Oklahoma Health Information Privacy Complaint Form for filing with HIPAA Privacy Office

State:
Multi-State
Control #:
US-354EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used to initiate a complaint based on a violation of the HIPPA laws.

How to fill out Health Information Privacy Complaint Form For Filing With HIPAA Privacy Office?

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FAQ

Go to our website at .ok.gov/health. Open the link to the Office of Accountability Systems. Open the ?Complaint Form? link in the body of the text. Print the form.

The Division of Consumer Protection within the Texas Department of State Health Services (DSHS) oversees licensing for, enforcement of, and compliance with standards and regulations for credentialed professionals.

If you need to report a privacy violation, file a complaint with Texas Health and Human Services by calling 2-1-1 or 877-541-7905, toll-free.

If the review identifies a potential HIPAA violation, it will be investigated further. An investigation can result in several outcomes. If no violation is identified, you should receive a communication explaining why. If a minor violation is identified, the organization will likely take steps to rectify it.

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.

HIPAA privacy violations can be reported to the HHS Office for Civil Rights by sending an email to the OCR complaint portal at OCRCompliance@hhs.gov.

A HIPAA violation refers to the failure to comply with HIPAA rules, which can include unauthorized access, use, or disclosure of Protected Health Information (PHI), failure to provide patients with access to their PHI, lack of safeguards to protect PHI, failure to conduct regular risk assessments, or insufficient ...

Submit a privacy complaint To submit a complaint, you can write a letter that includes: Your name. A summary of your complaint or a written description of the specific circumstances. A summary of other steps taken, if any, by you or the CFPB to resolve this complaint.

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Oklahoma Health Information Privacy Complaint Form for filing with HIPAA Privacy Office