WNW i. DEPARTMENT OF HEALTH HUMAN SERVICES OFFICE OF THE SECRETARY Voice- (215) 351-4441 I Of?ce for Civil Rights, Region TDD - (215) 861-4440 150 s. independence Mall West FAX - (215) 351-4431 Public Ledger Building, Suite 3?2 Philadelphia, PA 19106-3499 Reference: 13-151474 Investigator: J. M. Fisher Contact Telephone: 202-619-0204 January 29, 2013 {bli?libliil Dear On November 16, 2012, the US. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), Region received your complaint alleging that CV S, the covered entity, 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, you allege that an employee of CV (covered entity) loudly discussed your personal health information such that it could be overheard by others when picking up your prescription. This allegation could re?ect a violation of 45 CPR 164.502(a) and Thank you for bringing this matter to attention. Your complaint plays an integral part in I enforcement efforts. 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 circumstances, sex and religion. The Privacy Rule permits certain incidental uses and disclosures of protected health information (PHI) that occurs 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. 164.502(a) (1) 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 hisiher voice. We have carefully reviewed your complaint against (covered entity) CVS and have determined to resolve this matter informally through the provision of technical assistance to (covered entity) CVS. Should OCR receive a similar allegation of noncompliance against (covered entity) CVS in the ?lture, 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 he 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 bylaw, 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 Ms. Janice M. Fisher, Investigator, at (202)619-0204. Sincerely, Barbara J. Holland Regional Manager DEPARTMENT OF HEALTH 3; HUMAN SERVICES OFFICE OF THE SECRETARY it a Voice- (215) 861-4441 Of?ce for Civil Rights, Region a TDD (215) 861-4440 150 S. Independence Mali West ?as, FAX (215) 861-4431 Public Ledger Building, Suite 372 Philadelphia, PA 19106-3499 Reference: 13?151474 Investigator: Ms. J.M. Fisher Contact Telephone: 202-619-0204 January 29, 2013 {bii?libitillCl CVS Pharmacy 9498 Chartergate Drive Mechanicsville, VA 23116 b6.bTC Dcart it it it it I1 011 November 16, 2012, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region received a complaint alleging that CVS, the covered entity, 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 an employee of CV (covered entity) loudly discussed his personal health information such that it could he overheard by others when picking up his prescription. 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 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 occurs 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 164.502(a) (1) 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 hisiher 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 andfor because the minimum necessary standard was not implemented when it should have been. Pursuant to its authority under 45 CPR. 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 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 matte?, and, if so, to take the steps necessary to ensure such noncompliance does not occur in the future. Please contact OCR if you need ?lrther information regarding the allegations in this matter. Should OCR receive a similar allegation of noncompliance against CV (covered entity) in the future, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without ?n?ther 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 Ms. Janice M. Fisher, Investigator, at 202-619-0204. Sincerely, jam/dicing 74M. Barbara 1. Holland Regional Manager Enclosures: Incidental Disclosures Reasonable Safeguards Minimum Necessary