Privacy Policy

NOTICE OF PRIVACY PRACTICES

HydeRx Services Corp. (HydeRx) - Effective Date: December 17, 2004

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.

Your Medical Information

At HydeRx, we are committed to protecting the privacy of your medical information.  This notice tells you about our policies and procedures regarding our use of your medical information and disclosure to others.  This notice also describes your rights concerning your medical information.

To perform our duties as the administrator of your drug benefit plan, we will be provided with or will create medical and health information about you, including information that relates to your past, present, and future physical or mental condition, the provision of health care, and payment for that care.  In this notice we will refer to such information as your medical information.

Our Responsibilities

We are required by law to maintain the privacy of your medical information and to provide you with a description of our legal duties and privacy practices with respect to your medical information.  This notice applies to all members of the plans administered by HydeRx. This notice describes how we may collect, use, and disclose your medical information. It also describes your rights concerning your medical information. We are required to abide by the terms of our current notice of privacy practices.

How We Use and Disclose Medical Information About You

Below are some examples of ways we may use medical information about you or disclose your medical information to others.

Treatment.  We may use your medical information to provide information and advice to your doctor, pharmacist, or other health care professionals to help manage your health care. For example, we might use your medical information to provide your pharmacist with drug-interaction warnings or to notify your doctor of less expensive drug alternatives. 

Information Regarding Benefits and Services.  We may use your medical information to contact you or send you information regarding benefits and services, alternative treatments, programs, or health-related products and services that may be of interest to you. We may also review your medical information with other patients information to evaluate the need for new services or treatment.  For example, we might send you information about quitting smoking or weight-loss programs, tablet splitting and mail order programs.

Payment.  We may use your medical information to determine costs and charges for your drug benefit coverage, to bill and collect payment from you or your drug benefit plan, and to help pay pharmacy bills for you submitted to us by you or your health care providers.  For example, we may give prescription information to your drug benefit plan administrator to determine if a drug is covered by the plan or to a pharmacy or other health care provider to help them check your eligibility for benefits.

Health Care Operations.  We may use your medical information to improve the drug benefit administration services and to evaluate the quality of services we provide.  For example, we may use or share your medical information:

• With a pharmacy, doctor, hospital, or other health care provider for pre-authorization or precertification of your health care services.
• For our business operations to ensure our members receive quality care.
• With an employee benefit plan or plan sponsor through which you receive health benefits. We only share your information with your benefit plan when they agree to keep it protected.
• With another health plan or payor in order to coordinate primary and secondary benefits.

Business Associates.  There are some services provided by our organization through contracts with business associates. When these services are arranged we may disclose your medical information to our business associate so that they can perform the job we have asked them to do.  To protect your medical information, however, we require the business associate to appropriately safeguard your information.

Legal Requirements.  We may be required or allowed to share your medical information with government agencies, including:

• The food and drug administration.
• Public health or legal authorities that prevent or control disease or promote health.
• Correctional institutions.
• Workers compensation agents.
• Organ and tissue donation organizations.
• Health oversight agencies.
• Funeral directors, coroners and medical directors.
• Military command authorities, national security and intelligence agencies, and others.

Law Enforcement/Legal Proceedings.  We may disclose your medical information in response to a court or administrative order, subpoena, discovery request, or other lawful process, including sharing medical information with law enforcement officials under limited circumstances. For example, in response to a warrant or subpoena, or for the purpose of identifying or locating a suspect, witness, or missing person, or to provide information concerning victims of crimes.

Research. We may disclose your medical information to researchers, if certain established steps are taken to protect your privacy.

Threat to Health or Safety. We may disclose your medical information to the extent necessary to avoid a serious and imminent threat to your health or safety or the health or safety of others.

State Requirements.  Your state may have requirements for reporting, including population-based activities relating to improving health or reducing healthcare costs.  Some states have their own privacy laws that may apply additional legal requirements.

Other Use or Disclosure of Your Medical Information.  Before we can use or disclose your medical information for any reason other than the reasons described above, we are required to obtain your written authorization. You may revoke any authorization you give at any time by telling us in writing that you revoke the authorization. After you revoke an authorization, your medical information will no longer be provided as a result of your earlier authorization.

What Are Your Rights?

You have the following rights regarding your medical information:
 
Restrictions on Use or Disclosure.  You have the right to ask us to restrict or limit the medical information about you we use and disclose for treatment, payment or health care operations, or other purposes.  This includes uses and disclosures to family members, relatives, close personal friends, or other persons identified by you who may be involved with your care or payment for your care. We are not required to agree to your request to restrict the information, but we will consider any request and tell you if we agree to your request.

Specific Manner of Communication.  You have the right to ask that we communicate with you about medical matters in a specific manner or at a specific location.  For example, you may ask that we contact you in writing at your home address.  Your request must be made in writing and clearly state that our disclosure of all or part of that communication could endanger you. You must also tell us the manner and/or location for communications (e.g., fax number, address, etc.).

Inspect and Copy.  You have the right to inspect and obtain a copy of the medical information that may be used to administer or make decisions regarding your enrollment, payment, claims processing, or case/medical management. If we don't maintain your requested medical information, but we know who does, we will tell you. Requests to access the information must be made in writing, and we will respond within 30 days of receipt of your request. We may charge a reasonable, cost-based fee to provide you with the information. In certain limited circumstances we may deny your request for information. For example, psychotherapy notes or information compiled for legal proceedings cannot be provided. If we deny access to your information we will notify you in writing. Our denial will include the reason for the denial, your review rights (if applicable), and information on how to file a complaint.

Amend.  If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.  All amendment requests must be in writing and include a reason for the request. We will respond within 60 days of receiving the request. If the request is approved, we will amend the information in our records and notify any other individual(s) whom we know and/or whom you have told us have received the information, and we will provide them with the amendment as well. In certain cases, your request may be denied. For example, we may deny a request if the information we have on file is accurate or if we did not create the information. We will notify you in writing if your request is denied and the reason for the denial and procedures available to you to challenge the denial.

Accounting of Disclosures.  You have the right to request an accounting of disclosures of your medical information. An accounting will list certain disclosures we make of your medical information for purposes other than disclosures for treatment, payment, or healthcare operations that are permitted without your authorization. The first accounting request in a 12-month period of time will be provided free of charge. Additional requests will be made if you pay a reasonable, cost-based fee, as agreed in advance. All requests for accounting must be made in writing.  We will respond within 60 days of receipt. There are some accountings we are not required to provide. For example, we will not provide accountings for disclosures that you have authorized, and certain other disclosures such as for national security purposes.

Paper Copy of this Notice.  You may request a copy of this notice at any time by writing or calling us at the address or phone number address provided below (See Complaints and Inquiries).  When we receive your request we will mail or fax a current notice to you. This privacy notice is also found on the following Web site: www.hyderx.com

For more information about this notice, or to assert these rights, please contact our Member Services Department at the telephone number below (See Complaints and Inquiries).

Complaints and Inquiries.

If you believe your privacy rights have been violated you may register a complaint with us or with the Secretary of the Department of Health and Human Services.  We will not retaliate against you or deny you any health plan benefit or service because you file a complaint. To file a complaint with us, please submit it in writing and address it to:

HydeRx Services Corporation
Attention: Privacy Officer
69 Marland Place
Colorado Springs, Colorado 80906
(720) 207-5107

To submit a complaint to the Secretary of the Department of Health and Human Services, please submit it in writing to:

Secretary, Department of Health and Human Services
200 Independence Ave SW
Washington, DC 20201 

Effective Date of this Notice and Changes to the Notice.

This notice is effective December 17, 2004. We reserve the right to change the terms of this notice.  Any changes to this notice will be effective for all medical information we already have about you as well as any medical information we receive in the future. If we change the notice, we will provide notice of the changes to you.  The current notice is posted on our Web site:  www.hyderx.com

We will promptly revise and distribute this notice whenever there is a material change to the uses or disclosures, your rights, our duties, or other practices stated in this notice. Except when required by law, we will not make a material change to this notice before the effective date of the new notice advising you of the material change.

This notice is a joint notice issued by HydeRx on behalf of itself and its agents and affiliates, including the organizations that provide data transfer and claims processing services to HydeRx. HydeRx shares medical information with affiliates and agents when necessary to carry out treatment, payment, or health care operations.