Wich_ 5 TMENT 5 ES a; voice (511} 555-1341), {300) 363-1019, TDD (cm 565- 1343, (son) FAX one: for Civil Rights. Region I JFK Federal Building, Room ens ?l 6 Government Center Boston. on 02203-0002 I Coordinator - Privacy Investigations CVS Caremark One CVS Drive Woonsocket, RI 02895 Re: (mound: CV5 OCR Transaction Number: 01-13-158254 On May 1, 2013, the U5. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), Region I received a complaint alleging that the CVS Pharmacy in South Yarmouth, MA, the covered entity, has violated the Federal Standards for Privacy of Individually Identifiable Health Information (45 C.F.R. Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, the complainant alleges that, on November 1, 2013, an employee at the South Yarmouth CVS disclosed his protected health information when he discussed the payment for a prescription in a loud voice that other customers were able to hear. This allegation could reflect a violation of 45 C.F.R. 164.502(a) and OCR enforces the Privacy, Security, and Breach Notification Rules, and also enforces Federal civil rights laws which prohibit discrimination in the delivery of health and human services because of race, color, nationai 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 disciosure 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 his/her voice. In this matter, the complainant alleges the incidental use or disclosure of PHI was not permissible, either because reasonable safeguards were not in place to prevent the use or disclosure and/or because the minimum necessary standard was not implemented when it should have been. Pursuant to its authority under 45 C.F.R. 160.304(a) and OCR has determined 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 at the South Yarmouth location 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 the CVS in South Yarmouth 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 identifies individuals or that, if released, could constitute a clearly unwarranted invasion of personal p?vacy. If you have any questions regarding this matter, please contact Vicki Kaufman, Investigator, at (617) 565-1344 (Voice) or (617) 565-1343 (TDD). Sincerely, mac? Peter K. han Regional Manager Enclosures: Incidental Disclosures Reasonable Safeguards Minimum Necessary