HIPAA Authorization Form

HIPAA authorization form notaryHIPAA Authorization Form

When doing estate planning, common documents include a last will, living trust, living will, financial power of attorney (POA), and a medical durable power of attorney. An HIPAA authorization is another important form.

A medical durable power of attorney gives the agent the power to make decisions regarding medical treatment in the event that the principal is incapacitated and unable to make or communicate his/her own medical decisions.

HIPAA Privacy Rule

Medical records contain confidential, personal health information.  The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule establishes national standards to protect medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.

The Rule requires appropriate safeguards to protect the privacy of personal health information and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization.

HIPAA Security Rule

The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records and to request corrections.  The HIPAA Security Rule requires safeguards to protect electronic records.

In order to make informed medical decisions on behalf of an incapacitated principal, the principal must authorize the agent to inspect or receive copies of the relevant medical records.

Doctors, hospitals, and other healthcare providers may refuse to provide an agent with access to private medical records unless an HIPAA authorization form has been signed by the principal.

Medical Power of Attorney

Check your medical power of attorney form.  It may already contain an HIPAA authorization section.  If not, you may need to complete a separate authorization form to allow your designated agent to inspect or receive copies of your medical records.  Your agent must also take care to safeguard your medical records to keep them private.

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[Last-Modified Date 2017-03-28] add review schema, add page links, new image

HIPAA Authorization Form
  • HIPAA Authorization Form
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