[From Costco.com website]
PLEASE REVIEW THE FOLLOWING INFORMATION CAREFULLY,
AS THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
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ONCE YOU HAVE REVIEWED AND UNDERSTAND THIS
NOTICE, SELECT THE 'ACCEPT' BUTTON BELOW TO CONTINUE. |
| Translation: If
you do not "ACCEPT" the contract you cannot access your
prescriptions. How do you like them apples, Mr. Robinson? |
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Effective Date: April 14, 2003
Costco Health Centers
NOTICE OF PRIVACY PRACTICES
General Information About This Notice
Costco continues its commitment to maintaining the confidentiality of
your private health information. This Notice describes our efforts to
safeguard your health information from improper or unnecessary use or
disclosure while providing you with the high quality/low cost goods and
services Costco members have come to expect. This Notice only applies to
health-related information received by or on behalf of Costco
Pharmacies, Costco Optical Centers, and Costco Hearing Aid Centers
(collectively, the "Costco Health Centers"). A new federal law requires
us to provide you with a summary of the Costco Health Centers' privacy
practices and related legal duties, and your rights in connection with
the use and disclosure of your Costco Health Center information.
This Notice applies to customers and patrons of any of the Costco Health
Centers, whether services are provided by a Costco Health Center
representative or through our www.costco.com Web site.
The Costco Health Centers, and Costco employees and third parties who
perform services for the Costco Health Centers, are bound by the terms
of this Notice. When we refer to actions by or obligations of the Costco
Health Centers in this Notice, we are including these Costco employees
and third parties who perform Costco Health Center functions.
Contact Information
If you have any questions regarding this Notice, please contact:
Costco Wholesale
999 Lake Drive
Issaquah, Washington 98027
Attn: Privacy Officer
(425) 313-8347
email: healthcareprivacy@costco.com
Please note:
This Notice only applies to Costco Members and other patrons who are
customers of the Costco Pharmacies, Costco Optical Centers, and Costco
Hearing Aid Centers.
This Notice does not apply to products or services provided by
independent contractors who may provide health-related services and
products at Costco Warehouses. Independent optometrists/ophthalmologists
and certain providers of medical services, such as osteoporosis testing
and flu shots, are not employees of Costco. If you are a customer of, or
receive services from, any of these independent health care providers,
you should request from them a copy of their privacy notice.
What is Protected?
The Health Insurance Portability and Accountability Act of 1996 ("HIPAA"),
a new federal law, requires that Costco Health Centers have a special
policy for safeguarding a category of health information related to you
called "protected health information," or "PHI," received or created in
the course of providing services to you through the Costco Health
Centers. PHI is health information that relates to: your physical or
mental health condition, the provision of health care to you, or payment
for your health carethat can be used to identify you. Your
prescriptions, vision test results, and audiogram results, as well as
the information you provide on any Costco Health Center patient health
history form are all examples of PHI.
The remainder of this Notice generally describes our rules with respect
to PHI received or created by the Costco Health Centers.
Uses and Disclosures of PHI
To protect the privacy of PHI, the Costco Health Centers not only guard
the physical security of PHI, but we also limit the way PHI is used or
disclosed to others. We may use or disclose PHI in certain permissible
ways described below.
To provide you with health care services and products. Costco Health
Centers use and disclose PHI in order to provide you with health care
services and products. For example, in our hearing aid department we use
your audiogram results in order to provide you with the appropriate
hearing aid. Our pharmacists ask you questions regarding drug allergies
or review your prescription history in order to ensure that we do not
provide you prescription drugs to which you may be allergic or which may
interact with other prescriptions. Costco opticians use your
prescription from your ophthalmologist or optometrist to provide you
with the appropriate corrective eye glasses or contact lenses.
To another health care provider if needed for your treatment. For
example, we may discuss your prescription information with your primary
care physician if a Costco pharmacist has a drug interaction concern or
questions regarding your prescription.
To bill you for health care services or products. Costco Health Centers
use and disclose PHI to bill you and to accept payment for prescription
drugs, glasses, contact lenses, or hearing aids which you may purchase.
For example, an associate in the Costco Pharmacy may ring up your
prescription drug purchases.
To seek reimbursement or calculate rebates for health care products or
services you receive at Costco Health Centers. For example, Costco
Health Centers use and disclose PHI to receive payments from your health
plan for covered prescription drugs purchased from a Costco Pharmacy. If
you are a Costco Executive Member, your purchase information from any
Costco Health Center will be combined with other personal information to
calculate your Executive Member 2% Reward, subject to the terms and
conditions of that program. We may also submit PHI to a third party who
will help you secure rebates from manufacturers on your Costco Health
Center purchases.
For the administration and operation of the Costco Health Centers. We
use and disclose PHI for numerous administrative and quality control
functions necessary for the Costco Health Centers' proper operation. For
example, we may use your pharmacy prescription drug purchase information
for fraud and abuse detection activities or to conduct data analyses for
planning-related purposes.
To inform you about treatment alternatives or other health-related
benefits that may be offered by Costco Health Centers. For example, we
may use your prescription data to alert you to a generic drug available
as a substitute for the prescription drug you are currently using.
To another health care provider or health plan for administration and
operations purposes. We may share PHI with another health care provider
or a health plan who has a relationship with you for quality assessment
and improvement activities, to review the qualifications of health care
professionals who provide care to you, or for fraud and abuse detection
and prevention purposes.
To a family member, friend, or other person involved in your health
care if you are present and you do not object to the sharing of PHI or
in the event of an emergency. Our Health Centers may also allow a family
member, friend or other person to pick up your purchases if, in the
exercise of professional judgment and experience, we determine it is in
your best interests.
To comply with an applicable federal, state, or local law, including,
for example, workers' compensation programs established by law.
For public health reasons, including to a public health authority for
the prevention or control of disease, injury or disability; to a proper
government or health authority to report child abuse or neglect; to
report reactions to medications or problems with products regulated by
the Food and Drug Administration; to notify individuals of recalls of
medication or products they may be using; or to notify a person who may
have been exposed to a communicable disease or who may be at risk for
contracting or spreading a disease or condition.
To report a suspected case of abuse, neglect or domestic violence, as
permitted or required by applicable law.
To comply with health oversight activities, such as audits,
investigations, inspections, licensure actions, and other government
monitoring and activities related to health care provision or public
benefits or services. For example, Costco Pharmacies are subject to
reporting requirements regarding narcotics under state and federal law,
and are subject to periodic and random inspections by state pharmacy
boards. Inspectors or other government officials may view or receive PHI
as a result of a government inspection or other request.
To the U.S. Department of Health and Human Services to demonstrate our
compliance with HIPAA.
To respond to an order of a court or administrative tribunal, such as
a court ordered warrant, subpoena or summons, grand jury subpoena, or
administrative subpoena or other request.
To respond to a subpoena, warrant, summons or other legal request if
sufficient safeguards, such as a protective order in the case of a
private lawsuit, are in place to maintain PHI privacy.
To a law enforcement official for a law enforcement purpose as
required by law.
For purposes of public safety or national security.
To allow a coroner or medical examiner to identify you or determine
your cause of death.
To allow a funeral director to carry out his or her duties.
To respond to a request by military command authorities if you are or
were a member of the armed forces.
To the extent required under law, we use the minimum amount of PHI
necessary to perform these tasks.
If an applicable state law provides greater health information privacy
protections than the federal law, we will comply with the stricter state
law.
Other Uses and Disclosures of PHI
Before we use or disclose PHI for any other purpose than as described
above, we must obtain your written authorization. You may revoke your
authorization, in writing, at any time. If you revoke your
authorization, the Costco Health Centers will no longer use or disclose
PHI except as described above (or as permitted by any other
authorizations that have not been revoked). However, please understand
that we cannot retrieve any PHI disclosed to a third party in reliance
on your prior authorization.
Your Rights
Federal law provides you with certain rights regarding PHI that pertains
to you. Parents of minor children and other individuals with legal
authority to make health decisions for customers of Costco Health
Centers may exercise these rights on behalf of such customers,
consistent with state law.
Right to request restrictions: You have the right to request a
restriction or limitation on the Costco Health Centers' use or
disclosure of PHI. The law does not require the Costco Health Centers to
agree to your request for restriction and depending upon your request,
we may not be able to grant it because it may affect our ability to
provide health care services or products to you. However, if we do agree
to your requested restriction or limitation, we will honor the
restriction until you agree to terminate the restriction or until we
notify you that we are terminating the restriction on a going-forward
basis.
You may submit a written request for restriction on the use and
disclosure of PHI to our Privacy Officer. Your request must specify: (i)
the PHI you want to limit; (ii) how you want the Costco Health Centers
to limit the use, disclosure, or both of that PHI; and (iii) to whom you
want the restrictions to apply.
Right to receive confidential communications: You have the right to
request that the Costco Health Centers communicate with you about PHI at
a new address or by different means if you believe that communication
through normal business practices could endanger you. You may submit a
written request for confidential communications to your local Costco
Health Center.
Right to obtain a copy of PHI: You have the right to review and obtain a
copy of PHI that is contained in medical or billing records that the
Costco Health Centers maintain or other records that the Costco Health
Centers use to make decisions about you.
However, we will not give you access to PHI records created in
anticipation of a civil, criminal or administrative action or
proceeding. We will also deny your request to inspect and copy PHI if a
licensed health care professional hired by the Costco Health Centers has
determined that giving you the requested access is reasonably likely to
endanger the life or physical safety of you or another individual or to
cause substantial harm to you or another individual, or that the record
makes references to another person (other than a health care provider),
and that the requested access would likely cause substantial harm to the
other person.
If your request to access PHI is denied, you may have that decision
reviewed. A different licensed health care professional chosen by the
Costco Health Centers will review the request and denial, and we will
comply with the health care professional's decision.
You may make a request to review or obtain a copy of PHI at your local
Costco Health Center. We may charge you a fee to cover the costs of
copying, mailing or other supplies directly associated with your
request. You will be notified of any costs before you incur any
expenses.
Right to amend PHI: You have the right to request an amendment of PHI if
you believe the information the Costco Health Centers have about you is
incorrect or incomplete. You have this right as long as PHI is
maintained by the Costco Health Centers. We will correct any mistakes if
we created the PHI or if the person or entity that originally created
the PHI is no longer available to make the amendment.
Amendments involving the addition of information to Costco Health Center
records may generally be made at your local Costco Health Center.
However, for other types of changes, or if the local Costco Health
Center is unable to accommodate your request, you must submit a written
request to amend PHI by filling out a Request for Amendment form
available from the Privacy Officer and submitting the form back to our
Privacy Officer. You should include evidence to support your request
because we cannot amend PHI that we believe to be accurate and complete.
Right to receive an accounting of disclosures of PHI: You have the right
to request a list of certain disclosures of PHI by the Costco Health
Centers. The accounting will not include (i) disclosures necessary to
provide treatment, to determine proper payment, or to operate the Costco
Health Centers, (ii) disclosures we make to you, (iii) disclosures
permitted by your authorization, (iv) disclosures to friends or family
members as discussed in this Notice, or made in your presence or because
of an emergency, or (v) disclosures for national security purposes. Your
first request for an accounting within a 12-month period will be free.
We may charge you for costs associated with providing you additional
accountings. We will notify you of the costs involved, and you may
choose to withdraw or modify your request before you incur any expenses.
You may submit a written request for an accounting of disclosures of PHI
by filling out a Request for Accounting of Disclosures form available
from the Privacy Officer and submitting the form back to the Privacy
Officer. Your request must include (i) the time period for the
accounting, which may not be longer than six (6) years and may not
include dates prior to April 14, 2003; and (ii) the form (e.g.,
electronic, paper) in which you would like the accounting.
Right to file a complaint: If you believe your rights have been
violated, you should let us know immediately. We will take steps to
remedy any violations of the Costco Health Centers' privacy policy or of
this Notice.
You may file a formal complaint with our Privacy Officer and/or with the
United States Department of Health and Human Services at the addresses
below. You should attach any documents or evidence that supports your
belief that your privacy rights have been violated. We take your
complaints very seriously. Costco policy and federal law prohibit
retaliation against any person for filing such a complaint.
Complaints should be sent to:
Costco Wholesale
Attn: Privacy Officer
999 Lake Drive
Issaquah, Washington 98027
(425) 313-8347
healthcareprivacy@costco.com U.S. Department of Health and Human
Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
www.hhs.gov/ocr/hipaa/
Additional Information About This Notice
Changes to this Notice: We reserve the right to change the Costco Health
Centers' privacy practices as described in this Notice. Any change may
affect the use and disclosure of PHI already maintained by the Costco
Health Centers, as well as any of PHI that the Costco Health Centers may
receive or create in the future. If there is a material change to the
terms of this Notice, revised Notices will be made available at each
Costco Health Center and by logging on to Costco's Web site at
www.costco.com under the Costco Health Centers section.
Acknowledgement: When first delivering this Notice to you, each of the
Costco Health Centers will ask you to sign an acknowledgement that you
were provided a copy of this Notice.
How to obtain an additional copy of this Notice: You can obtain a copy
of the current notice by writing our Privacy Officer at the address or
e-mail address set out in this Notice or by logging on to Costco's Web
site at www.costco.com under the Costco Health Centers section.
I have reviewed the Costco Health Center Notice of Privacy Practices
effective April 14, 2003 (the Notice) and understand that all my
medical information will be used by Costco in accordance with the
Notice.
©1998-2003 Costco Wholesale Corporation. All rights reserved. [Used by
Russell R. Robinson for the non-commercial
www.costcowebpharmacysucks.com website under the Fair Use
doctrine]
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