Memorial Medical Pharmacy is committed to safeguarding your protected health information and maintaining the privacy and security of your medical information. This HIPAA Notice is designed to inform you about your rights and our obligations under the Health Insurance Portability and Accountability Act (HIPAA).
Your protected health information Privacy Rights
You have the following rights concerning your protected health information:
a. Right to Access: You have the right to access and obtain a copy of your PROTECTED HEALTH INFORMATION held by our pharmacy. To do so, please contact us.
b. Right to Request Amendments: You can request corrections or amendments to your PROTECTED HEALTH INFORMATION if you believe the information is inaccurate or incomplete. Please contact us to initiate this process.
c. Right to Receive an Accounting: You can request an accounting of the disclosures of your PROTECTED HEALTH INFORMATION for certain purposes.
d. Right to Request Restrictions: You have the right to request restrictions on how your PROTECTED HEALTH INFORMATION is used or disclosed. We will consider your request but may not be able to accommodate it in all cases.
e. Right to Confidential Communications: You have the right to request alternative methods of communication or an alternative address for receiving your PROTECTED HEALTH INFORMATION.
f. Right to Complain: If you believe your privacy rights have been violated, you can file a complaint with us or with the Department of Health and Human Services. We will not retaliate against you for filing a complaint.
Our Obligations
We are required to:
a. Maintain the privacy of your PROTECTED HEALTH INFORMATION.
b. Provide you with this notice of our legal duties and privacy practices.
c. Abide by the terms of the notice currently in effect.
Uses and Disclosures of PROTECTED HEALTH INFORMATION
We may use and disclose your PROTECTED HEALTH INFORMATION for the following purposes:
a. Treatment: We may use your PROTECTED HEALTH INFORMATION to dispense medication and provide other pharmacy services.
b. Payment: We may use and disclose your PROTECTED HEALTH INFORMATION to bill and collect payment from you, your insurance, or a third party.
c. Health Care Operations: We may use and disclose your PROTECTED HEALTH INFORMATION for our internal operations, such as quality assurance and training.
d. Required by Law: We will use and disclose your PROTECTED HEALTH INFORMATION when required by law.
e. Public Health: We may disclose your PROTECTED HEALTH INFORMATION for public health activities and to report adverse events.
f. Law Enforcement: We may disclose your PROTECTED HEALTH INFORMATION to law enforcement for specific purposes, such as legal investigations.
g. Marketing: We will not use your PROTECTED HEALTH INFORMATION for marketing purposes without your written authorization.
Changes to this Notice
We reserve the right to change our practices and this notice. Any revised notice will be posted on our website and will apply to all PROTECTED HEALTH INFORMATION we maintain.
For More Information or to Report a Problem
If you have questions or concerns about this notice, please contact our Privacy Officer at
Memorial Medical Pharmacy
1510 S. Central Ave. Suite 110
Glendale, CA 91204
(818) 247-0526
https://www.memmedrx.com
This Notice is in effect from the Effective Date and remains in effect until a revised notice is issued.
Effective Date: 10/11/2023