Louisiana State University Health Sciences Center Administration & Finance
 

CM-53 - HIPAA Privacy Policies

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) (P. L. 104-191) is an amendment to the Social Security Act. Its primary purpose is to place restrictions on what can be categorized as pre-existing conditions when an employee moves from one job to another. However, Title II of the Act, entitled Administrative Simplification, sets new requirements for healthcare providers, payers and clearinghouses in the areas of privacy, information security, and electronic data interchange.   In accordance with these requirements, the following LSUHSC privacy policies have been enacted.
A. Privacy Notice Policy: Notice of Privacy Practices Policy, [ PDF version ]
bullet Attachment A: Notice of Privacy Practices for Protected Health Information * PDF format only
bullet Attachment B: Acknowledgement of Receipt of Notice of Privacy Practices * PDF format only
bullet Attachment C: Notice of Privacy Practices for Protected Health Information (Spanish) * PDF format only
bullet Attachment D: Acknowledgement of Receipt of Notice of Privacy Practices (Spanish) * PDF format only
B. Patient Information Policy: Privacy Official and Complaint Contact,  [ PDF version ]
C. Patient Information Policy: Accounting of Disclosures of Protected Health Information, [ PDF version ]
bullet Attachment A: Accounting of Disclosures of Protected health Information * PDF format only
bullet Attachment B: Accounting of Disclosures of Protected Health Information for Research * PDF format only
bullet Attachment C: Tracking Form for Disclosure of Protected Health Information * PDF format only
D. Minimum Necessary Policy: Minimum Necessary Uses and Disclosures of Protected Health Information, [ PDF version ]
E. Patient Information Policy: Whistleblower/Non-Retaliation, [ PDF version ]
F. Mitigation Policy: Mitigation after Improper Protected Health Information Use or Disclosure, [ PDF version ]
G. Patient Information Policy: Training and Education Requirements for Members of the LSU System Facility Workforce, [ PDF version ]

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 Attachment A: Confidentiality Agreement * PDF format only
H. Documentation Policy: Documentation Requirements, [ PDF version ]
I. Restriction Policy: Patient's Request for Restriction of Uses and Disclosures of Their Protected Health Information, [ PDF version ]
J. Patient Information Policy: Patient's Right of Access to and Obtain a Copy of their Protected Health Information, [ PDF version ]
bullet Attachment A: Patient’s Request for Access to and to Obtain a Copy of Their Protected Health Information * PDF format only
K. Patient Information Policy: Patient's Right to Request an Amendment to their Protected Health Information, [ PDF version ]
bullet Attachment A: Sample letter to Patient for Approved Amendments * PDF format only
bullet Attachment B: Sample Letter to Notify Other Entities of Amendment * PDF format only
bullet Attachment C: Sample Letter to Notify Individual’s of a Delay in Their Amendment Request * PDF format only
bullet Attachment D: Patient Request for Amendment of Protected Health Information * PDF format only
bullet Attachment E: Sample Letter to Patient Re: Denial Requests for Amendment * PDF format only
L. Patient Information Policy: Patient's Right to Request and to Receive Confidential Communications by Alternative Means or at Alternative Locations [PDF version]
bullet Attachment A: Request to Receive Confidential Information by Alternative Means or Alternative Locations * PDF format only
M. Patient Information Policy: Safeguards [PDF version]
N. Patient Information Policy: Limited Data Set [PDF version]
bullet Attachment A: Limited Data Set Request and Data Use Agreement * PDF format only
O. Patient Information Policy: De-Identification of Protected Health Information [PDF version]
bullet Attachment A: Request for De-Identified Information * PDF format only
P. Treatment Payment Operations Policy: Use and Disclosure of Protected Health Information for Payment, Treatment and Health Care Operations, [PDF version]
Q. Patient Information Policy: Use and Disclosure of Protected Health Information for Facility Directory Purposes [PDF version]
bullet Attachment A: Permission to Use and Disclose Protected Health Information for LSUHSC-NO Facility Directory * PDF format only
R. Patient Information Policy: Use and Disclosure of Protected Health Information for Marketing Purposes, [PDF version]
bullet Attachment A: Authorization for Use and Disclosure of Protected Health Information for Marketing Purposes Patient Identification * PDF format only
bullet Attachment B:  Authorization for Use and Disclosure of Protected Health Information for Media* Purposes * PDF format only
S. Human Subject /Patient Policy: Use and Disclosure of Protected Health Information for Research [PDF version]
bullet Attachment A1: Authorization for Use and Disclosure of Protected Health Information for Research Purposes (with HIV/Substance Abuse language) * PDF format only
bullet Attachment A2: Authorization for Use and Disclosure of Protected Health Information for Research Purposes (without HIV/Substance Abuse language) * PDF format only
bullet Attachment B: Principal Investigator’s Certification of Requisition for Research on Decedent’s Information * PDF format only
bullet Attachment C: Principal Investigator’s Certification of Review of Data Collection for Reviews Preparatory to Research * PDF format only
bullet Attachment D: Principal’s Investigators De-Identification Form for Approved Exempt Research * PDF format only
bullet Attachment E: Authorization for Use and Disclosure of Protected Health Information for Research Purposes — Stanley S. Scott Cancer Center * PDF format only
T. Patient Information Policy: Use or Disclosure of Protected Health Information That Require an Individual's Written Authorization  [PDF version]
bullet Attachment A: To Authorization Policy * PDF format only
bullet Attachment B: Authorization for Release of Protected Health Information Patient Identification * PDF format only
U. Patient Information Policy: Use and Disclosure of Protected Health Information to Persons Involved in the Patient's Care and For Notification Purposes [PDF version]
V. Patient Information Policy: Use and Disclosure of Protected Health Information to Business Associates [PDF version]
bullet Attachment A: Checklist for HIPAA Business Contracts * PDF format only
bullet Attachment B: Business Associate Contract Addendum [PDF version] [Word Version]
W. Patient Information Policy: Use and Disclosure of Protected Health Information for Fundraising [PDF version]
X. Discipline Policy: Employee Conduct and Disciplinary Sanctions [ PDF version ]
Disclaimer © 2012 LSUHSC Privacy Policy