Wyoming Authorization for Use and / or Disclosure of Protected Health Information

State:
Multi-State
Control #:
US-178EM
Format:
Word; 
Rich Text
Instant download

Description

This form allows an employee to authorize the types of medical information to be disclosed by human resources.

The Wyoming Authorization for Use and/or Disclosure of Protected Health Information is a legal document that allows individuals to give permission for their health information to be used or shared for specific purposes. This authorization is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other relevant state laws. Wyoming provides certain types of authorizations for the use and disclosure of protected health information that cater to different situations. These include: 1. General Authorization: This type of authorization allows individuals to give consent for their health information to be shared for any purpose specified by the authorization. It may be used in situations where a patient wants their health information to be disclosed to a specific party, such as a family member or a research organization. 2. Specific Authorization: A specific authorization is used when an individual wants to give consent for their health information to be used or disclosed for a particular purpose. For example, an individual may provide authorization for a healthcare provider to share their medical records with a specific specialist for treatment purposes. 3. Emergency Authorization: This type of authorization is utilized in emergency situations when individuals may not be able to give consent themselves due to incapacitation or unconsciousness. It allows healthcare providers to access and disclose protected health information to provide necessary treatment promptly. 4. Research Authorization: Research authorization is required when individuals agree to share their health information for research purposes. It specifies the type of research, the investigators involved, and how the information will be used. This authorization is important to protect individuals' privacy while allowing advancements in medical research. 5. Minors' Authorization: Wyoming also recognizes the need for authorizations specifically for minors. In cases where a minor's health information needs to be shared or used, parental or legal guardian consent is required. This ensures that the privacy and confidentiality of the minor's health information are protected. In Wyoming, these authorizations for use and/or disclosure of protected health information are essential for ensuring patient privacy and control over their medical records. Individuals have the right to dictate how their health information is used and shared, and these authorization forms provide a legal framework for granting or denying such permissions. It is crucial for healthcare providers, researchers, and other relevant parties to obtain proper authorization before accessing or disclosing an individual's health information to uphold privacy and compliance with HIPAA regulations.

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FAQ

When Must HIPAA Authorization be Obtained? The covered entity can use or disclosure of PHI for marketing purposes. If the marketing communication involves direct or indirect remuneration to the covered entity from a third party, the authorization must state that such remuneration is involved.

An authorization must specify a number of elements, including a description of the protected health information to be used and disclosed, the person authorized to make the use or disclosure, the person to whom the covered entity may make the disclosure, an expiration date, and, in some cases, the purpose for which the

Marketing Activities: A covered entity must obtain an individual's authorization prior to using or disclosing PHI for marketing activities. Marketing is considered any message or statement to the public in an effort to get them to use or seek more information about a product or service.

We may disclose your PHI for the following government functions: (1) Military and veterans activities, including information relating to armed forces personnel for the execution of military missions, separation or discharge from military services, veterans benefits, and foreign military personnel; (2) National security

Covered entities may disclose protected health information that they believe is necessary to prevent or lessen a serious and imminent threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat).

Under the HIPAA Privacy Rule, a covered entity must disclose protected health information in only two situations: (a) to individuals (or their personal representatives) specifically when they request access to, or an accounting of disclosures of, their protected health information; and (b) to the Department of Health

Valid HIPAA Authorizations: A ChecklistNo Compound Authorizations. The authorization may not be combined with any other document such as a consent for treatment.Core Elements.Required Statements.Marketing or Sale of PHI.Completed in Full.Written in Plain Language.Give the Patient a Copy.Retain the Authorization.

A patient authorization is not required for disclosure of PHI between Covered Entities if the disclosure is needed for purposes of treatment or payment or for healthcare operations. You may disclose the PHI as long as you receive a request in writing.

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Wyoming Authorization for Use and / or Disclosure of Protected Health Information