slm_ y? s. :2 ii DEPARTMENT OF HEALTH HUMAN SERVICES OFFICE OF THE SECRETARY r- Voice - [214} rot-4055. {coo} 363-1019 TDD - {214) tor-3940 - (214i rat-0432 Of?ce for Civil Rights, Region VI can SEP 1301 Young Street, Suite 1169 Dallas, TX. 752112 {bii?tiaimici Re: OCR Transaction Number: 13-166142 Dear {bli?liblii?ltcl On August 28, 2013, the U.S. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region VI received your complaint alleging that CVS Pharmacy, the covered entity, has violated the Federal Standards for Privacy of Individually Identi?able Health Information andfor the Security Standards for the Protection of Electronic Protected Health Information (45 C.F.R. Parts 160 and 164, Subparts A, C, and E, the Privacy and Security Rules). (45 C.F.R. Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, you allege that on August 2013, you went to the CVS Pharmacy for a prescription pickup and while waiting in the pharmacy drive thru, your protected health information (PHI) was spoken where other patients could hear. This allegation could re?ect a violation of 45 C.F.R. 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, 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 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 his/her voice. We have carefully reviewed your complaint against CVS Pharmacy, and have determined to resolve this matter informally through the provision of technical assistance to CVS Pharmacy. Should OCR receive a similar allegation of noncompliance against CVS Pharmacy in the ?Jture, OCR may initiate a formal investigation of that matter. Page 2 of 2 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 lnfonnation 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, at 214-76?- 4054 (Voice) or 2 111?767-8940 (TDD). Sincerely, femurk e- 1 DEPARTMENT OF HEALTH HUMAN SERVICES OFFICE OF THE SECRETARY Ta Voice - (214) tor-4055. (soc) 363-1019 Top - (214:: ?6??394El (FAX) - {214} FIST-0432 Office for Civil Rights, Region VI mm 130] Young Street, Suite 1169 Dallas, TX "5202 SEP IS 2013 CVS Pharmacy Ann: Privacy Of?cer One CV5 Drive Woonsocket, RI 02395 Re: OCR Transaction Number: 13-166142 Re: CVS Pharmacy Attn: Privacy Of?cer 8024 Walnut Hill Lane Dallas, TX 75231 Dear Privacy Of?cer: On August 23, 2013, the US. Department of Health and Human Services Of?ce for Civil Rights (OCR), Region VI received a complaint alleging that a workforce member at CVS Pharmacy, the covered entity, has violated the Federal Standards for Privacy of individually Identi?able Health Information andlor the Security Standards for the Protection of Electronic Protected Health Information (45 CPR, Parts 160 and 164, Subparts A, C, and E, the Privacy and Security Rules . 45 CPR. Parts 160 and 164, Subpans A and E, the Privacy Rule). Speci?cally, the complainant, alleges that on August 27, 2013, his protected health information (PHI) was spoken in a drive thru where other patients could heat. This allegation could re?ect a violation of 45 CPR. 164.502ia} and 164.53 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, sea 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 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 hisfher 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 audior 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 the CVS Pharmacy. To that end, OCR has enclosed material explaining the Privacy Rule CVS Pharmacy Page 2 of 2 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 the CVS Pharmacy 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, at 214-767- 4054 (Voice) or 214-767-8940 (TDD). . Sincerely, egional Manager Enclosures: Incidental Disclosures Reasonable Safeguards Minimum Necessary