HIPAA and Privacy

HIPAA Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

HIPAA Notice of Privacy Practices (.pdf)

Authorization to Release Information Forms

HIPAA and Maine law also require us to provide our patients, clients, and members with the opportunity to disclose or share their confidential information through the use of an authorization or release form that includes certain legal language.  A form is available individuals to provide such permission easily.

Authorization to Release Information Form (.pdf)

Patients, clients, and members can complete a form to name another as the authorized representative for MaineCare employees to disclose any information about the individual's MaineCare services. Please note that you need to complete the following form in addition to the Authorization to Release Information Form when naming an authorized representative.

Appointment of an Authorized Representative Form (.pdf)

Patients, clients, and members also have the right to revoke the authorization of release of information at any time. A form is available to individuals to revoke such permission easily.

Revocation of Authorization Form (.pdf)

For more information about Privacy and Security of Health Information, see the DHHS Privacy webpage.

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