Hill? on DEPARTMENT OF HEALTH 8: HUMAN SERVIGS OFFICE OF THE SECRETARY Voice . (no rat?ass, (sci) sas? 1019 TDD - (214} rat-sate Of?ce for Civil Rights, Region VI FAX - (214] 76.10432 hem-g 1301 Young Street, Suite 1169 Mn Dallas, TX 3520: JUN 8 20l2 CVS Carcmark Attention: Privacy O?icer One CV3 Place Woonsocket, RI 02395 Our Transaction Number: 12-14183?l Dear Privacy Of?cer: On April I5, 2012., the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region VI received a complaint alleging that CV Caremark, the covered entity, has violated the Federal Standards for Privacy of Individually Identi?able Health lnfonnation (45 CPR. Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, the complaint alleges that, on March 12 and 26, 2012, CVS Caremark mailed I'IbliBliblill'iCl prescriptions to her daughter?s address in Texas. 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 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 ndthout 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 andfor because the minimtnn 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 Caremark. 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 Caremark 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 regarding this matter, please contact Vaniecy Nwigwe, Investigator, at 214-767?4054 (Voice), 214-767-8940 (TDD). Sincerely, as, Ralph D. Rouse Regional Manager Region VI Regional Manager Enclosures: Incidental Disclosures Reasonable Safeguards Minimum Necessary alum. distill-I'll DEPARTMENT OF HEALTH EC HUMAN OFFICE OF THE SECRETARY Voice . (214) assess, ass. rots TDD - {214) res-3940 Office for Civil Rights, Region VI FAX - (214) sensor raw I nor Young Street. Suite 1159 Da?as, TX 75202 JUN182012 iblt?lfbl??ltcl Our Transaction Number: 12-14180? On April 6, 2012, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region VI received your complaint alleging that CVS Caremark, 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, on March 12 and 26, 2012, CVS Caremark mailed your prescriptions to your daughter?s address in Texas. 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 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, set 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 miniminn 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 hisr?her voice. We have carefully reviewed your complaint against CVS Caremark and have determined to resolve this matter informally through the provision of technical assistance to CVS Caremark, Should OCR receive a similar allegation of noncompliance against CV Caremarl: in the ?itnre, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without 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 Vaniecy Nwigwe, lnvesti gator, at 214-767-4054 (Voice), 214-767-8940 (TDD). Sincerely, Ralph D. Rouse Regional Manager Region VI Regional Manager