HIPAA Privacy Notice

Effective: July 1, 2020  |  Last Updated: September 1, 2022

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.

Our Role as a Business Associate

CAPSLRx acts as a Business Associate to Covered Entities (such as health plans and plan sponsors) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations. In that role, we receive, create, maintain, and transmit Protected Health Information (PHI) on behalf of those Covered Entities in connection with our pharmacy benefit management services.

We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices with respect to your PHI, and to notify affected individuals following a breach of unsecured PHI.

How We May Use and Disclose Your PHI

The following categories describe the ways we may use and disclose your PHI:

  • Treatment: We may use or disclose PHI to facilitate medical treatment or services by providers, including pharmacies. For example, we may disclose PHI to a pharmacy to enable them to fill your prescription.
  • Payment: We may use or disclose PHI to determine eligibility, process claims, and facilitate payment for health care services. This includes coordination of benefits with other payers.
  • Health Care Operations: We may use or disclose PHI for our internal operations, including quality assessment and improvement activities, case management, formulary development, and compliance activities.
  • As Required by Law: We will disclose PHI when required to do so by federal, state, or local law.
  • Public Health Activities: We may disclose PHI to public health authorities for activities such as reporting disease or injury, reporting vital events, or reporting to the FDA regarding products under FDA jurisdiction.
  • Business Associates: We may share PHI with our Business Associates who perform services on our behalf, provided they agree in writing to maintain the privacy and security of your PHI.

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke such an authorization at any time, in writing, except to the extent that we have already acted in reliance on your authorization.

The following uses and disclosures will only be made pursuant to a signed authorization from you unless otherwise permitted by law:

  • Most uses and disclosures of psychotherapy notes
  • Uses and disclosures for marketing purposes
  • Disclosures that constitute a sale of PHI

Your Rights Regarding Your PHI

You have the following rights regarding the PHI we maintain about you:

  • Right to Access: You have the right to inspect and copy PHI that we maintain about you. We may charge a reasonable fee for the costs of copying and mailing.
  • Right to Amend: If you believe that PHI we maintain about you is incorrect or incomplete, you may request an amendment. We may deny your request under certain circumstances.
  • Right to an Accounting of Disclosures: You have the right to request a list of the disclosures we have made of your PHI during the six years prior to the date of your request, other than disclosures for treatment, payment, and health care operations.
  • Right to Request Restrictions: You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to your request in most circumstances.
  • Right to Confidential Communications: You have the right to request that we communicate with you about health matters through alternative means or at alternative locations.
  • Right to a Copy of This Notice: You have the right to a paper copy of this Notice at any time.
  • Right to Notification of Breach: You have the right to be notified following a breach of unsecured PHI.

How to Exercise Your Rights

To exercise any of the rights described above, or if you have questions about this Notice, please contact us in writing at:

CAPSLRx Privacy Office
905 W. 27th Street
Scottsbluff, NE 69361
Phone: (833) 636-0208

Complaints

If you believe that we have violated your privacy rights, you have the right to file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services (HHS). To file a complaint with HHS, contact:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201
Toll-free: 1-877-696-6775
Website: hhs.gov/ocr/privacy

We will not retaliate against you for filing a complaint.

Changes to This Notice

We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI 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 our principal place of business and on our website. The Notice will contain on the first page, in the top right-hand corner, the effective date.