[Code of Federal Regulations]

[Title 42, Volume 1]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR2.2]



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                         TITLE 42--PUBLIC HEALTH

 

    CHAPTER I--PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN 

                                SERVICES

 

PART 2_CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS--Table of 

Contents

 

                         Subpart A_Introduction

 

Sec.  2.2  Statutory authority for confidentiality of alcohol abuse patient 

records.



    The restrictions of these regulations upon the disclosure and use of 

alcohol



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abuse patient records were initially authorized by section 333 of the 

Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and 

Rehabilitation Act of 1970 (42 U.S.C. 4582). The section as amended was 

transferred by Pub. L. 98-24 to section 523 of the Public Health Service 

Act which is codified at 42 U.S.C. 290dd-3. The amended statutory 

authority is set forth below:



            Sec.  290dd-3. Confidentiality of patient records



    (a) Disclosure authorization

    Records of the identity, diagnosis, prognosis, or treatment of any 

patient which are maintained in connection with the performance of any 

program or activity relating to alcoholism or alcohol abuse education, 

training, treatment, rehabilitation, or research, which is conducted, 

regulated, or directly or indirectly assisted by any department or 

agency of the United States shall, except as provided in subsection (e) 

of this section, be confidential and be disclosed only for the purposes 

and under the circumstances expressly authorized under subsection (b) of 

this section.

    (b) Purposes and circumstances of disclosure affecting consenting 

patient and patient regardless of consent

    (1) The content of any record referred to in subsection (a) of this 

section may be disclosed in accordance with the prior written consent of 

the patient with respect to whom such record is maintained, but only to 

such extent, under such circumstances, and for such purposes as may be 

allowed under regulations prescribed pursuant to subsection (g) of this 

section.

    (2) Whether or not the patient, with respect to whom any given 

record referred to in subsection (a) of this section is maintained, 

gives his written consent, the content of such record may be disclosed 

as follows:

    (A) To medical personnel to the extent necessary to meet a bona fide 

medical emergency.

    (B) To qualified personnel for the purpose of conducting scientific 

research, management audits, financial audits, or program evaluation, 

but such personnel may not identify, directly or indirectly, any 

individual patient in any report of such research, audit, or evaluation, 

or otherwise disclose patient identities in any manner.

    (C) If authorized by an appropriate order of a court of competent 

jurisdiction granted after application showing good cause therefor. In 

assessing good cause the court shall weigh the public interest and the 

need for disclosure against the injury to the patient, to the physician-

patient relationship, and to the treatment services. Upon the granting 

of such order, the court, in determining the extent to which any 

disclosure of all or any part of any record is necessary, shall impose 

appropriate safeguards against unauthorized disclosure.

    (c) Prohibition against use of record in making criminal charges or 

investigation of patient

    Except as authorized by a court order granted under subsection 

(b)(2)(C) of this section, no record referred to in subsection (a) of 

this section may be used to initiate or substantiate any criminal 

charges against a patient or to conduct any investigation of a patient.

    (d) Continuing prohibition against disclosure irrespective of status 

as patient

    The prohibitions of this section continue to apply to records 

concerning any individual who has been a patient, irrespective of 

whether or when he ceases to be a patient.

    (e) Armed Forces and Veterans' Administration; interchange of record 

of suspected child abuse and neglect to State or local authorities

    The prohibitions of this section do not apply to any interchange of 

records--

    (1) within the Armed Forces or within those components of the 

Veterans' Administration furnishing health care to veterans, or

    (2) between such components and the Armed Forces.



The prohibitions of this section do not apply to the reporting under 

State law of incidents of suspected child abuse and neglect to the 

appropriate State or local authorities.



    (f) Penalty for first and subsequent offenses

    Any person who violates any provision of this section or any 

regulation issued pursuant to this section shall be fined not more than 

$500 in the case of a first offense, and not more than $5,000 in the 

case of each subsequent offense.

    (g) Regulations of Secretary; definitions, safeguards, and 

procedures, including procedures and criteria for issuance and scope of 

orders

    Except as provided in subsection (h) of this section, the Secretary 

shall prescribe regulations to carry out the purposes of this section. 

These regulations may contain such definitions, and may provide for such 

safeguards and procedures, including procedures and criteria for the 

issuance and scope of orders under subsection(b)(2)(C) of this section, 

as in the judgment of the Secretary are necessary or proper to 

effectuate the purposes of this section, to prevent circumvention or 

evasion thereof, or to facilitate compliance therewith.



(Subsection (h) was superseded by section 111(c)(4) of Pub. L. 94-581. 

The responsibility of the Administrator of Veterans' Affairs to write 

regulations to provide for confidentiality of alcohol abuse patient 

records under Title 38 was moved from 42 U.S.C. 4582 to 38 U.S.C. 4134.)



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