W. Va. Code R. § 114-57-16

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 114-57-16 - Authorizations

16.1. A valid authorization to disclose nonpublic personal health information pursuant to subsection 15.1 shall be in written or electronic form and shall contain all of the following:

a. The identity of the consumer or customer who is the subject of the nonpublic personal health information;

b. A general description of the types of nonpublic personal health information to be disclosed;

c. General descriptions of the parties to whom the licensee discloses nonpublic personal health information, the purpose of the disclosure and how the information will be used;

d. The signature of the consumer or customer who is the subject of the nonpublic personal health information or the individual who is legally empowered to grant authority and the date signed; and

e. Notice of the length of time for which the authorization is valid, which in no event shall be for more than twenty-four (24) months, and that the consumer or customer may revoke the authorization at any time and the procedure for making a revocation.

16.2. A consumer or customer who is the subject of nonpublic personal health information may revoke an authorization to disclose nonpublic personal health information at any time, subject to the rights of an individual who acted in reliance on the authorization prior to notice of the revocation.

16.3. A licensee shall retain the authorization or a copy thereof in the record of the individual who is the subject of nonpublic personal health information.

W. Va. Code R. § 114-57-16