• US Legal Forms

Maine Revocation of Authorization To Use or Disclose Protected Health Information

State:
Multi-State
Control #:
US-3579
Format:
Word; 
Rich Text
Instant download

Description

Revocation of Authorization To Use or Disclose Protected Health Information
Maine Revocation of Authorization to Use or Disclose Protected Health Information is a legal document that allows individuals in the state of Maine to revoke any prior consent they have given to healthcare providers or covered entities to use or disclose their protected health information (PHI). Protected health information refers to any individually identifiable information about a person's past, present, or future physical or mental health. This revocation form is an essential tool for patients who wish to regain control over the disclosure of their health information. By completing and submitting this form, individuals can effectively terminate any previous authorizations they have given to healthcare providers, insurers, or other covered entities, thereby restricting further sharing or use of their PHI. It enables individuals to exercise their rights under HIPAA (Health Insurance Portability and Accountability Act) and the HITCH (Health Information Technology for Economic and Clinical Health) Act. Some relevant keywords associated with Maine Revocation of Authorization to Use or Disclose Protected Health Information include: 1. HIPAA: The Health Insurance Portability and Accountability Act is a federal law in the United States that establishes privacy standards and safeguards to protect individuals' health information. 2. HITCH: The Health Information Technology for Economic and Clinical Health Act promotes the adoption and meaningful use of health information technology. It complements HIPAA by addressing the privacy and security concerns associated with the electronic transmission of health information. 3. Consent: The act of granting permission for the use or disclosure of protected health information. 4. Authorization: A legal document that provides consent for the use or disclosure of protected health information. 5. Covered Entity: Any healthcare provider, health insurance plan, or healthcare clearinghouse that collects, generates, uses, or maintains protected health information. 6. PHI: Protected Health Information includes information such as medical records, healthcare billing information, and any other individually identifiable health information. Types of Maine Revocation of Authorization to Use or Disclose Protected Health Information forms may vary based on specific healthcare providers or covered entities. Common variations could include revocations tailored for hospitals, clinics, physicians, insurance companies, or specific medical procedures, but the overall purpose remains the same: to revoke consent for the use or disclosure of PHI. In summary, the Maine Revocation of Authorization to Use or Disclose Protected Health Information is a powerful tool that allows individuals to regain control over their health information. By revoking prior authorizations, patients can exercise their rights and safeguard their privacy regarding the use and disclosure of their protected health information.

Maine Revocation of Authorization to Use or Disclose Protected Health Information is a legal document that allows individuals in the state of Maine to revoke any prior consent they have given to healthcare providers or covered entities to use or disclose their protected health information (PHI). Protected health information refers to any individually identifiable information about a person's past, present, or future physical or mental health. This revocation form is an essential tool for patients who wish to regain control over the disclosure of their health information. By completing and submitting this form, individuals can effectively terminate any previous authorizations they have given to healthcare providers, insurers, or other covered entities, thereby restricting further sharing or use of their PHI. It enables individuals to exercise their rights under HIPAA (Health Insurance Portability and Accountability Act) and the HITCH (Health Information Technology for Economic and Clinical Health) Act. Some relevant keywords associated with Maine Revocation of Authorization to Use or Disclose Protected Health Information include: 1. HIPAA: The Health Insurance Portability and Accountability Act is a federal law in the United States that establishes privacy standards and safeguards to protect individuals' health information. 2. HITCH: The Health Information Technology for Economic and Clinical Health Act promotes the adoption and meaningful use of health information technology. It complements HIPAA by addressing the privacy and security concerns associated with the electronic transmission of health information. 3. Consent: The act of granting permission for the use or disclosure of protected health information. 4. Authorization: A legal document that provides consent for the use or disclosure of protected health information. 5. Covered Entity: Any healthcare provider, health insurance plan, or healthcare clearinghouse that collects, generates, uses, or maintains protected health information. 6. PHI: Protected Health Information includes information such as medical records, healthcare billing information, and any other individually identifiable health information. Types of Maine Revocation of Authorization to Use or Disclose Protected Health Information forms may vary based on specific healthcare providers or covered entities. Common variations could include revocations tailored for hospitals, clinics, physicians, insurance companies, or specific medical procedures, but the overall purpose remains the same: to revoke consent for the use or disclosure of PHI. In summary, the Maine Revocation of Authorization to Use or Disclose Protected Health Information is a powerful tool that allows individuals to regain control over their health information. By revoking prior authorizations, patients can exercise their rights and safeguard their privacy regarding the use and disclosure of their protected health information.

How to fill out Maine Revocation Of Authorization To Use Or Disclose Protected Health Information?

If you want to comprehensive, obtain, or print out legal file templates, use US Legal Forms, the largest collection of legal varieties, which can be found on the Internet. Use the site`s basic and practical lookup to discover the files you need. A variety of templates for company and specific purposes are sorted by groups and suggests, or key phrases. Use US Legal Forms to discover the Maine Revocation of Authorization To Use or Disclose Protected Health Information in a handful of mouse clicks.

If you are previously a US Legal Forms buyer, log in in your profile and then click the Obtain option to obtain the Maine Revocation of Authorization To Use or Disclose Protected Health Information. You can even entry varieties you formerly downloaded within the My Forms tab of the profile.

If you are using US Legal Forms for the first time, follow the instructions beneath:

  • Step 1. Ensure you have selected the form to the correct metropolis/country.
  • Step 2. Use the Review option to check out the form`s information. Never forget about to read the description.
  • Step 3. If you are not happy with all the kind, make use of the Search industry on top of the screen to discover other versions of your legal kind web template.
  • Step 4. Upon having found the form you need, click on the Acquire now option. Select the rates program you favor and include your qualifications to sign up for the profile.
  • Step 5. Process the financial transaction. You may use your Мisa or Ьastercard or PayPal profile to complete the financial transaction.
  • Step 6. Choose the format of your legal kind and obtain it in your device.
  • Step 7. Total, edit and print out or indication the Maine Revocation of Authorization To Use or Disclose Protected Health Information.

Each and every legal file web template you get is your own property eternally. You might have acces to each kind you downloaded within your acccount. Select the My Forms area and pick a kind to print out or obtain once again.

Be competitive and obtain, and print out the Maine Revocation of Authorization To Use or Disclose Protected Health Information with US Legal Forms. There are thousands of specialist and condition-particular varieties you can utilize for your company or specific needs.

Form popularity

FAQ

For example, Maine hospitals must keep medical records for at least 7 years. If the patient is a minor, the hospital must keep the records at least until the patient is 24 (6 years after the patient reaches 18, the age of majority). In practice, many health care providers keep their medical records longer.

A violation is an unauthorized disclosure that results in the conclusion there is a low probability of compromise to the PHI. If this low risk is determined and supported by the Risk Assessment, reporting the incident to the OCR and the involved patient is deemed to be unnecessary.

What Are Some Common HIPAA Violations?Stolen/lost laptop.Stolen/lost smart phone.Stolen/lost USB device.Malware incident.Ransomware attack.Hacking.Business associate breach.EHR breach.More items...?

5 Most Common HIPAA Privacy ViolationsLosing Devices.Getting Hacked.Employees Dishonestly Accessing Files.Improper Filing and Disposing of Documents.Releasing Patient Information After the Authorization Period Expires.

A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information.

Under HIPAA, a breach is defined as the unauthorized acquisition, access, use or disclosure of protected health information (PHI) which compromises the security or privacy of such information.

Which of the following is NOT a way to safeguard electronic medical records? Limit access by using passwords, codes, or fingerprints.

If you believe that a HIPAA-covered entity or its business associate violated your (or someone else's) health information privacy rights or committed another violation of the Privacy, Security, or Breach Notification Rules, you may file a complaint with the Office for Civil Rights (OCR).

A HIPAA authorization is a detailed document in which specific uses and disclosures of protected health are explained in full. By signing the authorization, an individual is giving consent to have their health information used or disclosed for the reasons stated on the authorization.

Health information such as diagnoses, treatment information, medical test results, and prescription information are considered protected health information under HIPAA, as are national identification numbers and demographic information such as birth dates, gender, ethnicity, and contact and emergency contact

More info

Authorization to use and disclose your protected health information in these situations, you always have the right to revoke that authorization. PATIENT AUTHORIZATION FOR SPECIFIC DISCLOSURE. OF PROTECTED HEALTH INFORMATION. Patient Name: I, the undersigned, hereby authorize ...1 page PATIENT AUTHORIZATION FOR SPECIFIC DISCLOSURE. OF PROTECTED HEALTH INFORMATION. Patient Name: I, the undersigned, hereby authorize ...How We May Use and Disclose Your Protected Health Information (?PHI?):with the HIPAA Privacy and Security Rule, the HITECH Act, and Maine state and ... You may choose to not make your protected health information available to this state-wide arrangement by completing an ?opt-out? election form available online, ... Section 264 of HIPAA required the Secretary of Health and Human Services topermit both the use and disclosure of information for treatment purposes. I authorize the disclosure of mental health facility information contained in my medical records. Check this box if you wish this authorization to authorize the ... I understand that if I revoke this authorization I must do so in writing and present my revocation to the Health Information Management department. I understand ... As Required or Authorized by Law: We may use anddisclose your protected health information to a publicrevocation to Pines' Privacy Officer. Written authorization to use your health information or to disclose it to anyone for any purpose. If you give us authorization, you may revoke it in writing ... Other uses and disclosures of your protected health information will be made only with your written authorization. You may revoke your authorization at any time ...

Trusted and secure by over 3 million people of the world’s leading companies

Maine Revocation of Authorization To Use or Disclose Protected Health Information