HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
2016 ANNUAL HIPAA PRIVACY AND SECURITY ASSESSMENT FOR BROADSCOPE DISABILITY SERVICES
Click the link below to see the 2016 HIPAA Training Document for this Assessment.
2016 HIPAA Training Document for Broadscope Disability Services
Broadscope Disability ServicesCONFIDENTIALITY AGREEMENTI understand that information obtained about persons served by Broadscope Disability Services is to be kept confidential under the requirements established by Wisconsin State Law and the Wisconsin Administrative Code.
I also understand that all treatment records shall remain confidential and are privileged information to the subject individual. Such records may be released only as permitted by the Wisconsin Statutes (Chapter 51.30) and the Wisconsin Administrative Code (HFS 92.01(1)). A release of information requires the informed written consent of the subject individual except in the few special circumstances noted in these regulations. (Note that “Treatment Records” include spoken information about the person who is receiving services.)
I understand that the information about service recipients is privileged and confidential. I agree not to make unauthorized copies of confidential materials, allow any unauthorized person access to them or discuss them with anyone who is not specifically authorized.
My electronic signature below indicates I acknowledge that failure to adhere to the requirements set forth in this statement could constitute a violation of the Law, a violation of the public trust and discontinued reimbursement by Broadscope Disability Services.
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