home | self help | glossary | site map
eMedNYHIPAASupport > eMedNY HIPAA Privacy and Security
Please open and type your information into the form, then print, sign and mail in to eMedNY.
Please use the tab key or the mouse to move from field to field on typeable forms.
- This icon designates a typeable form. Please type in your information before printing and signing.
The HIPAA Privacy and Security Rules (45 CFR 164.308(6)(i), 45 CFR 164.308 (6)(ii), 45 CFR 164.530(d)(1) and 45 CFR 164.530(d)(2)) state a process to receive and document complaints regarding protected health information (PHI) and to identify and respond to concerns regarding suspected or known security incidents must exist and be implemented. eMedNY has provided an avenue for staff, business associates, trading partners, and Medicaid members with a consistent mechanism for reporting HIPAA Privacy and Security Incidents and Concerns.HIPAA Incident and Concern Form
eMedNY has provided an avenue for staff, business associates, trading partners, and Medicaid members with a consistent mechanism for filing a Confirmation of Return or Destruction of Misdirected Correspondence. In the event correspondence is received/viewed or data is accessed from eMedNY for a provider who is not located at the address and who has no association with the addressee, please use the below form: