HIPAA: Privacy Practices—Notices and Forms

HIPAA (Health Insurance Portability and Accountability Act) requires most health plans and health care providers to give patients a clear, written explanation of their privacy rights and how their PHI is used. That's called a Notice of Privacy Practices (NPP). Wisconsin statute contains additional guidance for health care providers regarding the uses and disclosures of protected health information.

Notice of Privacy Practices

DHS has issued a Notice of Privacy Practices for a number of our program areas, describing how personal health information is used and shared. We have issued a Notice of Privacy Practices for the following programs:

• Chronic Disease Program
• Medicaid and BadgerCare Plus
• SeniorCare
• Treatment Facilities
• Well Woman Program

Find more information by contacting the person or office listed on each notice.

Forms

Along with describing how personal information is used, a Notice of Privacy Practices includes a list of patients' rights. This includes the right to:

• Access health records:
  • Medicaid HIPAA Privacy Access Request, F-13148
  • SeniorCare HIPAA Privacy Access Request, F-13162
• Amend health records:
  • Medicaid HIPAA Privacy Amendment Request, F-13151
  • SeniorCare HIPAA Privacy Amendment Request, F-13165
• Receive specifics of where personal health information has been shared:
  • Medicaid HIPAA Privacy Accounting Request, F-13149
  • SeniorCare HIPAA Privacy Accounting Request, F-13163
• Revoke authorization:
  • Medicaid HIPAA Revocation of Authorization, F-13146
  • SeniorCare HIPAA Revocation of Authorization, F-13167
• File a complaint:
  • Medicaid HIPAA Privacy Complaint, F-13152
  • SeniorCare HIPAA Privacy Complaint, F-13166