HIPAA Compliance Office

 

Kathy Pilkenton, Privacy Officer
HIPAA Compliance Office
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #4
Tallahassee, FL 32308-5403
Phone: (850) 412-3960
Fax: (850) 414-6837
Email:hipaaco@ahca.myflorida.com

Welcome to the Agency for Health Care Administration's HIPAA Compliance Office. Our primary function is to advise and assist the Agency in its compliance efforts and to assist Medicaid recipients in exercising their rights as provided by HIPAA. This includes making sure that all AHCA employees safeguard the privacy of any Protected Health Information (PHI) in our custody.

HIPAA, AHCA and You

If you are a Medicaid recipient, the HIPAA Compliance Office can assist you or your authorized representative in obtaining your Medicaid claims information and in exercising your rights under HIPAA. For a detailed description of your rights, as well as information on how Medicaid may use your Protected Health Information (PHI), please see The Agency for Health Care Administration Notice of Privacy Practices.

The following forms are available to assist you with requesting your health information maintained by the agency and to excercise your rights provided by HIPAA.

  1. Request to Access Protected Health Information [115.97KB, PDF] form (to request your or your child's health information)
  2. Request to Access Protected Health Information (Spanish) [139.23KB, PDF] form (to request your or your child's health information)
  3. HIPAA Compliant Medical Release form (for attorneys representing Medicaid recipients needing to substantiate Medicaid’s lien relating to a tort or casualty accident/incident or Medicaid’s claim against the estate or against a trust account or annuity pursuant to Sections 409.010(l), 409.901, 409.910, 409.9101 and 733.2121(3)(d), Florida Statutes))
  4. Authorization for the Use and Disclosure of Protected Health Infomation [120.06KB, PDF] form (to authorize someone else such as a family member to receive your health information)
  5. Authorization for the Use and Disclosure of Protected Health Infomation (Spanish) [91.16KB, PDF] form (to authorize someone else such as a family member to receive your health information)
  6. Request for an Accounting of Disclosures of Protected Health Information [118KB, PDF] form (to determine who the agency has shared your health information with for purposes other than treatment payment or health care operations)
  7. Request for a Restriction on Protected Health Information [60KB, PDF] form (to restrict with whom the agency may share your health information)
  8. Request to Receive Confidential Communications at an Alternative Location [76KB, PDF] form (to request the agency send your health information to a location other than your primary residence)

HIPAA Questions and Complaints

Our Agency, including our Medicaid Area Offices, does not have the authority to advise non-AHCA personnel on any HIPAA related issues. All such questions should be directed to the Office for Civil Rights HIPAA Website: http://www.hhs.gov/ocr/hipaa/ , or contact them at 1-866-627-7748. Included on this site are the Privacy Rule, Frequently Asked Questions and directions on how to file a HIPAA complaint.

The following is a list of commonly asked questions that should be directed to the Office for Civil Rights:

Please Note: If you feel that an AHCA employee has violated HIPAA, in addition to contacting the Office for Civil Rights, please notify AHCA's HIPAA Compliance Office at (850) 412-3960.

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