The statements made above are true and accurate to the best of my knowledge. I understand that federal laws provide for criminal penalties for submitting knowingly or making false, fictitious or fraudulent statement or claim in any manner. Because personal information is requested from you, we are required by HIPAA to notify you of the following: This information is requested under the authority of Chapter 55, Title 10, United States Code, Section 1076A. The information is requested to update enrollment records in order to process claims. Routinely, this information will be used to determine eligibility for benefits and to review and process claims.