HIPAA Privacy Policies and Forms
All current and retired employees enrolled in The University of Texas Systems self-insured employee group health plans (UT Select, UT Dental Select and UT Flex) are entitled to receive a Notice of the Privacy Practices adopted by The University of Texas System Administration on behalf of the self-funded health plans operated by the Office of Employee Benefits in compliance with Title 2 of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH) Act, and the federal regulations adopted to implement HIPAA (45 CFR Parts 160 & 164 "the HIPAA Privacy Rule"). These Policies and Forms, which constitute The University of Texas System Administration Manual has been formally adopted by of The University of Texas System Administration as INT 166, which can be found in the UT System Policy Library at www.utsystem.edu/board-of-regents/policy-library. Similar privacy policies have also been adopted by all carriers who provide the fully-insured group health plans in which current and retired employees are also eligible to enroll in through OEB.
The contents of System Administration's HIPAA Privacy Manual Policies are also set forth below. If you need assistance with the Manual or HIPAA in general, please contact Privacyofficer@utsystem.edu . Please be assured that OEB's policy has always been and continues to be that utmost care be used at all times to safeguard any information provided to OEB by or for its enrollees. Information is released only when it is required to make sure that your health care provider is properly reimbursed for medical services provided to you, for reasons related to the provision and maintenance of coverage, or if required by law.
- UT System Administration Notice of Privacy Practices
- Request for Access to Protected Health Information
- Staff Assistance Authorization
- General Authorization Form
- Request for Accounting of Disclosures
- Request for Amendment of Protected Health Information
- Request for Confidential Communications of Medical Information
- Request for Restriction on Use or Disclosure of Protected Health Information
- Revocation of Authorization
- Complaint Form
- Disclosure Log
- Breach Log
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