I 

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. 

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 ‘‘Overdose Prevention 

5 and Patient Safety Act’’. 

6 SEC. 2. CONFIDENTIALITY AND DISCLOSURE OF RECORDS 

7 RELATING TO SUBSTANCE USE DISORDER. 

8 (a) CONFORMING CHANGES RELATING TO SUB9 STANCE USE DISORDER.—Subsections (a) and (h) of secVerDate Sep 11 2014 23:25 May 30, 2018 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5795.IH H5795

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1 tion 543 of the Public Health Service Act (42 U.S.C. 

2 290dd–2) are each amended by striking ‘‘substance 

3 abuse’’ and inserting ‘‘substance use disorder’’. 

4 (b) DISCLOSURES TO COVERED ENTITIES CON5 SISTENT WITH HIPAA.—Paragraph (2) of section 543(b) 

6 of the Public Health Service Act (42 U.S.C. 290dd–2(b)) 

7 is amended by adding at the end the following: 

8 ‘‘(D) To a covered entity or to a program 

9 or activity described in subsection (a), for the 

10 purposes of treatment, payment, and health 

11 care operations, so long as such disclosure is 

12 made in accordance with HIPAA privacy regu13 lation. Any redisclosure of information so dis14 closed may only be made in accordance with 

15 this section.’’. 

16 (c) DISCLOSURES OF DE-IDENTIFIED HEALTH IN17 FORMATION TO PUBLIC HEALTH AUTHORITIES.—Para18 graph (2) of section 543(b) of the Public Health Service 

19 Act (42 U.S.C. 290dd–2(b)), as amended by subsection 

20 (b), is further amended by adding at the end the following: 

21 ‘‘(E) To a public health authority, so long 

22 as such content does not include any individ23 ually identifiable health information and meets 

24 the standards established in section 164.514 of 

25 title 45, Code of Federal Regulations (or sucVerDate Sep 11 2014 23:25 May 30, 2018 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5795.IH H5795

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1 cessor regulations) for creating de-identified in2 formation.’’. 

3 (d) DEFINITIONS.—Subsection (b) of section 543 of 

4 the Public Health Service Act (42 U.S.C. 290dd–2) is 

5 amended by adding at the end the following: 

6 ‘‘(3) DEFINITIONS.—For purposes of this sub7 section: 

8 ‘‘(A) COVERED ENTITY.—The term ‘cov9 ered entity’ has the meaning given such term 

10 for purposes of HIPAA privacy regulation. 

11 ‘‘(B) HEALTH CARE OPERATIONS.—The 

12 term ‘health care operations’ has the meaning 

13 given such term for purposes of HIPAA privacy 

14 regulation. 

15 ‘‘(C) HIPAA PRIVACY REGULATION.—The 

16 term ‘HIPAA privacy regulation’ has the mean17 ing given such term under section 1180(b)(3) of 

18 the Social Security Act. 

19 ‘‘(D) INDIVIDUALLY IDENTIFIABLE

20 HEALTH INFORMATION.—The term ‘individually 

21 identifiable health information’ has the meaning 

22 given such term for purposes of HIPAA privacy 

23 regulation. 


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1 ‘‘(E) PAYMENT.—The term ‘payment’ has 

2 the meaning given such term for purposes of 

3 HIPAA privacy regulation. 

4 ‘‘(F) PUBLIC HEALTH AUTHORITY.—The 

5 term ‘public health authority’ has the meaning 

6 given such term for purposes of HIPAA privacy 

7 regulation. 

8 ‘‘(G) TREATMENT.—The term ‘treatment’ 

9 has the meaning given such term for purposes 

10 of HIPAA privacy regulation.’’. 

11 (e) USE OF RECORDS IN CRIMINAL, CIVIL, OR AD12 MINISTRATIVE INVESTIGATIONS, ACTIONS, OR PRO13 CEEDINGS.—Subsection (c) of section 543 of the Public 

14 Health Service Act (42 U.S.C. 290dd–2) is amended to 

15 read as follows: 

16 ‘‘(c) USE OF RECORDS IN CRIMINAL, CIVIL, OR AD17 MINISTRATIVE CONTEXTS.—Except as otherwise author18 ized by a court order under subsection (b)(2)(C) or by the 

19 consent of the patient, a record referred to in subsection 

20 (a) may not— 

21 ‘‘(1) be entered into evidence in any criminal 

22 prosecution or civil action before a Federal or State 

23 court; 


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1 ‘‘(2) form part of the record for decision or oth2 erwise be taken into account in any proceeding be3 fore a Federal agency; 

4 ‘‘(3) be used by any Federal, State, or local 

5 agency for a law enforcement purpose or to conduct 

6 any law enforcement investigation of a patient; or 

7 ‘‘(4) be used in any application for a warrant.’’. 

8 (f) PENALTIES.—Subsection (f) of section 543 of the 

9 Public Health Service Act (42 U.S.C. 290dd–2) is amend10 ed to read as follows: 

11 ‘‘(f) PENALTIES.—The provisions of section 1176 of 

12 the Social Security Act shall apply to a violation of this 

13 section to the extent and in the same manner as such pro14 visions apply to a violation of part C of title XI of such 

15 Act. In applying the previous sentence— 

16 ‘‘(1) the reference to ‘this subsection’ in sub17 section (a)(2) of such section 1176 shall be treated 

18 as a reference to ‘this subsection (including as ap19 plied pursuant to section 543(f) of the Public Health 

20 Service Act)’; and 

21 ‘‘(2) in subsection (b) of such section 1176— 

22 ‘‘(A) each reference to ‘a penalty imposed 

23 under subsection (a)’ shall be treated as a ref24 erence to ‘a penalty imposed under subsection 


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1 (a) (including as applied pursuant to section 

2 543(f) of the Public Health Service Act)’; and 

3 ‘‘(B) each reference to ‘no damages ob4 tained under subsection (d)’ shall be treated as 

5 a reference to ‘no damages obtained under sub6 section (d) (including as applied pursuant to 

7 section 543(f) of the Public Health Service 

8 Act)’.’’. 

9 (g) ANTIDISCRIMINATION.—Section 543 of the Public 

10 Health Service Act (42 U.S.C. 290dd–2) is amended by 

11 adding at the end the following: 

12 ‘‘(i) ANTIDISCRIMINATION.— 

13 ‘‘(1) IN GENERAL.—No entity shall discrimi14 nate against an individual on the basis of informa15 tion received by such entity pursuant to a disclosure 

16 made under subsection (b) in— 

17 ‘‘(A) admission or treatment for health 

18 care; 

19 ‘‘(B) hiring or terms of employment; 

20 ‘‘(C) the sale or rental of housing; or 

21 ‘‘(D) access to Federal, State, or local 

22 courts. 

23 ‘‘(2) RECIPIENTS OF FEDERAL FUNDS.—No re24 cipient of Federal funds shall discriminate against 

25 an individual on the basis of information received by 


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1 such recipient pursuant to a disclosure made under 

2 subsection (b) in affording access to the services 

3 provided with such funds.’’. 

4 (h) NOTIFICATION IN CASE OF BREACH.—Section 

5 543 of the Public Health Service Act (42 U.S.C. 290dd– 

6 2), as amended by subsection (g), is further amended by 

7 adding at the end the following: 

8 ‘‘(j) NOTIFICATION IN CASE OF BREACH.— 

9 ‘‘(1) APPLICATION OF HITECH NOTIFICATION

10 OF BREACH PROVISIONS.—The provisions of section 

11 13402 of the HITECH Act (42 U.S.C. 17932) shall 

12 apply to a program or activity described in sub13 section (a), in case of a breach of records described 

14 in subsection (a), to the same extent and in the 

15 same manner as such provisions apply to a covered 

16 entity in the case of a breach of unsecured protected 

17 health information. 

18 ‘‘(2) DEFINITIONS.—In this subsection, the 

19 terms ‘covered entity’ and ‘unsecured protected 

20 health information’ have the meanings given to such 

21 terms for purposes of such section 13402.’’. 

22 (i) SENSE OF CONGRESS.—It is the sense of the Con23 gress that any person treating a patient through a pro24 gram or activity with respect to which the confidentiality 

25 requirements of section 543 of the Public Health Service 


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1 Act (42 U.S.C. 290dd–2) apply should access the applica2 ble State-based prescription drug monitoring program as 

3 a precaution against substance use disorder. 

4 (j) REGULATIONS.—The Secretary of Health and 

5 Human Services, in consultation with appropriate Federal 

6 agencies, shall make such revisions to regulations as may 

7 be necessary for implementing and enforcing the amend8 ments made by this section, such that such amendments 

9 shall apply with respect to uses and disclosures of informa10 tion occurring on or after the date that is 12 months after 

11 the date of enactment of this Act. 

12 (k) DEVELOPMENT AND DISSEMINATION OF MODEL

13 TRAINING PROGRAMS FOR SUBSTANCE USE DISORDER

14 PATIENT RECORDS.— 

15 (1) INITIAL PROGRAMS AND MATERIALS.—Not 

16 later than 1 year after the date of the enactment of 

17 this Act, the Secretary of Health and Human Serv18 ices (referred to in this subsection as the ‘‘Sec19 retary’’), in consultation with appropriate experts, 

20 shall identify the following model programs and ma21 terials (or if no such programs or materials exist, 

22 recognize private or public entities to develop and 

23 disseminate such programs and materials): 

24 (A) Model programs and materials for 

25 training health care providers (including physiVerDate Sep 11 2014 23:25 May 30, 2018 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5795.IH H5795

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1 cians, emergency medical personnel, psychia2 trists, psychologists, counselors, therapists, 

3 nurse practitioners, physician assistants, behav4 ioral health facilities and clinics, care managers, 

5 and hospitals, including individuals such as gen6 eral counsels or regulatory compliance staff who 

7 are responsible for establishing provider privacy 

8 policies) concerning the permitted uses and dis9 closures, consistent with the standards and reg10 ulations governing the privacy and security of 

11 substance use disorder patient records promul12 gated by the Secretary under section 543 of the 

13 Public Health Service Act (42 U.S.C. 290dd– 

14 2), as amended by this section, for the con15 fidentiality of patient records. 

16 (B) Model programs and materials for 

17 training patients and their families regarding 

18 their rights to protect and obtain information 

19 under the standards and regulations described 

20 in subparagraph (A). 

21 (2) REQUIREMENTS.—The model programs and 

22 materials described in subparagraphs (A) and (B) of 

23 paragraph (1) shall address circumstances under 

24 which disclosure of substance use disorder patient 

25 records is needed to— 


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1 (A) facilitate communication between sub2 stance use disorder treatment providers and 

3 other health care providers to promote and pro4 vide the best possible integrated care; 

5 (B) avoid inappropriate prescribing that 

6 can lead to dangerous drug interactions, over7 dose, or relapse; and 

8 (C) notify and involve families and care9 givers when individuals experience an overdose. 

10 (3) PERIODIC UPDATES.—The Secretary 

11 shall— 

12 (A) periodically review and update the 

13 model programs and materials identified or de14 veloped under paragraph (1); and 

15 (B) disseminate such updated programs 

16 and materials to the individuals described in 

17 paragraph (1)(A). 

18 (4) INPUT OF CERTAIN ENTITIES.—In identi19 fying, reviewing, or updating the model programs 

20 and materials under this subsection, the Secretary 

21 shall solicit the input of relevant stakeholders. 

Æ 


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