NATIONS 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.

Nations 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”).

Nations Pharmacy is required to follow the terms of the Notice. We will not use or disclose your PHI without your written authorization, except as described or otherwise permitted by the 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.

YOUR HEALTH INFORMATION RIGHTS

You have the following rights with respect to PHI about you:

Obtain a paper copy of the Notice upon request. You may request a copy of the Notice at any time. Even if you agreed to receive the Notice electronically, you are still entitled to a paper copy. You may obtain a paper copy from the pharmacy by contacting our Privacy Office to request that a Notice be mailed to you.

Inspect and obtain a copy of PHI. You have the right to access and copy PHI about you contained in a designated record set for as long as the Pharmacy maintains the PHI. The designated record set will include prescription, delivery tickets, and billing records. To inspect or obtain a copy of PHI about you, you must send a written request to our Privacy Office. 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 communications of PHI by alternative means or at alternative locations. You have the right to request to receive communications of PHI from the Pharmacy by alternative means or at an alternative location. To request confidential communication of PHI about you, you must submit a request in to the Privacy Office. Your request must tell us how or where you would like to be contacted. We will accommodate all reasonable requests.

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 the Privacy Office. You must include a reason that supports your request. In certain cases, we may deny your request for amendment.

Request an accounting of disclosures of PHI. You have the right to receive an accounting of disclosures we have made of your PHI about you after April 14, 2003 for most purposed other than treatment, payment, or health care operations. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to our Privacy Office. Your request must specify the time period for which you wish to obtain an accounting, which may not exceed six years.

Request a restriction on certain use and disclosures of PHI. You have the right to request additional restrictions on our use or disclosure of PHI about you by sending a written request to our Privacy Office. We are not required to agree to those restrictions.

EXAMPLES OF HOW WE MAY USE AND DISCLOSE PHI

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, information obtained by the pharmacist will be used to dispense prescription medications to you, and may be used to monitor the effectiveness, safety, and compliance of your drug therapy. In addition, we may contact you to provide refill reminders, information about medication management services that we offer, educational information about current or new therapeutic products; and/or other health-related benefits and services that may be of interest to you.

Payment. The pharmacy and its billing office may use your health information for various payment-related functions. Example: We may contact your insure, 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 my use your health information for certain operational, administrative, and quality assurance activities. Example: We may use information in your health record to monitor drug usage and inventory levels.

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

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.

Business Associates: We contract with business associates to perform certain services or functions to or on behalf of the Pharmacy. For example, we may contract with a business associate to perform billing services for us. We may disclose PHI about you to our business associates so that they can perform the job we have asked them to do. To protect PHI about you, we require our business associates to appropriately safeguard the PHI.

Communication 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.

Workers’ Compensation: We may disclose PHI about you as authorized by and as necessary to comply with laws relating to workers’ compensation or similar programs established by law.

Public Health: As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law Enforcement: We may disclose PHI about you for law enforcement purposes as required by law or in response to a valid subpoena or other legal process.

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 our 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 PHI about you in response to a court or administrative order. We may also disclose PHI about you in a 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 requested PHI.

Research: We may disclose PHI about you to researchers when their research has been approved by an institutional review 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 PHI about you 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 carry out their duties.

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

Fundraising: We may contact you as part of a fundraising effort.

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

Correctional Institution: If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others.

To Avert a Serious Threat to Health or Safety: We may use and disclose PHI about you 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 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 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 your or someone else.

For More Information or To Report a Problem
If you have questions or would like additional information about Nations Pharmacy privacy practices, you may contact our Privacy Officer at Nations Pharmacy , P.O. Box 6510, Spring Hill, Fl 34611, or you may call the Privacy Office toll-free at 1-800-752-7139. If you believe your privacy rights have been violated, you can file a complaint with our Privacy Officer or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

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