H-E-B Retail Health Care Services
Notice of Privacy Practice

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say "no" to your request, but we will tell you why in writing within 60 days.

• 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.
• We will say "yes" to all reasonable requests.

• You can ask us not to use or share certain health information 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.
• If you pay for a service or healthcare 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.

• You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and healthcare operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another one within 12 months.

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

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

• You can complain if you feel we have violated your rights. You can file a complaint with the H-E-B Privacy Office at (210) 938-4907, toll free at 1-866-432-4318, or by email at privacyoffice@heb.com.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.

Your Choices

• Share information with your family, close friends, or others involved in your care;
• Share information in a disaster relief situation;
• Include your information in a hospital directory; however, H-E-B does not create or manage a hospital directory;
• Contact you for fundraising efforts.

• We may only use and disclose your health information for marketing purposes with your written authorization, unless the communication is a face-to-face communication made by us to you or a promotional gift of nominal value provided to you by us.
• We may sell your health information only with your written authorization.
• We usually do not maintain psychotherapy notes about you. If we do, we will only use and disclose them with your written authorization except in limited situations.

• We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

• We can use your health information and share it with other professionals who are treating you.
  • Example: A pharmacist fulfilling your prescription asks another pharmacist about your prescription.
  • Example: A pharmacist fulfilling your prescription asks your doctor about your prescription.

• We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  • Example: We use health information about you to manage your treatment and services.
  • Example: We access your health information to ensure our pharmacy staff is performing well.
  • Example: The pharmacy contacts you to inform you about certain health-related products or services that we offer.

• We can use and share your health information to bill and get payment from health plans or other entities.
  • Example: We give information about you to your health insurance plan so it will pay for your services.

• We can share health information about you for certain situations such as:
  • Preventing disease;
  • Helping with product recalls;
  • Reporting adverse reactions to medications;
  • Reporting suspected abuse, neglect, or domestic violence;
  • Preventing or reducing a serious threat to anyone's health or safety.

• We can use or share your non-identifiable information for health research

• We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.

• We can share health information about you with organ procurement organizations.

• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

• We can share health information about you in response to a court or administrative order, or in response to a subpoena.