Language used in new CE panelist acknowledgement can take the following form:
“I acknowledge and understand that the Social Security Act and its implementing
Regulation No.1 (42 U.S.C. 1306; 20 C.F.R. 401)
prohibit the unauthorized disclosure of information obtained in the administration
of Social
Security programs and make such disclosure a crime. These prohibitions extend to any
background data
furnished to the provider in conjunction with the performance of the services contracted
for herein,
and to any reports generated as a result of providing such services, including any
copies of such
reports retained by the provider. Unauthorized disclosure of such records by the provider
is
prohibited. I further acknowledge and understand that should referral of any individual,
or data
pertaining to an individual, to any third party provider, (for additional diagnostic
studies,
clerical or transcription services, messenger services, etc.) become necessary in
providing services
contracted for herein, such
third-party
provider must be made aware that services are being performed in connection with a
Social Security
program, and that improper disclosure of information about the subject individual
is
prohibited.”