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2003-050
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2003-050
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Last modified
9/27/2016 2:22:17 PM
Creation date
9/30/2015 6:22:38 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
03/04/2003
Control Number
2003-050
Agenda Item Number
7.U.
Entity Name
Agency for Health Care Administration
Subject
Medicaid Program data sharing agreement
Archived Roll/Disk#
3160
Supplemental fields
SmeadsoftID
3172
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RORIDAAGENCY FOR HEALTH CARE ADMINGTRA71ON <br /> JEB BUSH, GOVERNOR RHONDA M. MEDOWS , MD, FAAFP, SECRETARY <br /> February 4 , 2003 <br /> Ms . Joyce Johnston-Carlson <br /> Indian River County <br /> Welfare Department <br /> 1840 25th Street, Suite S -308 <br /> Vero Beach FL 32960 <br /> Dear Ms . Joyce Johnston-Carlson : <br /> The Agency for Health Care Administration currently provides your county with certain <br /> information for purposes of county financial participation in the Medicaid program as provided <br /> for by Section 409 . 915 , Florida Statutes (2002) . <br /> Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) , the <br /> Agency is required to safeguard the privacy of such information . Enclosed is a data sharing <br /> agreement outlining the permitted uses and disclosures of the information the Agency shares <br /> with you. If you have any questions concerning the agreement, please contact me at <br /> (850) 488-2734 . Please sign the agreement and return it to the address listed below before <br /> February 25 , 2003 . <br /> David R. Herman, Privacy Officer <br /> 2727 Mahan Drive, MS # 1 <br /> Tallahassee, FL 32308 <br /> Thank you for your anticipated cooperation . <br /> Respectfully, <br /> i <br /> David R. Herman <br /> Privacy Officer <br /> qxE s <br /> 2727 Mahan Drive • Mail Stop # 1 � Visit AHCA online at <br /> Tallahassee , FL 32308 'N � „S .�, s+` . www .fdhc . state .fl . us <br />
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