Elder Law News

Elderly Pharmaceutical Insurance Coverage Program Privacy

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

By law, the New York State Elderly Pharmaceutical Insurance Coverage (EPIC) Program is required to protect the privacy of your personal health related information. EPIC is also required to give you a notice to tell you how the program may use and disclose (give out) your personal health related information held by EPIC.

EPIC must use and disclose your personal health related information:

• to you or someone who has the legal right to act for you (your personal representative or caregiver),
• to the Secretary of the federal Department of Health and Human Services, if necessary, to make sure your privacy is protected, and
• where required by law (for example, government oversight and audit). EPIC has the right, based on your authorization (permission) during enrollment, to use and disclose your personal health related information to pay for your medications and to operate the EPIC Program. For example:

EPIC may share your personal health related information with EPIC pharmacists to make sure that they are paid for the services they provide to you.

EPIC may use and disclose your personal health related information to your prescribing physician in the event that your drug regimen is potentially dangerous to your health. For example, if you are taking a combination of drugs that may result in a serious drug interaction or therapeutic duplication, the doctor may change your medication based on this information.

EPIC may use your personal health related information to make sure you and other EPIC enrollees receive quality health care, to provide customer service to you, or to resolve any complaints you may have.

EPIC may disclose your personal health related information to other insurance companies to identify any prescriptions billed to the EPIC Program that appear to be the responsibility of the other insurer.

EPIC may disclose your personal health related information to any other governmental agencies, including Medicare as well as Medicare drug plans that have been authorized as agents by Medicare, that act as a co-payer.

EPIC may disclose your personal health related information to business partners to operate the EPIC Program. This includes entities that provide assistance and education to EPIC seniors regarding the Medicare Part D drug benefit. Read more at health.state.ny.us

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	Did You Know?
	Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups. Low income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds.