fm's {we ARTMENT HUMAN Voice 565-1340, (800} 3634019, TDD (451?) 565- 133.12%) FAX (617} 565-3309, TARY Of?ce for Civil Rights, Region I JFK Federal Building, Ram Government Center Boston. MA 02293-0002 AUG 2.6 2013 {bli?libliTIiC-l OCR Transaction Number: 13-l 53842 {bli?libliilicl Dear On December 1 l, 2012, the U.S. Department of Health and Human Services (HI-IS), Of?ce for Civil Rights (OCR), received your complaint alleging that CVS, store number 2353 in Florence South Carolina, has violated the Federal Standards for Privacy of Individually Identi?able Health Information andfor the Security Standards for the Protection of Electronic Protected Health Information (45 C.FR..Parts 160 and 164, Subparts A, C, and E, the Privacy and Security Rules]. Speci?cally, you allege that while standing at the checkout line at pharmacy, a pharmacist loudly discussed your protected health information This allegation could re?ect a violation of 45 C.F.R. Thank you for bringing this matter to attention. Your complaint piays an integral part in enforcement e?orts. OCR enforces the Privacy, Security, and Breach Noti?cation Rules, and also enforces Federal civil rights laws which prohibit discrimination in the delivery of health and human services because of race, color, national origin, disability, age, and under certain circtunstances, sex and religion. The Privacy Rule permits certain incidental uses and disclosures of protected health information - (PHI) that occur as a by-product of another permissible or required use or disclosure of PHI, as long as the covered entity has applied reasonable safeguards and implemented the minimum necessary standard, where applicable, with respect to the primary use or disclosure. See 45 C.F.R. For example, the Privacy Rule permits covered health care providers to share PHI for treatment purposes without patient authorization as long as they use reasonable safeguards when doing so. These safeguards may vary depending on the mode of communication used. For example, when discussing patient health information orally with another provider in proximity of others, a doctor may be able to reasonably safeguard the information by lowering hisfher voice. We have carefully reviewed your complaint against and have determined to resolve this matter informally through the provision of technical assistance to CVS. Should OCR receive a similar allegation of noncompliance against CVS in the future, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without further action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were reviewed by OCR. Under the Freedom of Information Act, we may be required to release this letter and other information about this case upon request by the public. In the event OCR receives such a request, we will make every effort, as permitted by law, to protect information that identi?es individuals or that, if released, could constitute a clearly unwarranted invasion of personal privacy. If you have any questions, please contact Keisha Edwards, Investigator, at (617) 565-1349 (Voice), (617) 565-1343, (800) 537-7697 (TDD). Sincerely, Peter K. Chan Regional Manager OCR HIPAA Privacy December 3, 2002 .ymw a ornrra 5 Voice (617) 565-1344148001 368-1019, TDD (til?) 565- 1343, (300) 53?v??9? FAX (til 555-3 :09, My D?iee for Civil Habits?? I JFK Federal Build II 1315 Governmurt Center Boston, MA MEWS-0002 I Coordinator Privacy Investigations CVS Caremark One CVS Drive Woonsocket, RI 02895 Our Transaction Number: 0'1-13-153842 {hlt?liblti?i Deal {Cl On December I 1, 2012, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), received a complaint alleging that CV8, store number 235 3 in Florence South Carolina, has violated the Federal Standards for Privacy of Individually Identi?able Health Information (45 C.F.R Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, the complainant alleges that CV5 failed to safeguard her protected health information (Pl-ll) when the Pharmacists spoke loud enough for other customers to heat. This allegation could re?ect a violation of 45 CPR. 164.502(a) and OCR enforces the Privacy, Security, and Breach Noti?cation Rules, and also enforces the Federal civil rights laws which prohibit discrimination in the delivery of health and human services because of race, color, national origin, disability, age, and under certain circumstances, sex and religion. The Privacy Rule permits certain incidental uses and disclosures of protected health information (PHI) that occur as a by-product of another permissible or required use or disclosure of PHI, as long as the covered entity has applied reasonable safeguards and implemented the minimum necessary standard, where applicable, with respect to the primary use or disclosure. See 45 CPR. For example, the Privacy Rule permits covered health care providers to share PHI for treatment purposes without patient authorization as long as they use reasonable safeguards when doing so. These safeguards may vary depending on the mode of communication used. For example, when discussing patient health information orally with another provider in proximity of others, a doctor may be able to reasonably safeguard the information by lowering hisfher voice. In this matter, the complainant alleges the incidental use or disclosure of was not permissible, either because reasonable safeguards were not in place to prevent the use or disclosure andlor because the minimum necessary standard was not implemented when it should have been- Pursuant to its authority under 45 can. mascara) and can has determined 1 OCR HIPAA Privacy Decaubcr 3, 2692 {Eli?ltblii'l Page 2- {Li to resolve this matter informally through the provision of technical assistance to CVS. To that end, OCR has enclosed material explaining the Privacy Rule provisions related to Incidental Uses and Disclosures, Reasonable Safeguards, and the Minimum Necessary requirement. You are encouraged to review these materials closely and to share them with your staff as part of the Health Insurance Portability and Accountability Act (HIPAA) training you provide to your workforce. You are also encouraged to assess and determine whether there may have been an incident of noncompliance as alleged by the complainant in this matter. and, if so, to take the steps necessary to ensure such noncompliance does not occur in the future. Please contact OCR if you need further information regarding the allegations in this matter. Should OCR receive a similar allegation of noncompliance against CVS in the future, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without ftuther action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were reviewed by OCR. Under the Freedom of Information Act, we may be required to release this letter and other information about this case upon request by the public. In the event OCR receives such a request, we will make every effort, as permitted by law, to protect information that identi?es individuals or that, if released, could constitute a clearly unwarranted invasion of personal privacy. If you have any questions regarding this matter, please contact Keisha Edwards, Investigator, at (617) 565-1349 (Voice) or (202) era?3257 (TDD). Sincerely, Magi/Wilt Peter K. Chan Regional Manager Region I Enclosure: Incidental Disclosures