North Carolina Request for Restrictions on Uses and Disclosures of Protected Health Information

State:
Multi-State
Control #:
US-3582
Format:
Word; 
Rich Text
Instant download

Description

This form is used by an individual to request restrictions on the disclosure and use of the individual's protected health information. The individual's rights regarding restricting such use and disclosure are explained, as well as the responsibilities of the record provider in regard to the restrictions.

The North Carolina Request for Restrictions on Uses and Disclosures of Protected Health Information is a legal document that allows individuals to request specific limitations on how their health information is used and shared by healthcare providers and entities in the state of North Carolina. This document ensures that patients' rights to privacy and confidentiality are upheld in accordance with state and federal laws, such as the Health Insurance Portability and Accountability Act (HIPAA). The request for restrictions on uses and disclosures of protected health information enables patients to control the flow of their personal medical data, by specifying certain restrictions that healthcare providers must adhere to when using or disclosing their health information. These restrictions can be related to who can access the information, for what purposes it can be used, and to whom it can be disclosed. Examples of common restrictions that patients may request include limiting access to health information by certain individuals or organizations, restricting the use of health information for marketing purposes, or specifying the specific healthcare professionals who can access and disclose the information. It is important to note that the North Carolina Request for Restrictions on Uses and Disclosures of Protected Health Information may have different types or variations depending on the healthcare provider or entity. While the core purpose remains the same, some providers may have their specific form or additional requirements that need to be fulfilled when making such a request. When completing the form, individuals should ensure that it includes all relevant information, such as their name, contact details, date of birth, and specific details regarding the requested restrictions. It is recommended to consult with a healthcare provider or legal professional to ensure the accuracy and completeness of the request. In summary, the North Carolina Request for Restrictions on Uses and Disclosures of Protected Health Information empowers patients to have more control over their personal health information. It allows them to specify certain limitations on how their information is used and shared, ensuring their privacy and confidentiality rights are respected. Understanding and utilizing this request can provide individuals with a sense of security and peace of mind regarding the handling of their health information.

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FAQ

Regardless of the method by which de-identification is achieved, the Privacy Rule does not restrict the use or disclosure of de-identified health information, as it is no longer considered protected health information, according to HHS.

A covered entity is required to agree to an individual's request to restrict the disclosure of their PHI to a health plan when both of the following conditions are met: (1) the disclosure is for payment or health care operations and is not otherwise required by law; and (2) the PHI pertains solely to a health care item

An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual.

HIPAA Exceptions DefinedTo public health authorities to prevent or control disease, disability or injury. To foreign government agencies upon direction of a public health authority. To individuals who may be at risk of disease. To family or others caring for an individual, including notifying the public.

Since its initial adoption, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule has granted individuals the right to request restrictions regarding the use and disclosure of their protected health information (PHI) for treatment, payment, and healthcare operations (TPO).

Unless otherwise required by law, the facility must agree to a patient's request for restrictions or limitations for disclosures to the patient's health plan for payment or health care operations purposes if the patient has paid out of pocket in full for the health care item or service and the PHI pertains solely to

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).

A covered entity may disclose protected health information to the individual who is the subject of the information. (2) Treatment, Payment, Health Care Operations. A covered entity may use and disclose protected health information for its own treatment, payment, and health care operations activities.

Under the new rule, individuals now have a right to obtain restrictions on the disclosure of health information (protected health information or PHI) in electronic or any other form to a health plan for payment or healthcare operations with respect to specific items and services for which the individual has paid the

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This enhancement to the HIPAA Privacy Rule also requires that a statement becan be used to alert workforce members that a restriction on disclosures to ... In addition to the protections under HIPAA, North Carolina Law and other Federalthe use and disclosure of PHI under HIPAA and other applicable laws.You have a right to request a restriction on the use and disclosure of your protected health information: You may ask us not to disclose some part of your ... Restrictions: You have the right to request that we place additional restrictions on our use or disclosure of your health information. If we agree to do so, we ... Vidant Health may use and disclose protected health information (PHI) about you without yourYou have the right to request restrictions on uses and The right to request a restriction on uses and disclosures of your protected health information. You may ask us not to use or disclose certain parts of your ... Request a Restriction of Uses or Disclosures: You have the right to ask that Coastal Horizons Center limit how your health care information is used or disclosed ... The request for a confidential communication must be received in writing and specify how or where you wish to be contacted. The organization will not request ... You have the right to request that we place additional restrictions on our use or disclosure of your protected health information. We are not required to agree ... We will ask you to complete and sign a form on-site acknowledging receipt of our privacy policy.Uses and Disclosures of Protected Health Information.

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North Carolina Request for Restrictions on Uses and Disclosures of Protected Health Information