NOTICE OF PRIVACY RIGHTS AND PRACTICES FOR YOUR PERSONAL INFORMATION
EFFECTIVE: 1/1/2021
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.
Our duties and pledge to protect your personal health information (“PHI”)
We are required by law to maintain the privacy of your health information and to provide you with this
Notice of our legal duties and privacy practices with respect to protected health information.
We are required to protect the confidentiality of your PHI and will disclose your PHI to a person other
than you or your personal representative only when permitted under federal or state law. This
protection extends to any PHI that is oral, written or electronic, such as information transmitted by
facsimile, modem or any other electronic device. This Notice describes how we may use and disclose
your PHI without your express permission. In all other circumstances, we will obtain your written
authorization before we use or disclose your PHI. This Notice also describes your rights and the
obligations we have regarding the use and disclosure of your PHI. Under federal and applicable state
law, we are required to follow the terms of the Notice currently in effect. In some situations, state
privacy or other applicable laws may provide greater privacy protections than those sated in this Notice.
For example, depending on the state in which you reside, there may be additional state law privacy
protections related to communicable diseases, reproductive health, substance abuse, and mental
health. When appropriate, we will follow these state or other applicable laws.
HOW WE MAY USE AND DISCLOSE YOUR PERSONAL HEALTH INFORMATION
How We May Use and Disclose Your PHI Without Your Permission for Treatment, Payment or
Healthcare Operations
Below are examples of how federal law permits use or disclosure of your PHI for these purposes without
your permission:
Treatment: PHI obtained by EPLS and its associates will be used to coordinate prescription assistance
services. We may also use and disclose your PHI to your physician, other healthcare providers, drug
companies or other third party sources to facilitate in this coordination.
We will not share your mobile details or personally identifiable information with third parties or affiliates. We do not conduct any marketing or promotional ideas.
Payment: We may contact drug companies or other third party sources to determine your potential
discount.
Other Special Circumstances
In addition to the above, we are permitted under federal and applicable state laws to use or disclose
your PHI without your permission only in certain circumstances, as described below:
Business Associates: We utilize services of other entities termed “business associates”. Federal law
requires us to enter into contracts with these entities to require them to safeguard your PHI and use
and disclose it only as specified by us.
Individuals involved in your care or payment for care: We may disclose your PHI to a friend,
personal representatives or family member involved in your medical care or payment for your care.
For example, if we can reasonably infer that you agree, we may provide information to your
caregiver on your behalf.
Disclosures to parents or legal guardians: If you are a minor, we may release your PHI to your
parents or legal guardians when we are permitted or required under federal or applicable state law.
Workers’ compensation: We may disclose your PHI to the extent authorized and necessary to
comply with laws relating to workers’ compensation or similar programs established by law.
Law enforcement: We may disclose your PHI for law enforcement purposes as required by law or in
response to a court order and in certain conditions, a subpoena, warrant, summons or similar
process.
As required by law: We must disclose your PHI when required to do so by applicable federal or state
law.
Judicial and administrative proceedings: We may disclose your PHI in response to a court
administrative order, and under certain conditions, subpoena, discovery request or other lawful
process.
Public health: We may disclose your PHI to federal, state or local authorities or other entities
charged with preventing or controlling disease, injury or disability for public health activities. These
activities may include the following: disclosures to report reactions to medications or other
products to the U.S. Food and Drug Administration or other authorized entity; disclosures to notify
individuals of recalls, exposure to a disease or risk for contracting or spreading a disease or
condition.
Health oversight activities: We may disclose your PHI to an oversight agency for health oversight
activities authorized by law. These activities include audits, investigations, government programs,
and compliance with federal and applicate state law.
United States Department of Health and Human Services: Under federal law, we are required to
disclose your PHI to the U.S. Department of Health and Human Services to determine if we are in
compliance with federal laws and regulations regarding the privacy of health information.
Coroners, medical examiners, and funeral directors: We may release your PHI to assist in identifying
a deceased person or determine a cause of death.
Administrators or executor: Upon your death, we may disclose your PHI to an administrator,
executor or other similarly authorized individual under applicable state law.
Organ or tissue procurement organizations: Consistent with applicable law, we may disclose your
PHI to organ procurement organizations or other entities engaged in the procurement, banking or
transplantation of organs for the purpose of tissue donation and transplant.
To avert a serious threat to health or safety: We may use and disclose your PHI to appropriate
authorities when necessary to prevent a serious threat to your health and safety or the health and
safety of another person or the public.
How We May Use or Disclose Your PHI for Other Purposes Only with Your Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes other than
those described. You may revoke this authorization at any time by submitting a written notice to our
address listed in the Contact Information below. Your revocation will not apply to information released
before we receive it. You have the following rights with respect to your PHI:
Obtain a paper copy of the Notice upon request. To obtain a copy, contact us at the address, phone
number or email address listed in the Contact Information.
Inspect and obtain a copy of your PHI. You have a right to access and copy your PHI. To inspect or
obtain a copy of your PHI, submit a written request to our address listed in the Contact Information.
We will respond to your request in writing within 30 days. A fee may be charged for the expense of
fulfilling your request. We may deny your request in certain circumstances, such as if we have
reasonably determined that providing access to PHI would endanger your life or safety or cause
substantial harm to you or another person. If we deny your request, we will notify you in writing
and provide you with the opportunity to request a review of the denial.
Request an amendment of PHI: If you feel that your PHI maintained by us is incomplete or incorrect,
you may request that we amend it. To request and amendment, submit a written request to our
address listed in the Contact Information. Requests must identify: (i) which information you seek to
amend, (ii) what corrections you would like to make, and (iii) why the information needs to be
amended. We will respond to your request in writing within 60 days (with a possible 30‐day
extension). In our response, we will either (i) agree to make the amendment, (ii) inform you of our
denial, explain our reason and outline appeal procedures. If denied, you have the right to file a
statement of disagreement with the decision. We will provide a rebuttal to your statement and
maintain appropriate records of your disagreement ad our rebuttal.
Receive an accounting of disclosures of PHI. You have the right to request an accounting of
disclosures of your PHI for purposes other than treatment, payment or healthcare operations. This
accounting will also exclude disclosures made directly to you, made with your authorization, made
to your caregivers, and certain other disclosures. To obtain an accounting, submit a written request
to our address listed in the Contact Information. Requests must specify the time period, not to
exceed six years. We will respond in writing within 60 days of receipt of your request (with a
possible 30‐day extension). We will provide one free accounting per 12‐month period, but you may
be charged for the cost of any subsequent accountings during the same period. We will notify you
in advance of the cost involved, and you may choose to withdraw or modify your request at that
time.
Request communications of PHI by alternative means or at alternative locations. You have the right
to request that we communicate with you in a certain way or at a certain location. For example, you
may request that we contact you only in writing at a specific address. To request confidential
communication of your PHI, submit a written request to our address listed in the Contact
Information. Your request must state how, where or when you would like to be contacted. We will
accommodate all reasonable requests.
Request a restriction on certain uses and disclosures of PHI. You have the right to request a
restriction or limitation on our use or disclosure of your PHI by submitting a written request to our
address listed in the Contact Information.
You must identify in this request: (i) what particular information you would like to limit,
(ii) whether you want to limit use, disclosure or both, and (iii) to whom you want the limits to apply.
All requests will be carefully considered, but we are not required to agree to those restrictions. We
will provide you with a written response to your request within 30 days. If we do agree to restrict
use or disclosure of your PHI, we will not apply these restrictions in the event of an emergency. We
also have the right to terminate the restriction if (i) you agree orally or in writing or (ii) we inform
you of the termination, which becomes effective only with respect to your PHI created or received
after we inform you of the termination.
We will notify you promptly if a disclosure occurs in a manner that has not been detailed in this Notice if
that disclosure may have compromised the privacy or security of your information.
Complaints, Questions, and Further Information
We are sincerely committed to protecting your personal privacy. We encourage you to contact us if you
any questions or concerns or want further information about this Notice, our privacy practices or your
privacy rights. We encourage you to contact us at the address listed in the Contact Information if you
have any complaint about our privacy practices, believe that your privacy rights have been violated or
have any complaint about your privacy rights. You may also file a complaint with the Office for Civil
Rights in the U.S. Department of Health and Human Services. You have our assurance that we will not
retaliate in any way for your asking questions, requesting further information or filing a complaint.
Contact Information
HIPAA Privacy Officer
EPLS, LLC
2250 Erin Court
Lancaster, PA 17601
Phone Number: 717-844-9030
Email Address: Rxinfo@epls.biz
Changes to this Notice
This Notice of Privacy Rights and Practices is effective 1/1/2021. We reserve the right to change our
privacy practices at any time by updating this Notice. We will provide a copy of this notice to you
through contact by any of the means above.
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