What are the required elements in an Authorization?
Specific and meaningful description of what information will be used or disclosed.
Identification of who may use or disclose the PHI.
Identification of to whom the PHI will be disclosed.
Why the use or disclosure is being made - each purpose must be included.
Statement regarding how long the use or disclosure will continue. For research purposes no expiration date is required but this must be stated in the authorization.
Notice that the authorization may be revoked by the subject.
Notice that the information may be disclosed to others who are not subject to the Privacy Rule.
Notice that the covered entity may or may not condition treatment or payment on the individual's signature of the authorization.
