recalls, preventing or controlling disease, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious and imminent threat to health or safety.

Compliance with law

We may disclose information when required by federal or state law, including legally required controlled-substance reporting and disclosures to HHS to determine compliance with privacy requirements.

Health oversight

We may disclose information to authorized health oversight agencies for activities such as audits, investigations, inspections, and licensure, as permitted by law.

Legal proceedings

We may disclose information in response to a court or administrative order, subpoena, discovery request, or other lawful process, subject to applicable legal requirements.

Law enforcement

We may disclose information to law enforcement officials as permitted or required by law, including to identify or locate a suspect, fugitive, material witness, or missing person, or to report a crime.

Coroners, medical examiners, and funeral directors

We may disclose information to coroners, medical examiners, and funeral directors as permitted by law.

Organ and tissue donation

We may disclose information to organizations involved in organ, eye, or tissue procurement or transplantation, as permitted by law.

Research

We may use or disclose information for research purposes when an institutional review board or privacy board has reviewed and approved the research, or when other legal conditions are met.

Military and veterans

We may disclose information about armed forces personnel as required by military command authorities or as otherwise permitted by law.

National security and intelligence

We may disclose information to authorized federal officials for lawful intelligence, counterintelligence, and national security activities.

Protective services

We may disclose information to authorized federal officials to protect the President, other authorized persons, or foreign heads of state, or to conduct special investigations.

Inmates

If you are an inmate of a correctional institution, we may disclose information to the institution or law enforcement officials as permitted by law.

Workers' compensation

We may disclose information as authorized by and to the extent necessary to comply with workers' compensation or similar programs.

Our Responsibilities

We are required by law to:

  • Maintain the privacy and security of your protected health information.
  • Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
  • Follow the duties and privacy practices described in this notice and provide you with a copy of it.
  • Not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to this notice

We may change the terms of this notice at any time. The new notice will apply to all health information we already have about you as well as any information we receive in the future.

We will post a copy of the current notice at the pharmacy and on our website. You may request a copy at any time.

Questions or Requests

To exercise your rights, ask questions about this notice, or file a complaint, contact our Privacy Contact:

Lake Buena Vista Pharmacy LLC

13401 Blue Heron Beach Drive, Suite 101, Orlando, FL 32821

(407) 778-1100

lakebuenavistapharmacy5@gmail.com

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