N.J. Admin. Code § 13:42-11.3
Current through Register Vol. 57, No. 1, January 6, 2025
Section 13:42-11.3 - Stage I (Preliminary Disclosure); required authorization(a) When a licensee receives a request from a third party payor for information about psychological services rendered by the licensee, the licensee shall request a valid authorization from the client or other designated person.(b) The licensee shall secure the authorization within 14 days of receiving the request from the third party payor, unless precluded from doing so by the circumstances of the case.(c) The authorization shall be in writing and shall specify at least the following: 1. The nature of the information to be disclosed, the person authorized to disclose the information, to whom the information may be disclosed, the specific purposes for which the information may be used at the time of disclosure and at any future time;2. That the client is aware of the statutory privilege for confidential communication between a client and a licensed psychologist; and3. That the consent may be revoked in writing by the client at any time, if such notice is given to both the treating psychologist and the recipient named in the authorization.(d) The authorization shall be signed and dated by the client or the person authorizing the disclosure. If the client is adjudicated incompetent or is deceased, the authorization shall be signed by the client's legally authorized representative. When the client is more than 14 years of age but has not yet reached age 18, the authorization shall be signed by the client and by the client's parent or legal guardian. When the client is less than 14 years of age, the authorization shall be signed only by the client's parent or legal guardian.(e) The authorization shall apply only to information existing as of the date signed and is effective for one year only from the date signed.(f) The licensee shall provide a copy of the authorization to the client or the person authorizing the disclosure.N.J. Admin. Code § 13:42-11.3