HIPAA Authorization: Ensuring Patient Privacy and Consent

HIPAA authorization is an important part of safeguarding sensitive patient health information. It is necessary when Personal Health Information (PHI) is utilized or shared for actions that are prohibited under the HIPAA Privacy Rule. As a covered entity, if you fail to comply with this component of HIPAA, you are subject to penalties. 

What is HIPAA authorization?

HIPAA authorization is a form filled by a patient that allows a covered entity to disclose or use protected health information (PHI). It is used for cases where the information in question is not permitted to be disclosed by HIPAA Privacy Rule.

Note: A Covered Entity or a CE under HIPAA is an organization or person that handles PHI and includes healthcare providers, health plans, and healthcare clearinghouses. These entities must comply with HIPAA’s privacy, security, and breach notification rules.

Patients must fill out the detailed HIPAA authorization document to legally allow the covered entity to use PHI for purposes excluding treatment, payment, operations, or to disclose health data to a third party. 

It is compulsory to fill this document since voluntary consent is not adequate to allow covered entities to use or disclose PHI unless it meets the requirements of a valid authorization. 

When HIPAA authorization is required?

The administrative simplification regulation mandate of HIPAA lists out the cases that require authorization: 

Psychological notes

Covered entities must obtain authorization to disclose psychotherapy notes. Exceptions to this rule apply when used for treatment, payment, operations, training programs, and in legal proceedings. 

Marketing

Covered entities must obtain HIPAA authorization for marketing purposes.  They also must get authorization before disclosing protected health information if the disclosure involves selling that information. Exceptions apply in the case of face-to-face communications and promotional gifts. 

Sale of PHI

Authorization is required for disclosing PHI for sales purposes that involves direct payment by a third party. For example, when a pharmaceutical company pays a healthcare provider to send promotional emails to patients about a new medication, they must have the signed authorization form. 

Key elements of HIPAA authorization form

The key elements of a HIPAA authorization form include: 

1. Description of the information being disclosed such as medical records, test results, and treatment plans.
2. Name or other identifying information of the individual authorized to disclose the PHI. This helps to add clarity and transparency.
3. Name or other identifying information who authorized the covered entity to make the disclosure. 
4. A description of the purpose of the use or disclosure. The purpose usually falls within three categories: treatment, payment, and healthcare operations.
5. An expiration date of the purpose of the disclosure. The expiration date helps to ensure that the PHI is not used once the purpose is no longer valid. 
6. Signature of the individual and the date of authorization to ensure the authorising party understands the terms and conditions of the disclosure. 

What must be added to a HIPAA authorization form?

A HIPAA authorization form must have the following statements: 

• Right of the individual to revoke the authorization or the exception to the right to revoke in written format. 
• The ability or inability to allow PHI disclosure for treatment, payment, or authorization. It should state if the covered entity is prohibited from conditioning treatment, payment, enrollment, or eligibility for benefits on the individual’s authorization. Similarly, if the covered entity is allowed to condition treatment, enrollment, or eligibility on obtaining the authorization, the consequences of refusing to sign must be clearly explained to the individual. 
• The authorization form must be written in plain and simple language to ensure no confusion. 
• The covered entity must share a copy of the signed authorization form with the individual. 

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Download the HIPAA authorization form

If you need a ready to use HIPAA consent form, the link below to download in the PDF format. 

Everything you need to get HIPAA compliant

A HIPAA authorization form for employers might protect the company but it’s not the best way to build a lasting, compliance-focused culture. Real compliance comes from educating employees on HIPAA regulations and why they matter. By investing in training, you empower every team member to practice compliance and contribute to a culture of security.

With Sprinto’s integrated training module, running HIPAA compliance programs is straightforward. You can host training sessions online, giving you a proactive stance on security while tracking your compliance status across your healthcare business in one central dashboard.

Sprinto’s dashboard keeps you in the loop on your security and compliance posture in real-time. If a new vulnerability appears or control isn’t working as expected, it immediately notifies the right people so they can address issues quickly. This real-time visibility makes it easy to spot gaps, apply patches, and keep your security strong.

Want a smoother path to HIPAA compliance? Talk to our experts today—Sprinto takes care of the heavy lifting, so you don’t have to!

FAQs

Is HIPAA authorization a legal document?

HIPAA authorization is a legitimate legal document. For a covered entity or business partner to use or disclose a patient’s protected health information for a reason that the HIPAA Privacy Rule does not otherwise permit, the patient must give written consent.

What is the difference between HIPAA authorization and informed consent?

In healthcare, informed consent and HIPAA authorization are two different ideas. Using or disclosing protected health information (PHI) for a reason that the HIPAA Privacy Regulation does not otherwise permit requires HIPAA authorization.

In contrast, informed consent is the procedure used to secure a patient’s willing consent to undergo a medical surgery or treatment after fully disclosing the risks, advantages, and available options.

How long is a HIPAA authorization valid?

A HIPAA authorization is effective until the expiration date or the time frame specified in the document has passed. The authorization may be in effect for an agreed-upon amount of time, such as six months or a year, or it may be in effect indefinitely. The authorization is valid until it is revoked by the owner or until its intended use has been achieved if no expiration date is stated.