Notice of Privacy Practices

Our commitment to your privacy

Tribeca Pharmacy is committed to preserving the privacy of your personal health information. In fact, we are required by law to protect the privacy of your medical information and to provide you with this notice describing the following how your medical information is used and disclosed for your treatment, to obtain payment for treatment, administrative purposes, and to evaluate the quality of care that you receive.

Uses and Disclosures

We use and disclose elements of your Protected Health Information (PHI) in the following ways:

We may be required or permitted by certain laws to use and disclose your medical information for other purposes without your consent or authorization.

We will notify you by e-mail or US Mail of any breaches of your PHI.

• Treatment: including, but not limited to, inpatient, outpatient or psychiatric care.
• To your treating physician(s).
• Payment: including, but not limited to, asking you about your health care plan(s), or other sources of payment; preparing and sending bills or claims; and collecting unpaid amounts, either ourselves or through a collection agency or attorney.
• Health care operations: including, but not limited to, financial or billing audits; internal quality assurance; personnel decisions; participation in managed care plans; defense of legal matters; business planning; and outside storage of our records.
• Disclosures when release is authorized by law: including, but not limited to, judicial settings and to health oversight regulatory agencies, law enforcement, and correctional institutions.
• Uses or disclosures for specialized government functions: including, but not limited to, the protection of the President or high-ranking government officials; for lawful national intelligence activities; for military purposes; or for the evaluation and health of members of the foreign services.
• In emergency situations or to avert serious health/safety situations.
• If you are a member of the armed forces, we may release medical information about you and your dependents as requested by military command authorities.
• Disclosures of de-identified information.
• Disclosures relating to worker's compensation claims.
• To medical examiners, coroners or funeral directors to aid in identifying you or to help them in performing their duties.
• To organizations that handle organ and tissue donations.
• To public health organizations or federal organizations in the event of a communicable disease or to report a defective device or untoward event to a biological product (food or medication).
• Disclosures to "business associates" who perform health care operations for us and who commit to respect the privacy of your health information.

Your Rights

You have the following rights concerning your protected health information (PHI):

• Restrictions: To request restricted access to all or part of your PHI. To do this, contact the organization's HIPAA Privacy and Security Officer. We are not required to grant your request and you do not have the right to restrict disclosures required by law. If we do agree, we must honor the restrictions you request.
• Confidential Communications: To receive correspondence of confidential information by alternate means or location such as phoning you at work rather than at home or mailing your health information to a different address. To do this, contact the organization's HIPAA Privacy and Security Officer. We will take reasonable actions to accommodate your request.
• Access: To inspect or receive copies of your PHI. To do this, contact the organization's HIPAA Privacy and Security Officer. In certain circumstances you may not have the right to access your records if the organization reasonably believes (or has reason to believe) that such access would cause harm. Examples include, but are not limited to, certain psychotherapy notes, information compiled in reasonable anticipation of or for use in civil, criminal or administrative actions or proceedings, or information obtained from someone other than a healthcare provider under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information.
• Amendments / Corrections: To request changes be made to your PHI. To do this, contact the organization's HIPAA Privacy and Security Officer. We are not required to grant your request if we did not create the record or the record is accurate and complete. If we deny your request for amendment / correction, we will notify you why, how you can attach a statement of disagreement to your records (which we may rebut), and how you can complain. If we agree to the request, we will make the correction within 60 days and will send the corrected information to persons we know who got the wrong information, and others you specify.
• Accounting: To receive an accounting of the disclosures by us of your PHI. To do this, contact the organization's HIPAA Privacy and Security Officer. By law, the list will not include disclosures for purposes of treatment, payment or health care operations; disclosures with your authorization; incidental disclosures; disclosures required by law; and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it, but by law, we can have one 30-day extension of time if we notify you of the extension in writing. We are not required to give you a list of disclosures that occurred before April 14, 2003.
• This Notice: To get updates or reissue of this notice, at your request.
• Complaints: To complain to us or the U.S. Department of Health & Human Services if you feel your privacy rights have been violated. To register a complaint with us, contact: Tribeca Pharmacy (212) 328-4111 or Email at info@tribecapharmacy.com. The law forbids us from taking retaliatory action against you if you complain.

Our Duties

We are required by law to maintain the privacy of your protected health information (PHI). We must abide by the terms of this notice or any update of this notice.

As a patient of Tribeca Pharmacy, you have important rights relating to inspection and copying your medical information that we maintain, amending or correcting the information, obtaining an accounting of our disclosures of your medical information, requesting that we communicate with you confidentially, requesting that we restrict certain uses and disclosures of your health information, and complaining if you think your rights have been violated.

Additional information

The sections above are the notice as we have published it. The sections that follow add what federal and New York law also require us to tell you, and answer the questions we are asked most often at the counter.

People who pick up prescriptions for you, and family

A pharmacist may use professional judgment and let a family member, a friend, or someone else you send pick up your filled prescriptions and medical supplies at the counter. You do not have to name that person in advance. Someone who arrives and asks for your specific prescription is normally enough.

Copies of your records go to someone else only when you have asked us for that in writing. For an HIV, PrEP or PEP prescription, we ask you first before anyone else collects it, because New York protects that information more strictly.

We may also share information that is directly relevant to a person's involvement in your care or in paying for it. That person could be a family member, a relative, a close friend or a caregiver you identify. If you are here and able to say so, we ask you first, and you can say no.

If you are not here, or you are too unwell to tell us what you want, a pharmacist uses professional judgment about what is in your best interest. We then share only what that person needs. For example, a friend arrives to collect your medicines while you are unwell at home, and we explain how to take them. In a public emergency we may also share with a disaster relief organization, so your family can be told where you are and how you are.

New York holds a pharmacist to this personally. Releasing information that identifies you without your prior consent is professional misconduct for a pharmacist, unless a law authorizes or requires the release. That sits on top of the federal privacy rules. So if you want someone to be able to ask us questions about your medicines, and not just carry the bag home, tell us who that person is.

Tell us at the counter, or call (212) 328-4111. You can name someone, change who is named, or tell us that nobody may collect for you or ask us about you.

One rule we will not bend. Say you are under 18 and you came to us for HIV prevention or treatment, including PrEP or PEP, or for another sexually transmitted infection. We will not release your records or your billing records to your parent or guardian without your permission.

One thing we cannot control: if we bill a parent's or a guardian's health plan, the plan may send that person an explanation of benefits. If you do not want that, tell us before we run the claim, and pay for the prescription yourself. We must honor that request, and we will not ask you why.

HIV related information, and other information New York protects more strictly

Where New York law protects your information more strictly than the federal rules, we follow the stricter New York rule. HIV related information is the clearest case.

New York Public Health Law Article 27-F gives HIV related information stronger protection than federal law, and this pharmacy is a health care provider under that law. Confidential HIV related information means anything showing that you have had an HIV test, or that you have HIV, an HIV related illness or AIDS. It also covers anything that could reasonably identify you as having one of those conditions.

You do not have to be HIV positive for this protection to matter to you. PrEP and PEP care includes HIV testing, so a PrEP or PEP record can show that you were tested. We treat the fact that you filled a PrEP or PEP prescription with us as confidential HIV related information. That is true at the counter and in our records, and we hold it to the rules in this section.

New York law already allows a few releases without a separate signed form, and two of them come up here. We may talk with a provider who is treating you, including your prescriber, when they need to know in order to care for you. And we may send your plan what it needs to pay for the prescription. Everything else needs the signed release described next, unless another law requires or allows the release. A court order under section 2785 and an inspection by the agencies that oversee us are examples.

To release your HIV related information to anyone else, we need a written release that you sign and date. It must name who may receive the information, say why, and say how long it lasts. A general medical release form is not enough. We use the New York State Department of Health release form that covers HIV related information, and we keep current copies at the counter. Another form works too, as long as it meets those three points.

You can cancel a release at any time in writing, and canceling does not undo a release we already made.

When we do release HIV related information, New York law requires us to attach this warning, and we do. If we give the information out loud, we send the warning in writing within ten days.

"This information has been disclosed to you from confidential records which are protected by state law. State law prohibits you from making any further disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. Any unauthorized further disclosure in violation of state law may result in a fine or jail sentence or both. A general authorization for the release of medical or other information is NOT sufficient authorization for further disclosure."

Two more New York rules matter here. A subpoena is not enough for HIV related information. New York requires a court order that meets Public Health Law section 2785 before we may release it.

If you are under 18 and came to us for HIV prevention or treatment, including PrEP or PEP, or for another sexually transmitted infection, you consent for yourself. We will not give your records or your billing records to a parent or guardian without your permission. Where a minor has consented for their own care under New York law, the minor, not the parent, controls that information and holds the rights in this notice.

We write down each release of your HIV related information in your record. If you ask, we will tell you about those releases. That list is broader than the federal list of disclosures described below, because it includes releases for treatment and payment too.

When we need your written permission

Other uses and disclosures of your health information not described in this notice will be made only with your written permission.

You may take back a written permission at any time. Put it in writing and give it to us at the counter, email it to info@tribecapharmacy.com, or fax it to (212) 328-4100. Taking it back stops future sharing, except for anything we already did while the permission was in place.

Three kinds of use always need your written permission. After those three we add one promise of our own about advertising.

We do not use your health information to raise funds for the pharmacy or for any cause.

We may contact you about the medicines you are taking now. That includes refill reminders, reminders to keep taking your medicine, a generic version of what you take, and information about a medicine currently prescribed for you. Federal law does not count that as marketing.

We may also contact you about an appointment with us, for example a vaccination or a medication review. And we may tell you about services we offer that may help you, such as medication synchronization, blister packaging or a Medicare Part D plan review.

Tell us at the counter or call (212) 328-4111 to stop any of those messages, or to change how we send them.

• Psychotherapy notes: most uses and disclosures of psychotherapy notes require your written permission. We are a retail pharmacy and we do not create or keep psychotherapy notes.
• Marketing: we will not use or share your health information for marketing without your written permission. The only exceptions are talking with you face to face and giving you a promotional gift of small value. If anyone would pay us for a marketing message, the permission form will say so before you sign it.
• Sale of your health information: we do not sell your health information. If we ever asked your permission for something that counted as a sale, the form would have to say that we would be paid for it.
• Advertising, our own promise: we do not use your prescription records, your health information, or your visits to our health service pages to build advertising audiences. Any advertising audience we build comes from our retail shop pages only.

If you pay for something yourself

If a prescription or a service is paid for in full, and not by your health plan, you may ask us not to share information about it with the plan. You can pay yourself, or someone else can pay for you. That covers sharing for payment and for running the pharmacy. We must agree to that request, unless a law requires us to share it.

This is the one limit we cannot turn down, and we will not ask you why. Ask at the counter before we run the claim, or call (212) 328-4111. Once we have agreed, only you can lift the limit. We will not end it on our own.

There are honest limits to what this does. You have to pay in full at the time. It covers what we send to your plan, so it does not unwind a claim that has already gone through. And it does not stop your prescriber from sharing their own records.

If the medicine is a controlled substance, we must still report it to the New York State Prescription Monitoring Program registry, because that reporting is required by law. In an emergency, we may still use the information to treat you.

This right matters most to people who pay cash so a fill stays off a shared family plan or an employer linked plan. We treat those requests as routine.

Changes to this notice

We may change this notice. We reserve the right to change its terms, and to apply the new terms to all of the health information we hold, including information we created or received before the change.

If we make a material change, we will post the revised notice at the pharmacy at 177 Smith St and on our website. Paper copies will be at the counter for you to take. Ask us any time and we will give you the current version, or mail one to you.

We do not start doing anything new with your information before the date on the notice that describes it. Every version of this notice is dated, and we keep the earlier versions.

Some New York laws protect your information more strictly than federal law. Where that is true, we follow the stricter New York rule, and this notice describes it. Questions about anything here go to Adam Wahab, RPh, at (212) 328-4111 or info@tribecapharmacy.com.

More rights you have

These rights come from federal and New York law as well. To use any of them, ask at the counter, call (212) 328-4111, fax (212) 328-4100, or email info@tribecapharmacy.com.

• Get a paper copy of this notice. You can have a paper copy at any time, even if you read it here or agreed to receive it electronically. Ask any staff member at the counter, or call (212) 328-4111 and we will mail one to you.
• An electronic copy. We keep your records electronically, so you can ask for an electronic copy. We give it to you in the format you ask for, if we can produce it that way. If we cannot, we agree another electronic format with you.
• What a copy costs. We charge no more than what it actually costs us, and never more than the New York ceiling of 75 cents a page for paper copies. The charge covers only the work of copying, the paper, and postage if we mail it. We never refuse you a copy because you cannot pay. If the cost is a problem, tell us and we will work it out with you.
• Say who may collect for you. Name a person who may pick up your prescriptions, change who is named, or tell us that nobody may.
• Speak for yourself if you are a minor who consented to your own care. Where New York law lets you consent for yourself, these rights are yours, not your parent's. If you are twelve or older, we may tell you when someone else asks to see your records, and if you say no we may turn that person down.
• Have someone act for you. Someone with legal authority to make health care decisions for you may use these rights for you. That could be a parent or guardian of a child, a health care agent you appointed, a court appointed guardian, or the person settling your estate. We treat that person as if they were you. We ask to see the paperwork. We may say no if we reasonably believe that person has harmed you or would harm you. The New York rules for minors above still apply.