42 USC 290dd-2: Drug treatment

            
 
          Sec. 290dd-2. Confidentiality of records
(a) Requirement

    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 substance abuse education, prevention, 
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) Permitted disclosure

                             (1) Consent

        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) Method for disclosure

        Whether or not the patient, with respect to whom any given 
    record referred to in subsection (a) of this section is maintained, 
    gives 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, including the need to avert a substantial risk 
        of death or serious bodily harm. 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) Use of records in criminal proceedings

    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) Application

    The prohibitions of this section continue to apply to records 
concerning any individual who has been a patient, irrespective of 
whether or when such individual ceases to be a patient.

(e) Nonapplicability

    The prohibitions of this section do not apply to any interchange of 
records--
        (1) within the Uniformed Services or within those components of 
    the Department of Veterans Affairs furnishing health care to 
    veterans; or
        (2) between such components and the Uniformed Services.

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) Penalties

    Any person who violates any provision of this section or any 
regulation issued pursuant to this section shall be fined in accordance 
with title 18.

(g) Regulations

    Except as provided in subsection (h) of this section, the Secretary 
shall prescribe regulations to carry out the purposes of this section. 
Such 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.

(h) Application to Department of Veterans Affairs

    The Secretary of Veterans Affairs, acting through the Under 
Secretary for Health, shall,
to the maximum feasible extent consistent with their responsibilities 
under title 38, prescribe regulations making applicable the regulations 
prescribed by the Secretary of Health and Human Services under 
subsection (g) of this section to records maintained in connection with 
the provision of hospital care, nursing home care, domiciliary care, and 
medical services under such title 38 to veterans suffering from 
substance abuse. In prescribing and implementing regulations pursuant to 
this subsection, the Secretary of Veterans Affairs shall, from time to 
time, consult with the Secretary of Health and Human Services in order 
to achieve the maximum possible coordination of the regulations, and the 
implementation thereof, which they each prescribe.

(July 1, 1944, ch. 373, title V, Sec. 543, formerly Pub. L. 91-616, 
title III, Sec. 321, Dec. 31, 1970, 84 Stat. 1852, as amended Pub. L. 
93-282, title I, Sec. 121(a), May 14, 1974, 88 Stat. 130; Pub. L. 94-
371, Sec. 11(a), (b), July 26, 1976, 90 Stat. 1041; Pub. L. 94-581, 
title I, Sec. 111(c)(1), Oct. 21, 1976, 90 Stat. 2852; renumbered 
Sec. 522 of act July 1, 1944, and amended Pub. L. 98-24, Sec. 2(b)(13), 
Apr. 26, 1983, 97 Stat. 181; renumbered Sec. 543, Pub. L. 100-77, title 
VI, Sec. 611(2), July 22, 1987, 101 Stat. 516; Pub. L. 102-321, title I, 
Sec. 131, July 10, 1992, 106 Stat. 368; Pub. L. 102-405, title III, 
Sec. 302(e)(1), Oct. 9, 1992, 106 Stat. 1985; Pub. L. 105-392, title IV, 
Sec. 402(c), Nov. 13, 1998, 112 Stat. 3588.)

                          Codification

    Section was formerly classified to section 4581 of this title prior 
to renumbering by Pub. L. 98-24.
                               Amendments

    1998--Subsec. (e)(1), (2). Pub. L. 105-392 substituted ``Uniformed 
Services'' for ``Armed Forces''.
    1992--Pub. L. 102-405 substituted ``Under Secretary for Health'' for 
``Chief Medical Director'' in subsec. (h).
    Pub. L. 102-321 amended section generally, substituting provisions 
relating to confidentiality of records for provisions relating to 
admission of alcohol abusers and alcoholics to general hospitals and 
outpatient facilities.
    1983--Pub. L. 98-24, Sec. 2(b)(13), renumbered section 4581 of this 
title as this section.
    Subsec. (a). Pub. L. 98-24, Sec. 2(b)(13)(C), made a technical 
amendment to reference to section 300s-3 of this title.
    1976--Subsec. (a). Pub. L. 94-371, Sec. 11(a), inserted ``, or 
outpatient facility (as defined in section 300s-3(6) of this title)'' 
after ``hospital''.
    Subsec. (b)(1). Pub. L. 94-371, Sec. 11(b), inserted ``and 
outpatient facilities'' after ``hospitals'', and ``or outpatient 
facility'' after ``hospital'' wherever appearing, and substituted 
``shall issue regulations not later than December 31, 1976'' for ``is 
authorized to make regulations''.
    Subsec. (b)(2). Pub. L. 94-581 provided that subsec. (b)(2), which 
directed the Administrator of Veteran's Affairs, through the Chief 
Medical Director, to prescribe regulations making applicable the 
regulations prescribed by the Secretary under subsec. (b)(1) to the 
provision of hospital care, nursing home care, domiciliary care, and 
medical services under title 38 to veterans suffering from alcohol abuse 
or alcoholism and to consult with the Secretary in order to achieve the 
maximum possible coordination of the regulations, and the implementation 
thereof, which they each prescribed, was superseded by section 4131 [now 
7331] et seq. of Title 38, Veterans' Benefits.
    1974--Subsec. (a). Pub. L. 93-282, in revising text, prohibited 
discrimination because of alcohol abuse, substituted provisions 
respecting eligibility for admission and treatment based on suffering 
from medical conditions for former provision based on medical need and 
ineligibility, because of discrimination, for support in any form from 
any program supported in whole or in part by funds appropriated to any 
Federal department or agency for former requirement for treatment by a 
general hospital which received Federal funds, and deleted prohibition 
against receiving Federal financial assistance for violation of section 
and for termination of Federal assistance on failure to comply, now 
incorporated in regulation authorization of subsec. (b) of this section.
    Subsec. (b). Pub. L. 93-282 substituted provisions respecting 
issuance of regulations by the Secretary concerning enforcement 
procedures and suspension or revocation of Federal support and by the 
Administrator concerning applicable regulations for veterans, and for 
coordination of the respective regulations for former provisions 
respecting judicial review.
                    Effective Date of 1992 Amendment

    Amendment by Pub. L. 102-321 effective Oct. 1, 1992, with provision 
for programs providing financial assistance, see section 801(c), (d) of 
Pub. L. 102-321, set out as a note under section 236 of this title.
                    Effective Date of 1976 Amendment

    Amendment by Pub. L. 94-581 effective Oct. 21, 1976, see section 211 
of Pub. L. 94-581, set out as a note under section 111 of Title 38, 
Veterans' Benefits.
     Report of Administrator of Veterans' Affairs to Congressional 
               Committees; Publication in Federal Register

    Section 121(b) of Pub. L. 93-282, which directed Administrator of 
Veterans' Affairs to submit to appropriate committees of House of 
Representatives and Senate a full report (1) on regulations (including 
guidelines, policies, and procedures thereunder) he had prescribed 
pursuant to section 321(b)(2) of Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 [former 
subsec. (b)(2) of this section], (2) explaining bases for any 
inconsistency between such regulations and regulations of Secretary 
under section 321(b)(1) of such Act [subsec. (b)(1) of this section], 
(3) on extent, substance, and results of his consultations with 
Secretary respecting prescribing and implementation of Administrator's 
regulations, and (4) containing such recommendations for legislation and 
administrative actions as he determined were necessary and desirable, 
with Administrator to submit report not later than sixty days after 
effective date of regulations prescribed by Secretary under such section 
321(b)(1) [subsec. (b)(1) of this section], and to publish such report 
in Federal Register, was characterized by section 111(c)(5) of Pub. L. 
94-581 as having been superseded by section 4134 [now 7334] of Title 38, 
Veterans' Benefits.