[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5795 Introduced in House (IH)]
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115th CONGRESS
2d Session
H. R. 5795
To amend the Public Health Service Act to protect the confidentiality
of substance use disorder patient records.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 15, 2018
Mr. Blumenauer (for himself, Mr. Mullin, Mr. Moulton, Mr. Barr, Mr.
Hultgren, Mr. Johnson of Ohio, and Mr. Kelly of Pennsylvania)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to protect the confidentiality
of substance use disorder patient records.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Overdose Prevention and Patient
Safety Act''.
SEC. 2. CONFIDENTIALITY AND DISCLOSURE OF RECORDS RELATING TO SUBSTANCE
USE DISORDER.
(a) Conforming Changes Relating to Substance Use Disorder.--
Subsections (a) and (h) of section 543 of the Public Health Service Act
(42 U.S.C. 290dd-2) are each amended by striking ``substance abuse''
and inserting ``substance use disorder''.
(b) Disclosures to Covered Entities Consistent With HIPAA.--
Paragraph (2) of section 543(b) of the Public Health Service Act (42
U.S.C. 290dd-2(b)) is amended by adding at the end the following:
``(D) To a covered entity or to a program or
activity described in subsection (a), for the purposes
of treatment, payment, and health care operations, so
long as such disclosure is made in accordance with
HIPAA privacy regulation. Any redisclosure of
information so disclosed may only be made in accordance
with this section.''.
(c) Disclosures of De-Identified Health Information to Public
Health Authorities.--Paragraph (2) of section 543(b) of the Public
Health Service Act (42 U.S.C. 290dd-2(b)), as amended by subsection
(b), is further amended by adding at the end the following:
``(E) To a public health authority, so long as such
content does not include any individually identifiable
health information and meets the standards established
in section 164.514 of title 45, Code of Federal
Regulations (or successor regulations) for creating de-
identified information.''.
(d) Definitions.--Subsection (b) of section 543 of the Public
Health Service Act (42 U.S.C. 290dd-2) is amended by adding at the end
the following:
``(3) Definitions.--For purposes of this subsection:
``(A) Covered entity.--The term `covered entity'
has the meaning given such term for purposes of HIPAA
privacy regulation.
``(B) Health care operations.--The term `health
care operations' has the meaning given such term for
purposes of HIPAA privacy regulation.
``(C) HIPAA privacy regulation.--The term `HIPAA
privacy regulation' has the meaning given such term
under section 1180(b)(3) of the Social Security Act.
``(D) Individually identifiable health
information.--The term `individually identifiable
health information' has the meaning given such term for
purposes of HIPAA privacy regulation.
``(E) Payment.--The term `payment' has the meaning
given such term for purposes of HIPAA privacy
regulation.
``(F) Public health authority.--The term `public
health authority' has the meaning given such term for
purposes of HIPAA privacy regulation.
``(G) Treatment.--The term `treatment' has the
meaning given such term for purposes of HIPAA privacy
regulation.''.
(e) Use of Records in Criminal, Civil, or Administrative
Investigations, Actions, or Proceedings.--Subsection (c) of section 543
of the Public Health Service Act (42 U.S.C. 290dd-2) is amended to read
as follows:
``(c) Use of Records in Criminal, Civil, or Administrative
Contexts.--Except as otherwise authorized by a court order under
subsection (b)(2)(C) or by the consent of the patient, a record
referred to in subsection (a) may not--
``(1) be entered into evidence in any criminal prosecution
or civil action before a Federal or State court;
``(2) form part of the record for decision or otherwise be
taken into account in any proceeding before a Federal agency;
``(3) be used by any Federal, State, or local agency for a
law enforcement purpose or to conduct any law enforcement
investigation of a patient; or
``(4) be used in any application for a warrant.''.
(f) Penalties.--Subsection (f) of section 543 of the Public Health
Service Act (42 U.S.C. 290dd-2) is amended to read as follows:
``(f) Penalties.--The provisions of section 1176 of the Social
Security Act shall apply to a violation of this section to the extent
and in the same manner as such provisions apply to a violation of part
C of title XI of such Act. In applying the previous sentence--
``(1) the reference to `this subsection' in subsection
(a)(2) of such section 1176 shall be treated as a reference to
`this subsection (including as applied pursuant to section
543(f) of the Public Health Service Act)'; and
``(2) in subsection (b) of such section 1176--
``(A) each reference to `a penalty imposed under
subsection (a)' shall be treated as a reference to `a
penalty imposed under subsection (a) (including as
applied pursuant to section 543(f) of the Public Health
Service Act)'; and
``(B) each reference to `no damages obtained under
subsection (d)' shall be treated as a reference to `no
damages obtained under subsection (d) (including as
applied pursuant to section 543(f) of the Public Health
Service Act)'.''.
(g) Antidiscrimination.--Section 543 of the Public Health Service
Act (42 U.S.C. 290dd-2) is amended by adding at the end the following:
``(i) Antidiscrimination.--
``(1) In general.--No entity shall discriminate against an
individual on the basis of information received by such entity
pursuant to a disclosure made under subsection (b) in--
``(A) admission or treatment for health care;
``(B) hiring or terms of employment;
``(C) the sale or rental of housing; or
``(D) access to Federal, State, or local courts.
``(2) Recipients of federal funds.--No recipient of Federal
funds shall discriminate against an individual on the basis of
information received by such recipient pursuant to a disclosure
made under subsection (b) in affording access to the services
provided with such funds.''.
(h) Notification in Case of Breach.--Section 543 of the Public
Health Service Act (42 U.S.C. 290dd-2), as amended by subsection (g),
is further amended by adding at the end the following:
``(j) Notification in Case of Breach.--
``(1) Application of hitech notification of breach
provisions.--The provisions of section 13402 of the HITECH Act
(42 U.S.C. 17932) shall apply to a program or activity
described in subsection (a), in case of a breach of records
described in subsection (a), to the same extent and in the same
manner as such provisions apply to a covered entity in the case
of a breach of unsecured protected health information.
``(2) Definitions.--In this subsection, the terms `covered
entity' and `unsecured protected health information' have the
meanings given to such terms for purposes of such section
13402.''.
(i) Sense of Congress.--It is the sense of the Congress that any
person treating a patient through a program or activity with respect to
which the confidentiality requirements of section 543 of the Public
Health Service Act (42 U.S.C. 290dd-2) apply should access the
applicable State-based prescription drug monitoring program as a
precaution against substance use disorder.
(j) Regulations.--The Secretary of Health and Human Services, in
consultation with appropriate Federal agencies, shall make such
revisions to regulations as may be necessary for implementing and
enforcing the amendments made by this section, such that such
amendments shall apply with respect to uses and disclosures of
information occurring on or after the date that is 12 months after the
date of enactment of this Act.
(k) Development and Dissemination of Model Training Programs for
Substance Use Disorder Patient Records.--
(1) Initial programs and materials.--Not later than 1 year
after the date of the enactment of this Act, the Secretary of
Health and Human Services (referred to in this subsection as
the ``Secretary''), in consultation with appropriate experts,
shall identify the following model programs and materials (or
if no such programs or materials exist, recognize private or
public entities to develop and disseminate such programs and
materials):
(A) Model programs and materials for training
health care providers (including physicians, emergency
medical personnel, psychiatrists, psychologists,
counselors, therapists, nurse practitioners, physician
assistants, behavioral health facilities and clinics,
care managers, and hospitals, including individuals
such as general counsels or regulatory compliance staff
who are responsible for establishing provider privacy
policies) concerning the permitted uses and
disclosures, consistent with the standards and
regulations governing the privacy and security of
substance use disorder patient records promulgated by
the Secretary under section 543 of the Public Health
Service Act (42 U.S.C. 290dd-2), as amended by this
section, for the confidentiality of patient records.
(B) Model programs and materials for training
patients and their families regarding their rights to
protect and obtain information under the standards and
regulations described in subparagraph (A).
(2) Requirements.--The model programs and materials
described in subparagraphs (A) and (B) of paragraph (1) shall
address circumstances under which disclosure of substance use
disorder patient records is needed to--
(A) facilitate communication between substance use
disorder treatment providers and other health care
providers to promote and provide the best possible
integrated care;
(B) avoid inappropriate prescribing that can lead
to dangerous drug interactions, overdose, or relapse;
and
(C) notify and involve families and caregivers when
individuals experience an overdose.
(3) Periodic updates.--The Secretary shall--
(A) periodically review and update the model
programs and materials identified or developed under
paragraph (1); and
(B) disseminate such updated programs and materials
to the individuals described in paragraph (1)(A).
(4) Input of certain entities.--In identifying, reviewing,
or updating the model programs and materials under this
subsection, the Secretary shall solicit the input of relevant
stakeholders.
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