Except where prohibited by federal or state laws that require special privacy protections, we may use and disclose your PHI for treatment, payment and health care operations without your prior authorization as follows:
We may use and disclose your PHI to provide and coordinate the treatment, medications and services you receive. For example, we may disclose PHI to pharmacists, doctors, nurses, technicians and other personnel involved in your health care. We may also disclose your PHI with other third parties, such as hospitals, other pharmacies and other health care facilities and agencies, including healthcare information exchange networks, to facilitate the provision of health care services, medications, equipment and supplies you may need.
We may use and disclose your PHI in order to obtain payment for the health care products and services that we provide to you and for other payment activities related to the services that we provide or arrange. For example, we may contact your insurer, pharmacy benefit manager or other health care payer to determine whether it will pay for health care products and services you need and to determine the amount of your co-payment, deductible or co-insurance. We may contact you about a payment or balance due on your account. We may also disclose your PHI to other health care providers or HIPAA covered entities who may need it for their payment activities.
Health Care Operations
We may use and disclose your PHI for our health care operations. Health care operations are activities necessary for us to operate our health care businesses. For example, we may use your PHI to monitor the performance of the staff, including pharmacists or other health care professionals, providing treatment to you. We may use your PHI as part of our efforts to continually improve the quality and effectiveness of the health care products and services we provide. We may also analyze PHI to improve the quality and efficiency of health care, for example, to assess and improve outcomes for health care conditions. We may also disclose your PHI to HIPAA covered entities that have provided services to you so that they can improve the quality and effectiveness of the health care services that they provide. We may use your PHI to create de-identified data, which is stripped of your identifiable data and no longer identifies you.
We may contract with third parties to perform certain services for us, such as billing services or consulting services. These third party service providers, referred to as Business Associates, may need to access your PHI to perform services for us. They are required by contract and law to protect your PHI and only use and disclose it as necessary to perform their services for us.
To Communicate 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. Additionally, we may disclose PHI to your “personal representative.” If a person has the authority by law to make health care decisions for you, we will generally regard that person as your “personal representative” and treat him or her the same way we would treat you with respect to your PHI.
Food and Drug Administration (“FDA”)
We may disclose to 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.
To the extent necessary to comply with law, we may disclose your PHI to workers’ compensation or other similar programs established by law.
We may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability, including the FDA. In certain circumstances, we may also report work-related illnesses and injuries to employers for workplace safety purposes.
We may disclose your PHI for law enforcement purposes as required or permitted by law for example, in response to a subpoena or court order, in response to a request from law enforcement, and to report limited information in certain circumstances.
Comply With the Law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Health Oversight Activities
We may disclose your 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 your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to first tell you about the request or to obtain an order protecting the information requested.
We may use your PHI to conduct research and we may disclose your PHI to researchers as authorized by law. For example, we may use or disclose your PHI as part of a research study when the research has been approved by an institutional review board or privacy 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 your PHI to these entities so that they can carry out their duties.
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.
We may use or disclose your PHI to notify or assist in notifying a family member, personal representative, or another person
responsible for your care, regarding your location and general condition.
We may use and disclose your PHI to organizations for purposes of disaster relief efforts.
If you are or become an inmate of a correctional institution, we may disclose to the institution, or its agents, PHI necessary for your health and the health and safety of other individuals.
To Avert a Serious Threat to Health or Safety
We may use and disclose your PHI 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 or under law. We may also release PHI about foreign military personnel to the appropriate foreign 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 of 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 you or someone else.