DEPARTMENT OF HEALTH HUMAN SERVICES OFFICE OF THE SECRETARY Office for Civil Rights, Region 150 5. Independence Hall West Public Ledger Building, Suite 372 Philadelphia, PA 19106?3499 Voice? (215) 861-4441 TDD (215) 361-4440 FAX - (215) 861-4431 Worm Reference: 152410 Investigator: Elizabeth Benson Contact Telephone: 215-861-442? February 22, 2013 Privacy Kdvisor, CVS Caremark PO Box 52072 Phoenix, AZ 85022-2072 $33.0?le .cvs (2400 Aramingo Avenue, Philadelphia, PA) OCR Transaction Number: 152410 {bll?libllil Dear On December 4 2012, the U.S. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region 3 received a complaint alleging that the CVS located at 2400 Aramingo Avenue in Philadelphia has violated the Federal Standards for Privacy of Individually Identi?able Health Information (45 C.F.R. Parts 160 and 164, $11pr A and E, the Privacy Rule). Speci?cally, the complainant alleges during a pharmacy visit on July 21, 2012, his full driver?s license number was written next to his prescription information on the pharmacy log that customer?s are required to sign. This allegation could re?ect a violation of 45 C.F.R. 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 occur as a by-product of another permissible or required uselor 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 perruits 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 infermation 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 andfor because the minimum necessary standard was not implemented when it should have been. Pursuant to its authority under 45 160.304(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 sta?? 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 fauna. 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 further action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were renewed 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 Elizabeth Benson, Investigator, at (215) 861-4427 (Voice) or (215) 861-4440 (TDD). bare J. Holland Regional Manager Enclosures: Incidental Disclosures Reasonable Safeguards Minimum Necessary gem DEPARTMENT on HEALTH at HUMAN OFFICE on THE SECRETARY 3 voice? (215} 861-4441 Of?ce for Civil Rights, Region - TDD (215) 861-4440 150 5. Independence Mall 1West Mu FAX (215) 361-4431 Public Ledger Building, Suite 372 William: Philadelphia, PA 19106-3499 R'efereme: 152410 Investigator: Elizabeth Banson Contact Telephone: 215861-442? Iiiebruary 22, 2013 Our Transaction number: 03-13-152410 - On December 04, 2012, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region 3 received your complaint alleging that the CVS located at 2400 Ammingo Avenue, Philadelphia, 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 during a visit to the CVS Pharmaeynn July 21, 2012, your full driver?s license number was mitten next to your prescription information on the pharmacy log that customer?s are required to sign. This allegation could re?ect a violation of 45 C.F.R. 16450201) and Thank you for bringing this matter to attention. Your complaint plays an integral part in 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 occuras a by-product of anotzter 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 ureatment purposes without patient authorization as long as they use reasonable safeguards when doing so. These safeguards may vary depending on the mode _cf 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 care?tlly reviewed your complaint against the CVS Pharmacy located at 2400 Aramingo Avenue, Philadelphia, and have determined to resolve this matter informally through the provision of technical assistance to the covered entity. Should OCR receive a similar allegation of noncompliance against the covered entity in the future, OCR may a formal investigation of that matter. Based on the foregoing, OCR is closing this case without ?thher 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. Ifyou have any questions regarding this matter, please contact Elizabeth Benson, Investigator, at 215-361-4427 (Voice) or 215-861-4430 (TDD). Sincerely, .?wmwe Barbara I. Holland Regional Manager