Except for the permitted uses of PHI by CHS, there will be no other use of PHI without written authorization from the individual.  When CHS receives such an authorization for its use or disclosure of PHI, that use or disclosure must be consistent with the authorization.

CHS must obtain an authorization for any use or disclosure of psychotherapy notes, except:

• To carry out treatment, payment or healthcare operations; or
• Use by the originator of the psychotherapy notes for treatment; or
• Use or disclosure by CHS for its own training programs; or
• Use or disclosure by CHS to defend itself in a legal action or other proceeding brought by the individual; or
• A use or disclosure that is required or permitted with respect to the oversight of the originator of the notes.

CHS must obtain an authorization for any use or disclosure of PHI for marketing, except if the communication is in the form of:

• Face to face communication
• Promotional gift of nominal value.

If CHS expects the marketing to result in remuneration from a third party, the authorization must state such remuneration is expected.