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*** See www.compliance.wisc.edu/hipaa for up-to-date content. ***
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On this page, you will find links to UW-Madison's Privacy and Security Rule policies and procedures and its Personnel policies and procedures.
In addition to these policies and procedures, UW-Madison faculty, staff and students are also subject to the policies and procedures of the Health Care Component Unit within which they are employed or assigned (e.g. University Health Services, State Laboratory of Hygiene) and to the policies and procedures of other covered entities within which they practice (e.g. University of Wisconsin Hospital and Clinics, Meriter-Unity Point Health, St. Mary's).
Jump to UW-Madison's Personnel Policies and Procedures.
Privacy and Security Rule Policies and Procedures
UW-Madison's policies are under review and continue to be updated as to Security Rule provisions. Please check back periodically for updates.
1.1 Designation of the UW-Madison Health Care Component (UW HCC)
1.2 Designation of the University of Wisconsin Affiliated Covered Entity (UW ACE)
2.1 Notice of Privacy Practices (NPP) Distribution and Acknowledgement
Related Form: Authorization for Disclosure of Medical Information (General Purpose)
3.4 Uses and Disclosures of PHI That Require Providing Patient with an Opportunity to Agree or Object
3.5 Uses and Disclosures of Protected Health Information for Education and Training
3.6 Uses and Disclosures of Protected Health Information for Marketing
3.7 Uses and Disclosures of Protected Health Information for Fundraising
Related Form: Determination of Access to Protected Health Information
3.10 Designated Record Set
5.1 De-identification of Protected Health Information Under the HIPAA Privacy Rule
5.2 Creation of a Limited Data Set Under the HIPAA Privacy Rule
Related Form: Data Use Agreement for Disclosure of a Limited Data Set
6.3 Use of and Safeguards for PHI by UW-Madison Internal Business Support Personnel
Related Form: Business Associate Agreement
Related Form: Sample Request for Accounting of DisclosuresRelated Form: Sample Disclosure Tracking LogRelated Form: Sample Reports of Disclosures to Third Parties
Related Form: Sample Request for Amendment of Health Information
Related Form: Sample Letter Accepting Amendment
Related Form: Sample Letter Denying Amendment
Related Form: Sample Letter Responding to Statement of Disagreement
Related Form: Sample Letter Notifying of Need for 30 Day Extension
Related Form: Sample Request for Notification of Amendment
Related Form: Alternative Confidential Communication Request Form
Related Form: Sample Letter Notifying of Need for 30 Day ExtensionRelated Form: Sample Letter Denying Request to Obtain a Copy of PHI
Related Form: Request for Restrictions on Use/Disclosure of PHIRelated Form: Sample Letter of Approval of Request for RestrictionsRelated Form: Sample Letter of Denial of Request for Restrictions
8.5 Security of Faxed, Printed, and Copied Documents Containing Protected Health Information
Related Form: Fax Transmission Cover Sheet
Related Form: Sample Certificate of Destruction
Related Form: HIPAA Breach Analysis Form
9.2 Responding to Employee Noncompliance with Polices and Procedures Relating to HIPAA
9.3 Responding to Student Noncompliance with Policies and Procedures Relating to HIPAA
10.1 Complaints Under the HIPAA Privacy Rule
Related Form: Patient Privacy Complaint
UW-Madison's Personnel Policies and Procedures
UW-Madison faculty and staff may be subject to discipline, up to and including termination, for violations of HIPAA regulations and/or UW-Madison rules and policies relating to HIPAA. The applicable personnel policies and procedures appear below.