PLEASE REVIEW IT CAREFULLY.

Protected Health Information.  Under applicable law, we are required to protect the privacy of your individual health information (information we refer to in this notice as “Protected Health Information”).  We are permitted to make certain types of uses and disclosures under applicable law for treatment, payment, and healthcare operations purposes.  Therefore, this affects how your prescription fulfillment is managed.  We are also required to disclose such information under certain other circumstances and, of course, you have certain rights as well. 

Treatment.  We may obtain information to dispense prescriptions and for the documentation of pertinent information in your records that may assist us in managing your medication therapy or your overall health.  For treatment purposes, such use and disclosure will take place without your authorization in providing, coordinating, or managing healthcare and its related services by one or more of your providers, such as when your pharmacist consults with your physician or a specialist regarding your medications, treatment or condition.  Under certain circumstances, we may use and disclose your Protected Health Information if we are contacted by another pharmacy who states they have your request and consent to transfer pharmacy records to them.  We may also use your Protected health Information to communicate directly with you about services you have requested of us or to provide traditional pharmacy services such as refill reminders.

Payment.  We do not accept prescription insurance plans.  However, under certain circumstances your carrier may have special arrangements with us—for example, under certain workers compensation or automobile accident agreements you have approved.  Or, you may be a member of a group discount plan we honor.  In those cases, use age and disclosure of your Protected Health Information to one or several intermediaries employed by your plan sponsor—including but not limited to insurers, pharmacy benefits managers, claims administrators and computer switching companies—will take place to obtain or provide reimbursement for providing pharmaceutical care services.

Healthcare Operations.  For healthcare operations purposes, such use and disclosure will take place in a number of ways, including for quality assessment and improvement; provider review and training; underwriting activities; reviews and compliance activities; and planning, development, management and administration.  Your information could be used, for example, to assist in the evaluation of the quality of care that you were provided.

Managing Your Protected Health Information in Prescription Fulfillment.  We may use your name to reference your prescriptions and pharmaceutical care services.  You may be required to sign an acknowledgement of service and of receipt of this Notice and the disclosure of Protected Health Information as outlined herein.  We may disclose this to others who ask for you or your prescriptions by name.  We are able to provide treatment services to you even if you object to signing the acknowledgment of the receipt of this Notice or if we decide not to honor a request regarding the information in this document.  In the event of an emergency or your incapacity, we will do in our reasonable judgment what is consistent with your known preference, and what we determine to be in your best interest.  We will inform you of any such uses or disclosures if uses and disclosures would require your signed authorization under such circumstances and give you an opportunity to object as soon as practicable.  We may disclose to one of your family members, to a relative, to a close personal friend, or to any other person identified by you, Protected Health Information that is directly relevant to the person’s involvement with your care or payment related to your care.  In addition, we may use or disclose the Protected Health Information to notify, identify, or locate a member of your family, your personal representative, another person responsible for care, or certain disaster relief agencies of your location, general condition, or death.  If you are incapacitated, there is an emergency, or you object to this use or disclosure, we will do in our judgment what is in your best interest regarding such disclosure and will disclose only the information that is directly relevant to the person’s involvement with your healthcare.  We will also use our judgment and experience regarding your best interest in allowing people to pick up filled prescriptions or other similar forms of Protected Health Information.

Other Disclosure Requirements.  We may disclose Protected Health Information about you without your authorization to comply with workers compensation laws, as required by law enforcement, legal proceedings, public health requirements, health oversight activities and as required by law.  From time to time we may also employ the services of business associates who may assist us in one or more tasks and who may use, change or create Protected Health Information.  Business associates are required to comply with all the privacy regulations on your behalf. 

Your Rights.  Other than as described above, uses and disclosures will be made only with your written authorization, and you may revoke your authorization by notifying us at our address at the bottom of this page.  You may also ask us to restrict uses and disclosures of your Protected Health Information to carry out treatment, payment, or healthcare operations, or to restrict uses and disclosures to family members, relatives, friends, or other persons identified by you who are involved in your care or payment for your care orally or in writing.  However, we are not required to agree to your request.  You also have the right to request the following with respect to your Protected Health Information: (i) inspection and copying; (ii) amendment or correction; (iii) an accounting of the disclosures of this information by us (we are not required to account to you for disclosures made for treatment, payment, operations, disclosures to you, disclosures to your care givers, or for notifications or as otherwise excluded by law); and (iv) the right to receive a paper copy of this Notice upon request.  We may require you to pay for this request to cover our costs of copying, labor and postage.  In addition, you may request, and we must accommodate the request, if reasonable, to receive communications of Protected Health Information by alternative means or at alternative locations.  To make this request please write us at the address at the bottom of this page.  If you believe that your privacy rights have been violated, you may complain to us at the address below or to the Secretary of the Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue SW, Washington, DC 20201.  You will not be retaliated against for filing a complaint.

Other Information.  Only at your direction, and only to the extent specifically authorized by law, will we release other information to other persons.  For example, when you tell us how and where to ship your order, we provide that information to the courier service in order to deliver your order.  Normally, however, such information does not include Protected Health Information.

Electronic Data and Communications Security.  We store some of your Protected Health Information and other information in electronic computer files.  We backup our electronic records daily, secure that information off site, and employ other precautions to safeguard the integrity of your Protected Health Information and other information.  In spite of these precautions it is possible but unlikely that a computer crash or other technological failure could cause the loss of data.  In addition, reasonable safeguards are employed to protect your Protected Health Information and other information stored on electronic media.  Your communications with us over the Internet are encrypted using SSL—a standard encryption technology built into your computer’s browser.  We do not place any cookies on your computer.  We store the data you have provided over the Internet in a separate database apart from and not accessible by the Internet.  Only our customer service personnel and pharmacy professionals have access to your data.

Marketing.  We do not market by mail, telephone or e-mail, nor do we cooperate with anyone else to send promotional e-mails or make promotional telephone calls on our behalf to anyone.  Other than as described above, we do not give your name, telephone number, mailing address, e-mail address or any other information to anyone. 

About this Notice.   We must provide you with this Notice about our policies and procedures regarding your Protected Health Information and we must abide by the terms of this notice, as it may be updated from time to time.  We reserve the right to change the terms of this Notice and to make new Notice provisions effective for all Protected Health Information we maintain. You may receive a copy of this Notice by contacting us as at the address below, visiting us at www.United-Rx.com, or upon the receipt of pharmacy care services.  In a word, United Prescription Services, Inc. is absolutely committed to customer privacy.  If you have a question or comment about these issues, please e-mail us at Customer-Service@United-Rx.com, or just give us a call.

Date of Notice: February 20, 2003