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-pary 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.”