The University of Texas System recognizes an Individual’s right to request that UT SELECT, UT DENTAL SELECT & UT FLEX restrict its uses and disclosures of medical information for purposes of payment, health care operations, and certain notification disclosures. As a practical matter, normally System cannot agree to restrictions on use and disclosure of medical information. However, System will consider the special circumstances for which you make your request. If we agree to your request, we will comply with your requested restriction unless either the restriction is terminated, the use or disclosure is necessary for your emergency treatment, or the use or disclosure is legally permissible for reasons other than payment, health care operations, or notification disclosures.
HIPAA Request for Restriction on Use or Disclosure of Protected Health Information
Document File(s)
Document Description
Employee Benefits
Special Notices