Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice



  • To comply with the HIPAA Privacy Rule, a Client Notice will be mailed the first week of April 2003 to persons receiving Medical benefits.
  • Beginning April 1, 2003, all dispositions on applications for cash and/or medical benefits must receive Illinois Department of Public Aid Privacy Notice (Form 3806) explaining the use and disclosure of protected health information.

This Policy Memorandum was prepared by the Illinois Department of Public Aid. DPA administers the Medicaid and KidCare programs. These programs provide medical benefits to families with children and to other persons. This information is to be used by staff of the Illinois Department of Human Services (DHS) when authorizing medical benefits for persons on behalf of DPA.

The HIPAA Privacy Rule creates national standards to protect individuals' personal health information and guarantees patients increased access to their medical records. The Privacy Rule covers health plans, health care clearinghouses, and those health care providers who conduct certain financial and administrative transactions electronically.

DHS collects medical information from individuals to determine eligibility, approve transportation requests or to meet spenddown. DPA collects medical information to pay medical bills, to approve transportation requests and for other medical purposes. Both DHS and DPA are required to comply with the HIPAA Privacy Rule.

Client Notice CN 03.05 will be mailed early in April 2003 to all cases receiving medical benefits to inform clients of their privacy rights. This includes categories 00, 01, 02, 03, 04, 06, 90, 91, 92, 93, 94, 94R, 94U, 94W, and 96. It includes SeniorCare cases. It does not include Food Stamp only cases.

The notice explains how DPA and DHS may use and disclose protected health information without authorization. It also explains how clients may authorize and withdraw authorization for the release of their information for other purposes. Finally, the notice explains how clients may file a complaint when they believe protected health information about them was released in error.

A facsimile of the CN 03.05 is attached. The Privacy Notice contained in CN 03.05 is identical to Form 3806.

Effective April 1, 2003, send Form 3806, explaining privacy rights and the use and disclosure of protected health information, with all dispositions (approvals, denials) on applications for cash or medical benefits. When a person applies for benefits (TANF, AABD, Medical only benefits or KidCare Share, Premium, and Rebate) and disposition is made on the application, the system prints and centrally sends a disposition notice. Form 3806 will print at the same time and will be centrally mailed (along with the disposition notice) to the applicant. Anytime a manual disposition notice is sent, also send Form 3806. Please use the attached copy of Form 3806 until an initial supply is received.

[signed copy on file]

Secretary, Illinois Department of Human Services

Director, Illinois Department of Public Aid

Forms referenced:
CN 03.05
Form 3806 (IL444-4775 - Notice of Privacy Practices)