Indiana Health Information Privacy Complaint Form for filing with HIPAA Privacy Office
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How to fill out Health Information Privacy Complaint Form For Filing With HIPAA Privacy Office?
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FAQ
U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is responsible for enforcing the HIPAA Privacy and Security Rules.
HIPAA Breach Notification Rule. Not all HIPAA violations are required to be reported to the relevant patient or HHS. Under the breach notification rule, covered entities are only required to self-report if there is a ?breach? of ?unsecured? PHI. (45 CFR § 164.400 et seq.).
Your complaint must: Be filed in writing by mail, fax, e-mail, or via the OCR Complaint Portal. Name the covered entity or business associate involved, and describe the acts or omissions, you believed violated the requirements of the Privacy, Security, or Breach Notification Rules.
compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.
Your complaint must: Be filed in writing: sent by mail, fax or e-mail. Name the person that is the subject of the complaint and describe the act or acts believed to be in violation of the Patient Safety Act requirement to keep PSWP confidential.
Ideally, the complaint should be filed with your HIPAA compliance officer, or failing that, the matter should be brought to the attention of your supervisor.
To submit a complaint using the online complaint form, go to Online Complaint Submission form. Toll-free Complaint Report Line: 1-800-246-8909 (available during state business hours).
The risk assessment will help the Privacy Officer determine whether the violation is a reportable incident. Not all internal violations of HIPAA Rules need to be reported, but the failure to notify the patient and OCR of a reportable breach of unsecured PHI could result in a financial penalty.
