HIPAA Compliance Statement

ProCompounding Pharmacy will ask you to sign an Acknowledgement that you have received this Notice of Privacy Practices (Notice). This Notice describes how ProCompounding Pharmacy may use and disclose your protected health information in accordance with the HIPAA Privacy Rule. It also describes your rights and ProCompounding Pharmacy's duties with respect to protected health information about you.

Section A: Uses and Disclosures of Protected Health Information

1. Treatment, Payment and Health Care Operations

• We will use your health information to provide treatment. This may involve receiving or sharing information with other health care providers such as your physician.
• We will use your health information to obtain payment. This will include sending claims for payment to your insurance or third-party payer.
• We will use your health information for our health care operations necessary to run the pharmacy.

2. Permitted or Required Uses and Disclosures

Our pharmacists, using their professional judgment may disclose your protected health information to a family member, other relative, close personal friend or other person you identify as being involved in your health care.

Under certain circumstances ProCompounding Pharmacy may be required to disclose health information as required or permitted by federal or state laws, including but not limited to:

• To the Secretary of Health and Human Services for investigations
• To the Food and Drug Administration (FDA) relating to adverse events
• To public health or legal authorities charged with preventing or controlling disease
• To law enforcement agencies as required by law
• To health oversight agencies for audits, investigations and inspections
• In response to a court order or legal process
• As necessary to comply with worker's compensation laws
• To a Coroner or Medical Examiner when necessary
• To organ procurement organizations
• When necessary to prevent a serious threat to health and safety
• As required by military command authorities
• To authorized federal officials for national security activities

3. Authorized Use and Disclosure

Use or disclosure other than those previously listed will not be made unless we obtain your written Authorization in advance. You may revoke any such Authorization in writing at any time.

Section B: Patient's Rights

• Restriction Requests: You have a right to request a restriction be placed on the use and disclosure of your protected health information.
• Alternative Means of Communication: You have a right to receive confidential communications of protected health information by alternate methods or at alternate locations.
• Access to Health Information: You have a right to inspect and copy your protected health information.
• Amendments to Health Information: If you believe that your protected health information is incomplete or incorrect, you may request an amendment.
• Accounting of Uses and Disclosures: You have the right to request an accounting of uses and disclosures.
• Notice of Privacy Practices: You have a right to receive a paper copy of this Notice.

Section C: ProCompounding Pharmacy's Duties

ProCompounding Pharmacy is required by law to maintain the privacy of protected health information, to provide individuals with notice of its legal duties and privacy practices, and to notify affected individuals following a breach of unsecured protected health information.

Section D: Contacting Us

If you have questions about this Notice or how ProCompounding Pharmacy uses and discloses your protected health information please contact our Privacy Officer:

Secretary of Health and Human Services, Office for Civil Rights
For online complaint forms: www.hhs.gov/ocr/privacy
Email: OCRComplaint@hhs.gov