gyms. DEPARTMENT OF HEALTH 8: HUMAN SERVICES OFFICE OF THE SECRETARY Voice 4214] tenses, {sue} sea-101a Too 4214} tar-asst Of?ce for Civil Rights, Region VI {Fall-{21411510432 130! Young Street, Suite 1169 Watthan Dallas, TX 75202 APR 1 6 2013 Privacy omeer CV3 Carcmark One CV Drive Woonsocket, RI 02895 Transaction Number: [3457977 Re: CVS Pharmacy, 2823 Spears Rd., Houston, TX b? . . Dear Edi?libliil On March 28, 2013, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR) Region VI, received a complaint alleging that CVS Pharmacy Houston, 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 complaint alleges on January 13, 2013, a workforce member named Jaimee of CVS Pharmacy Houston loudly discussed Fmimimmig] Iprotected health information (PHI) in {tent of everyone in the waiting area. This allegation could re?ect a violation of 4S 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 inunan services because of race, color, national origin, disability, age, and under certain 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. For example, the Privacy Rule permits covered health care providers to share PHI for treatment purposes udthout 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 PHI was not permissible, because either 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 C.F.R. 160.304(a) and OCRhas determined to resolve this matter informally through the provision of technical assistance to CVS Pharmacy Houston. 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 ?irther information regarding the allegations in this matter. Should OCR receive a similar allegation of noncompliance against CVS Pharmacy Houston 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 Yvonne Butler, Investigator, at 214-767-4055 (Voice), 214-767-8940 (TDD). Sincerelf W. orge A. Lo 0 Regional ger Enclosures: Incidental Disclosures Reasonable Safeguards Minimum Necessary .. DEPARTMENT OF HEALTH SERVICES OFFICE OF THE SECRETARY i Voice- (214) res-4056, (an) 368-1019 roo- {214} rears-to cash: for Civil Rights, Region V1 Fan - (214) rat-0432 mammogram not Young Street, Suite no em Dales, rxrsan APR 1 6 2013 (bane: Transaction Number: 13-15797?! Dear On March 28, 2013, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR) Region VI, received your complaint alleging that CVS Pharmacy Houston, the covered entity, has violated the Federal Standards for Privacy of Individually Identi?able Health Infomation (45 C.F.R. Parts 160 and 164, Subparts A and the Privacy Rule). Speci?cally, you allege on January 18, 2013, a workforce member named of CVS Pharmacy Houston loudly discussed your protected health information (PHI) in front of everyone in the waiting area. 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,I disability, age, and under certain circumstancm, 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 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 treannent 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 Pharmacy Houston and have determined to resolve this matter informally through the provision of technical assistance to CVS Pharmacy Houston. Should OCR receive a similar allegation of noncompliance against CVS Pharmacy Houston in the future, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without further action, e??ective 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 Yvonne Butler, Investigator, at 214-767-4055 (Voice), 214-767-8940 (TDD).