Please discontinue use of any now-obsolete consent forms and update any online posting. The current HIPAA form is available on the Partner Dashboard. Type HIPAA or LU1250 in the search bar and look for your state-specific form.
To download the HIPAA PDFs without logon, use these links:
LU1250 Release of Health-Related Info (HIPAA) CA, CT, DC, DE, ND, SD Banner
LU1250WP NY Release of Health-Related Information (HIPAA) Penn
ICC17 LU1250ME ME Release of Health-Related Information (HIPAA) Banner
ICC17 LU1250VT VT Release of Health-Related Information (HIPAA) Banner
LU1250FL FL Release of Health-Related Information (HIPAA) Banner
ICC17 LU1250 ALL OTHER STATES Release of Health-Related Information (HIPAA) Banner
We also added “genetic information and genetic testing results” to the LU1282 reinstatement application PDF packages that contain the HIPAA form. Log on to the Partner Dashboard and type LU1282 in the search bar and look for your state-specific form. Uncheck “Only new application forms” since this is a reinstatement app rather than a new app.
All form vendors have been notified for implementation. |