Tennessee 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; 
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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

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).

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.

Be filed in writing by mail, fax, e-mail, or via the OCR Complaint Portal.

WHAT IS A PRIVACY BREACH? A privacy breach occurs when Ontario's Personal Health Information Protection Act (PHIPA) has been contravened, for example, where personal health information is stolen, lost or if it is used or disclosed without authority.

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).

U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is responsible for enforcing the HIPAA Privacy and Security Rules.

Call your local police department immediately. Report your situation and the potential risk for identity theft. The sooner law enforcement learns about the theft, the more effective they can be.

Contact information for the TDH Privacy Officer: Privacy Officer: privacy.health@tn.gov. TDH HIPAA Hotline: (615) 253-5637 or 1-877-280-0054.

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