HIPAA Release
(MI)

Summary

This template is an authorization to a medical professional to release and discuss any medical records in possession to the attorney-in-fact/patient advocate or to any other individual authorized by the principal. This template is for use in Michigan. It includes practical guidance and drafting notes. This authorization includes all protected medical information of the principal under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Medical Records Access Act (Mich. Comp. Laws 333.26261 et seq.). A physician is bound by certain laws of privacy, preventing the physician from disclosing medical information as it relates to his or her patient absent a signed waiver or release from the patient. Therefore, to ensure that a physician can disclose information to a patient advocate or attorney-in-fact, you should include a HIPAA release provision in the power of attorney or ensure the patient executes a separate HIPAA release. In either option, it is advisable to have the HIPAA release effective immediately. For a list of key resources that address healthcare advance planning topics, see Healthcare Advance Planning Resource Kit. For more information about patient advocates and living wills, see Living Wills and Healthcare Surrogates (MI). For a clause to insert into a power of attorney template, see Power of Attorney Clause (HIPAA) (MI) and Medical Power of Attorney Clause (HIPAA Release) (MI). For a template of a medical power of attorney, see Medical Power of Attorney (Durable) (MI). For a living will template, see Living Will (MI). For more on health information privacy and security, see Health Information Privacy and Security Resource Kit.