Pennsylvania Health Information Privacy Complaint for filing with Dept. of Health and Human Services Office of Civil Rights

State:
Multi-State
Control #:
US-AHI-017
Format:
Word; 
Rich Text
Instant download

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This AHI form is used by an employee that feels that their health care privacy rights were violated.
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  • Preview Health Information Privacy Complaint for filing with Dept. of Health and Human Services Office of Civil Rights
  • Preview Health Information Privacy Complaint for filing with Dept. of Health and Human Services Office of Civil Rights
  • Preview Health Information Privacy Complaint for filing with Dept. of Health and Human Services Office of Civil Rights

How to fill out Health Information Privacy Complaint For Filing With Dept. Of Health And Human Services Office Of Civil Rights?

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FAQ

6), OCR may refer the complaint to the Department of Justice for investigation. OCR reviews the information, or evidence, that it gathers in each case. In some cases, it may determine that the covered entity did not violate the requirements of the Privacy or Security Rule.

Complaint Requirements 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.

The Office of Civil Rights (OCR) is a federal agency that investigates complaints of discrimination on the basis of race, color, national origin, sex, disability and age in public schools.

Filing a Complaint If you believe that a HIPAA-covered entity or its business associate violated your (or someone else's) health information privacy rights or committed another violation of the Privacy, Security, or Breach Notification Rules, you may file a complaint with the Office for Civil Rights (OCR).

If you believe that a covered entity discriminated against you or violated your (or someone else's) civil rights, conscience rights, or religious freedom rights, you may file a complaint with OCR. You may file a complaint for yourself, your organization, or for someone else.

If a complaint describes an action that could be a violation of the criminal provision of HIPAA (42 U.S.C. 1320d-6), OCR may refer the complaint to the Department of Justice for investigation. OCR reviews the information, or evidence, that it gathers in each case.

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Pennsylvania Health Information Privacy Complaint for filing with Dept. of Health and Human Services Office of Civil Rights