Express Scripts

HIPAA Information

Business Associate Agreement
Download agreement forms or addendums to fulfill HIPAA requirements for business associates.

Authorization Form for the Release of Prescription Records (PDF file)
Requests for the release of prescription records to a third party, such as an insurance company or a lawyer, may be submitted through the form above.

Release to Disclose Protected Health Information to Vendor, Broker or Consultant (PDF file)
Plan Sponsors must complete this form to allow Express Scripts to transfer claims data to a Flexible Spending Account or Disease Management vendor, broker or consultant.

Privacy Notices
Read our Notice of Privacy Practices, which describes how our members' medical information may be used and disclosed and explains how members can access their information. You can also view our Internet Privacy Promise, which describes the policies and practices we have developed to safeguard our members' information online.

Frequently Asked Questions (PDF file)
This list of questions and answers is designed to inform clients of our continuing efforts to meet the applicable mandates of HIPAA.

PDF files require Adobe Acrobat Reader.