With all respect to the interpretation cautioning against maintenance of the
list or any list of pharmacy customers...

The spirit of the law is to opt out of release of that information...outside
marketing firms etc. would probably be covered and the transfer of the data
to them would probably require consent or if not explicit authorization  The
question is would a checkbox question solve this: Do you not wish to receive
offers on prescriptions?
Would this be an appropriate out a does the grocery pharmacy need consent on
signup at the pharmacy to maintain a list and to notify John Doe of specials
and loyalty offers.

Either way, I still do not see the requirement that you may no longer
maintain any company file on whomever might constitute a firm's current
customers by product line - you should be able to maintain it as long as it
does not indicate illness, diagnosis or treatment.

This was not a question about selling their list, it is a simple question of
list maintenance and sending a simple loyalty card or offer.

Any restrictions on a firms ability to do this basic customer tracking are
not reasonable.

Joe

Joseph Schein
Sr. Consultant
Director of Business Development
Axiom Systems, Inc.
Phone:       757-270-3069
800 #:        800-330-8119 ext 252 or 0 for Operator
Office:        301-840-3861
Fax:           208.275.1777
[EMAIL PROTECTED]
See our web site at www.axiom-systems.com
Axiom Systems: THE MANAGED CARE TECHNICAL EXPERTS

Co Chair - MAHI
Mid Atlantic Health / HIPAA Initiative
See our website at www.mahicentral.org
[EMAIL PROTECTED]
MAHI - Saving Time and Money on HIPAA Compliance





-----Original Message-----
From: Heiert, David [mailto:[EMAIL PROTECTED]]
Sent: Thursday, December 06, 2001 12:55 PM
To: '[EMAIL PROTECTED]'; [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject: RE: PHI Question


Actually, let's think about this...

Is a purchase of over the counter drugs PHI??

Personally, I think that the grocer should not be able to store
the fact that the person purchased a prescription at all; at least
outside of the pharmacy tracking system.  Surely to err on the side of
safety they would not make that information available with other
purchase information...

But, if John Doe also buys cough medicine to treat his Bronchitis along
with the prescription antibiotics, should that be disclosed or available
along with the fact that he bought dog food and toilet bowl cleaner?

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Thursday, December 06, 2001 12:27 PM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject: Re: PHI Question





Paul,

I would think that one must consider that the pharmacy operated by the
grocery store is a covered entity that is in possession of PHI regarding
customers to whom or for whose benefit prescriptions are dispensed.  In
order to send a "loyalty card" to a customer, the pharmacy or grocery store
must examine its customer records.  I would think data indicating that a
customer received a prescription from a particular pharmacy is just as much
PHI as data indicating that an individual is a patient of a particular
hospital, even though in both instances, the exact nature of the
prescription or care provided might not be discernible without more
information.

If the patient of the hospital has the right not to have it disclosed that
he or she is a patient of the hospital, why would he or she not also have
the right to object to the disclosure that he or she received a
prescription from a particular pharmacy?  Moreover, if the grocery store or
pharmacy has the capability of accessing the data to determine that the
customer has had prescriptions filled at its pharmacy, then wouldn't it
also have the capability to determine how frequently prescriptions were
filled.  From such data, damaging inferences might be drawn, with or
without more detail regarding the exact nature of the prescriptions, thus
rendering such data all the more sensitive and, one might argue, deserving
of even great protection as PHI.

Accordingly, if this leads one to conclude that the data is, in fact, PHI,
then limitations must be placed on who within the grocery store may have
access and consideration must be given to whether the access is for
purposes of treatment, payment or healthcare operations or something else,
like marketing, and whether express authorization for its use might be
necessary.

************************************************
Peter B. Goldstein, Esq.
Cap Gemini Ernst & Young, US LLC
4610 South Ulster Street, Suite 600
Denver, Colorado  80237-4323
(303) 796-4148 (Direct)
(413) 740-0512 (Facsimile)
cap comm: 657 4653
[EMAIL PROTECTED]
************************************************
|------------------------+------------------------+------------------------|
|                        |   "Paul Costello"      |                        |
|                        |   <pcostello@imrglobal.|           To:          |
|                        |   com>                 |   <[EMAIL PROTECTED]>   |
|                        |                        |           cc:          |
|                        |   12/05/2001 03:11 PM  |           Subject:     |
|                        |                        |   PHI Question         |
|------------------------+------------------------+------------------------|








I have a question regarding the definition of personal health  information
(PHI) and how it is defined the following  scenario:

A grocery store that uses "loyalty" cards (cards used by  consumers to
receive discounts on purchased items) captures, at the point of  sale, that
a consumer purchased a prescription drug at the  pharmacy.

The grocery store stores, in a database, the following  information:

Name:
John Doe

Date:
1/1/01

Items:
"Bread"
"Milk"
"Prescription Drug"

Would the fact that John Doe purchased a "prescription drug" on 1/1/01 be
considered PHI?

Any insight in greatly appreciated.

Thank you.
Paul Costello

__________________________
Paul V. Costello
Senior  Consultant
CGI
3100 Zinfandel Drive, Suite #250
Rancho Cordova,  CA  95670
Phone: (916) 631-7645 ext. 30
Fax: (916)  631-7647
E-Mail: [EMAIL PROTECTED]

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