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Maryland 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.

Maryland Authorization for Use and/or Disclosure of Protected Health Information (PHI) is a legal document that authorizes healthcare providers and organizations to share an individual's PHI with third parties under certain circumstances. This authorization is specific to the state of Maryland and complies with the relevant regulations and laws governing healthcare privacy, such as the Health Insurance Portability and Accountability Act (HIPAA) and the Maryland Confidentiality of Medical Records Act (CMA). The Maryland Authorization for Use and/or Disclosure of PHI is an essential component of protecting patient confidentiality while also allowing healthcare providers to share necessary information for treatment, payment, and healthcare operations. By granting this authorization, patients give their explicit consent to allow healthcare entities to use and disclose their PHI. There are different types of Maryland Authorization for Use and/or Disclosure of Protected Health Information that cater to specific circumstances or purposes. Some common types include: 1. General Authorization: This is a broad authorization that allows healthcare providers to use and disclose an individual's PHI for various purposes, including treatment, payment, or operations. 2. Specific Authorization: This type of authorization specifies the exact purpose for which the PHI will be used or disclosed. It is required when the patient wants to give consent for a particular situation or entity explicitly. 3. Research Authorization: Research studies often require specific authorization from participants to use their PHI for research purposes. This type of authorization typically includes detailed information about the study, its purpose, the information to be accessed, and how the data will be protected. 4. Psychotherapy Notes Authorization: Maryland specifically requires separate authorization for the use and disclosure of psychotherapy notes due to their sensitive nature. This type of authorization ensures that individuals have control over who can access their psychotherapy notes and for what purposes. 5. Minors' Authorization: In cases involving minors, parental or guardian authorization is required to access their PHI. This type of authorization ensures that caregivers have the legal authority to make decisions about the minor's healthcare and privacy. 6. HIV/AIDS-related Authorization: Maryland law mandates specific authorization for the disclosure of HIV/AIDS-related information due to the sensitive nature of this condition. This authorization ensures individuals maintain control over who can access their HIV/AIDS-related medical information and protects against discrimination. It is critical for healthcare providers, organizations, and patients alike to understand the different types of Maryland Authorization for Use and/or Disclosure of Protected Health Information. This knowledge helps ensure compliance with privacy laws and promotes the responsible and secure sharing of PHI while respecting patients' rights to privacy and consent.

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FAQ

What are two required elements of an authorization needed to disclose PHI? Response Feedback: All authorizations to disclose PHI must have an expiration date and provide an avenue for the patient to revoke his or her authorization. What does the term "Disclosure" mean?

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.

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.

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

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

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).

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.

More info

Request to Restrict Use/Disclosure of Protected Health Information (PHI)parent of a minor, legal guardian, or authorized HIPAA appointee of the Member.10 pages Request to Restrict Use/Disclosure of Protected Health Information (PHI)parent of a minor, legal guardian, or authorized HIPAA appointee of the Member. Safeguarding Your Protected Health Information. The BaltimoreYou can file a complaint with the County's Privacy Officer.Baltimore, Maryland 21212.Name; Address; Telephone numbers; Birthdate; Medicaid ID number and other medical record numbers; Social Security number; Name of employer. In most instances, ... And disclose their health information in connection with most healthcareof the uses and disclosure we may make of your protected health information, ... To conveniently request medical records, FMLA and Disability certifications. AUTHORIZATION FOR USE OR DISCLOSURE OF PATIENT HEALTH INFORMATION. To the ...3 pages to conveniently request medical records, FMLA and Disability certifications. AUTHORIZATION FOR USE OR DISCLOSURE OF PATIENT HEALTH INFORMATION. To the ... To request this list or accounting of disclosures, you must submit your request, which shall state a time period, which may not be longer than six years and may ... You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. If you give us an authorization, you ... We may use or disclose your protected health information in the following situations without your authorization. These situations include: as Required By Law, ... There are a number of Disclosures that do not require your Authorization: (1)Uses and disclosures of your protected health information (?PHI?) may be ... Privia may use and disclose your PHI to researchers for the purpose of conducting research with your written authorization or when the research has been ...

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