This post is intended for the Investigations Division of the Office of the Inspector General Hotline of the U.S. DOJ only.
All other readers are asked to exit this post at this time.
Because this post contains medical information, it will appear for a short time prior to being removed from this blog.
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OIG Hotline investigators, I am documenting herewith a Limited Medical Power of Attorney granted to me by my son Graham MacWilliams, together with a public notary witnessing of the signed document.
Related documentation will follow.
The text of this document is transcribed below for ease of reading.
In addition, this Limited POA will be faxed to the OIG Hotline in exactly the form and wording appearing here. The fax confirmation will also appear on this blog.
I hereby certify that the foregoing is true and correct.
Lane MacWilliams
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LIMITED MEDICAL POWER OF ATTORNEY FOR CALIFORNIA
I, Graham Tate MacWilliams, the "Principal," appoint my mother, Lane MacWilliams, to serve as my advocate in exercising the authority, specified herewith.
Phone Call Representation
I authorize my Agent to make phone calls to arrange medical consultations on my behalf.
Medical Release and HIPPA Waiver for My Agent
I authorize my Agent to exercise my rights regarding the use and disclosure of my medical records, including the following: (a) requesting, reviewing, and receiving any information, verbal or written regarding my health, including medical records insurance and financial information; and (b) any written or oral opinions of my physician or health care provider concerning such information. My Agent may also execute on my behalf any releases or other documents that may be required in order to obtain this information and consent to the disclosure of this information. This medical release applies to any information governed by the Health Insurance Portability and Accountability Act of 1996.
Agent
I, Lane MacWilliams, understand the above permissions and am willing to serve as the healthcare Agent for the named Principle in the capacities specified.
Signature: Lane MacWilliams. Date: January 28, 2023
Principal
I, Graham Tate MacWilliams, understand the above permissions and grant them to my Agent Lane MacWilliams in the capacities specified.
Signature: Graham MacWilliams. Date: January 28, 2023
California Notary Public Acknowledgement
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