EFFECTIVE July 16, 2018


This notice applies to clients of Simple Meds, LLC, (“Simple Meds” also referred to as “We,” “Us” or “Our”), a covered entity under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

Your Client Record

We are committed to protecting your privacy. We provide you with this notice to explain the ways in which we may use and disclose information about you, your rights and choices, and our responsibilities. We are required by law to maintain the privacy of your protected health information (“PHI”). For example, we must protect personal information in your client record, such as your name, social security number, and medical information from your health care provider or others, including notes about your symptoms, diagnoses, treatments, and a plan for future care.

It is our policy to provide customers with this Notice upon their first receipt of products or services from us. We must follow the terms of our current Notice. This notice is not a contract, and does not expand our obligations or create any rights not already provided by applicable law.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Our Uses and Disclosures

Our Typical Uses and Disclosures of PHI – Simple Meds is permitted to use of disclose PHI for the following purposes without prior notice or written authorization.

  1. Treatment – We can use your health information and share it with other professionals who are treating you. Example: We may use share your PHI to review and dispense your prescriptions or share your PHI with other providers in order to coordinate your health care services and medications.

  2. Run our organization – We can use and share your health information to run our business, improve your care, and contact you when necessary. This includes individuals and entities we contract with to perform various functions such as billing, copy services or consulting, (Business Associates), but only after We require the Business Associates to agree in writing to contract terms designed to appropriately safeguard your information. Examples: we may use your PHI in our efforts to continue to improve the quality of the services we provide. We may use your PHI to create de-identified data, which is stripped of your personally identifiable data and no longer identifies you. We may also share or transfer PHI in connection with a merger or sale of all or part of our business or as part of a corporate reorganization, stock sale, or other change in control.

  3. Payment – We can use and share your health information to bill and get payment from health plans or other entities and persons. This may include conducting insurance eligibility checks with state Medicaid, Medicare, or other health plans, determining enrollment status, and providing information to entities that help us submit bills and collect amounts owed. Example: We give information about you to your insurance company so it will pay for your services.

Other Possible Uses and Disclosures of PHI – Simple Meds is permitted to use of disclose PHI for the following purposes without written authorization, but may be required to provide notice, obtain verbal consent, or an opportunity to object.

  1. Individuals Involved in Your Care or Payment for Your Care

    • To a friend or family member who is involved in your care that you tell us can access your PHI, or because of incapacity or emergency that our pharmacists determine in their professional judgment would not object

    • To a friend or family member who helps pay for your services

  2. Disclosures to Parents or Legal Guardians

    • When in accordance with applicable federal or state law, as permitted or required

  3. Public Health and Safety – We can share health information about you for certain situations such as:

    • Reporting suspected abuse, neglect, or domestic violence

    • Preventing or reducing a serious threat to anyone’s health or safety

    • With health oversight agencies for activities authorized by law, such as reporting adverse events to the FDA

  4. Research – We can use or share your information for health research.

  5. Comply with the Law – We will share information about you if state or federal laws require it, including:

    • Sharing information with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

    • Entering PHI into program database for electronic monitoring of controlled substances, frequently called a prescription drug monitoring program (PDMP), as required by federal, state, or local law. Such information may be accessed for limited purposes and by necessary individuals pursuant to such federal, state, or local law.

  6. Organ and Tissue Donation Requests – We can share health information about you with organ procurement organizations.

  7. Medical Examiner or Funeral Director – We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

  8. Workers’ Compensation, Law Enforcement, and Other Government Requests – We can use or share health information about you:

    • For workers’ compensation claims

    • For law enforcement purposes or with a law enforcement official

    • For special government functions such as military, national security, and presidential protective services

  9. Lawsuits and Legal Actions – We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Your Rights

Get a copy of your personal records

  1. You can ask to see or get a copy of your paper or electronic medical records and other PHI We have about you. Ask Us how to do this.

  2. We will review your request and generally provide a copy or a summary of your PHI within 30 days. We may charge a reasonable, cost-based fee.

Ask Us to correct your personal records

  1. You can ask Us to correct your paper or electronic medical records if you think they are incorrect or incomplete. Ask Us how to do this.

  2. In certain cases, We may deny your request, but We’ll tell you why in writing within 60 days. For example, We may deny your request if the information you want to amend is not maintained by Us, but by another entity.

Request confidential communications

  1. If you believe that a disclosure of all or part of your PHI may endanger you, you can ask Us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.

  2. We will consider all reasonable requests, and must say “yes” if you tell Us you would be in danger.

Ask Us to limit what We use or share

  1. You can ask Us not to use or share certain PHI for treatment, payment, or Our operations. We are not required to agree to your request, and We may say “no” if it would affect your care.

  2. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom We’ve shared information

  1. You can ask for a list (accounting) of the times We’ve shared your PHI for six years prior to the date you ask, who We shared it with, and why.

  2. We will include all the disclosures except for those about treatment, payment, and personal care operations, and certain other disclosures (such as any you asked Us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Choose someone to act for you

  1. You may give someone the right to act on your behalf with appropriate documentation supporting that person’s right to act on your behalf.

  2. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI.

We will make sure the person has this authority and can act for you before We take any action.

Your Choices

To tell Us whether to share information:

  1. with your family, close friends, or others involved in payment for your care

  2. in a disaster relief situation

If you are not able to tell Us your preference, for example if you are unconscious, We may go ahead and share your information if We believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

To give us written permission before We ever share your information, unless specifically permitted by law, in the following ways:

  1. Marketing purposes

  2. Sale of your information

  3. Most sharing of psychotherapy notes or mental health records (to the extent we have any)

  4. Any sharing of other sensitive health information as required by state laws (e.g. HIV/AIDS information)

While We have no intent to contact you for fundraising purposes, if We should decide to contact you for that purpose, We will inform you of our intentions and provide you an opportunity to opt-out.

Our Responsibilities

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. If it is determined that a breach of unsecured PHI has occurred, We will notify you of the information involved, steps you may take, and a summary of actions being taken to investigate the breach, reduce harm to you, and protect against future breaches.

We are must provide you with a copy of this Notice and abide by the terms of this Notice. This notice has been drafted to be consistent with what is known as the “HIPAA Privacy Rule”, and any of the terms not defined in this Notice should have the same meaning as they have in the HIPAA Privacy Rule.

We will not sell or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know if writing if you change your mind.

We reserve the right to change the provisions of the Notice and the changes will apply to all information We have about you. If we make any changes to this Notice, the new notice will be available on our web site. You are also entitled to obtain a paper copy of the Notice. Upon request, we will provide any revised Notice to you by mail.

Additional Laws

If state privacy laws or other laws provide greater privacy protections, We will follow the more stringent privacy laws.

Certain states have requirements that relate to uses and disclosures of PHI concerning HIV/ AIDS status, STDs and communicable diseases, reproductive health, mental health, alcohol and drug abuse, genetic information, or abuse and neglect. Unless state or federal law allows or requires Us to make the specific type of use or disclosure without your authorization, We will not release any such information without the specific authorization required by law. If you would like additional information about state law protections in your state, or the additional use or disclosure restrictions that may apply to sensitive PHI, please contact us.

Company & Contact

For More Information. If you have questions or would like additional information about Simple Meds’ privacy practices, contact Simple Meds, 6862 Hillsdale Ct., Indianapolis, IN, 46250, or by telephone using our toll-free number (844) 275-6337.

Report a Problem. If you believe your privacy rights have been violated, you may submit a written complaint to our office by sending it to Simple Meds, 6862 Hillsdale Ct., Indianapolis, IN, 46250. There will be no retaliation for submitting a complaint. You may also submit a complaint to the Secretary of Health and Human Services.

How We May Contact You. Unless you tell us otherwise in writing, we may contact you by either telephone or by mail at either your home or your workplace. At either location, we may leave messages for you on voice mail, on an answering machine, or with an answering service.