II 

115TH CONGRESS 

1ST SESSION S. 1850 

To amend the Public Health Service Act to protect the confidentiality of 

substance use disorder patient records. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2017 

Mr. MANCHIN (for himself, Mrs. CAPITO, Mrs. FEINSTEIN, Mr. KING, Ms. 

HARRIS, and Ms. KLOBUCHAR) introduced the following bill; which was 

read twice and referred to the Committee on Health, Education, Labor, 

and Pensions 

A BILL 

To amend the Public Health Service Act to protect the 

confidentiality of substance use disorder patient records. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protecting Jessica 

5 Grubb’s Legacy Act’’. 

6 SEC. 2. CONFIDENTIALITY OF SUBSTANCE USE DISORDER 

7 PATIENT RECORDS. 

8 Section 543 of the Public Health Service Act (42 

9 U.S.C. 290dd–2) is amended— 


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1 (1) in the section heading, by inserting ‘‘SUB2 STANCE USE DISORDER PATIENT’’ before 

3 ‘‘RECORDS’’; 

4 (2) by redesignating subsections (a) through (h) 

5 as subsection (b) through (i), respectively; 

6 (3) by inserting before subsection (b), as so re7 designated, the following: 

8 ‘‘(a) PURPOSE.—It is the purpose of this section to 

9 protect the confidentiality of substance use disorder pa10 tient records. Except as provided in subsection (f), such 

11 records shall be confidential and may be disclosed only for 

12 the purposes and under the circumstances expressly au13 thorized under subsection (c), consistent with the allow14 able uses and disclosures to carry out treatment, payment, 

15 or health care operations as defined in regulations promul16 gated under section 264(c) of the Health Insurance Port17 ability and Accountability Act of 1996.’’; 

18 (4) in subsection (b), as so redesignated— 

19 (A) in the subsection heading, by striking 

20 ‘‘REQUIREMENT’’ and inserting ‘‘DEFINITION’’; 

21 (B) by striking ‘‘Records’’ and inserting 

22 ‘‘For purposes of this section, the term ‘sub23 stance use disorder patient record’ means any 

24 record’’; 


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1 (C) by striking ‘‘which are’’ and inserting 

2 ‘‘that is’’; and 

3 (D) by striking ‘‘shall, except’’ and all that 

4 follows through ‘‘subsection (b)’’; 

5 (5) in subsection (c), as so redesignated— 

6 (A) in the subsection heading, by inserting 

7 ‘‘OF SUBSTANCE USE DISORDER PATIENT

8 RECORDS ’’ after ‘‘DISCLOSURE’’; 

9 (B) in paragraph (1)— 

10 (i) by striking ‘‘The content’’ and in11 serting ‘‘Except as described in paragraph 

12 (2), the content’’; 

13 (ii) by striking ‘‘record referred to in 

14 subsection (a)’’ and inserting ‘‘substance 

15 use disorder patient record’’; and 

16 (iii) by striking ‘‘subsection (g)’’ and 

17 inserting ‘‘subsection (h)’’; and 

18 (C) by amending paragraph (2) to read as 

19 follows: 

20 ‘‘(2) PERMITTED DISCLOSURE.—Whether or 

21 not the patient with respect to whom any substance 

22 use disorder patient record referred is maintained 

23 gives written consent, the content of such record 

24 may be used or disclosed as follows: 


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1 ‘‘(A) In connection with the provision of 

2 medical services or health care to substance use 

3 disorder patients consistent with the allowable 

4 uses and disclosures to carry out treatment, 

5 payment, or health care operations as described 

6 in section 164.506 of title 45, Code of Federal 

7 Regulations, or any successor regulation. 

8 ‘‘(B) To qualified personnel for the pur9 pose of conducting scientific research, manage10 ment audits, financial audits, or program eval11 uation, but such personnel may not identify, di12 rectly or indirectly, any individual patient in 

13 any report of such research, audit, or evalua14 tion, or otherwise disclose patient identities in 

15 any manner.’’; 

16 (6) in subsection (d), as so redesignated— 

17 (A) by striking ‘‘Except as authorized’’ 

18 and all that follows through ‘‘may be used’’ and 

19 inserting the following: 

20 ‘‘(1) IN GENERAL.—Except as authorized by an 

21 appropriate order of a court of competent jurisdic22 tion granted after application showing good cause 

23 therefor, including the need to avert a substantial 

24 risk of death or serious bodily harm: 


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1 ‘‘(A) No substance use disorder patient 

2 record may be used or disclosed to a law en3 forcement official’’; and 

4 (B) by adding at the end the following: 

5 ‘‘(B) In the case of a use or disclosure of 

6 the content of a substance use disorder patient 

7 record for purposes of treatment, payment, or 

8 health care operations as provided for under 

9 subsection (c), no further disclosure or re-dis10 closure of such record is allowed to initiate or 

11 substantiate any criminal charges against a pa12 tient or to conduct any investigation of a pa13 tient. 

14 ‘‘(2) EXCLUSIONARY EFFECT AND DIS15 MISSAL.—Any content of a substance use disorder 

16 patient record that has been mistakenly, wrongfully, 

17 or intentionally used or disclosed to initiate or sub18 stantiate any criminal charges against a patient or 

19 to conduct any investigation of a patient in violation 

20 of paragraph (1)— 

21 ‘‘(A) shall be excluded from evidence in 

22 any proposed or actual proceedings relating to 

23 such criminal charges or investigation; and 

24 ‘‘(B) absent good cause shown, shall result 

25 in the automatic dismissal of any proceedings 


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1 for which the content of the record was of2 fered.’’; 

3 (7) in subsection (h), as so redesignated— 

4 (A) by striking ‘‘subsection (h)’’ and in5 serting ‘‘subsection (i)’’; and 

6 (B) by striking ‘‘, including procedures and 

7 criteria for the issuance and scope of orders 

8 under subsection (b)(2)(C),’’; and 

9 (8) in subsection (i), as so redesignated, by 

10 striking ‘‘subsection (g)’’ and inserting ‘‘subsection 

11 (h)’’. 

Æ 


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