Regulation detail

Pa. Code 5100.32

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Pa. Code 5100.32 active

Nonconsensual release of information

Jurisdiction: PA Agency: Pennsylvania Department of Human Services (OMHSAS) and Department of Drug and Alcohol Programs (DDAP)
CMHC (60%) OUTPATIENT (60%) PSYCH_FACILITY (60%)
Plain-English summary

This regulation establishes the conditions under which patient treatment records may be released without consent in Pennsylvania's mental health system. It enumerates specific permissible disclosures—such as to treating providers for continuity of care, third-party payors for billing verification, licensure reviewers, courts, and in medical emergencies—while requiring that released information be limited to what is relevant and necessary. Facilities must notify current patients (or parents of patients under 14) of the circumstances under which nonconsensual disclosure may occur, and must document all information requests and actions taken in the patient's record.

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Regulation text
55 Pa. Code § 5100.32 - Nonconsensual release of information 

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(a)
 Records concerning persons receiving or
 having received treatment shall be kept confidential and shall not be released
 nor their content disclosed without the consent of a person given under §
 
5100.34
 (relating to consensual
 release to third parties), except that relevant portions or summaries may be
 released or copied as follows:
(1)
 To those
 actively engaged in treating the individual, or to persons at other facilities,
 including professional treatment staff of State Correctional Institutions and
 county prisons, when the person is being referred to that facility and a
 summary or portion of the record is necessary to provide for continuity of
 proper care and treatment.

(2)
 To
 third party payors, both those operated and financed in whole or in part by any
 governmental agency and their agents or intermediaries, or those who are
 identified as payor or copayor for services and who require information to
 verify that services were actually provided. Information to be released without
 consent or court order under this subsection is limited to the staff names, the
 dates, types and costs of therapies or services, and a short description of the
 general purpose of each treatment session or service.

(3)
 To reviewers and inspectors, including
 the Joint Commission on the Accreditation of Hospitals (JCAH) and Commonwealth
 licensure or certification, when necessary to obtain certification as an
 eligible provider of services.

(4)

 To those participating in PSRO or Utilization Reviews.

(5)
 To the administrator, under his duties
 under applicable statutes and regulations.

(6)
 To a court or mental health review
 officer, in the course of legal proceedings authorized by the act or this
 chapter.

(7)
 In response to a court
 order, when production of the documents is ordered by a court under §
 
5100.35
(b) 

 (relating to release to courts).

(8)
 To appropriate Departmental personnel §
 
5100.38
 (relating to child or
 patient abuse).

(9)
 In response to
 an emergency medical situation when release of information is necessary to
 prevent serious risk of bodily harm or death. Only specific information
 pertinent to the relief of the emergency may be released on a nonconsensual
 basis.

(10)
 To parents or guardians
 and others when necessary to obtain consent to medical treatment.

(11)
 To attorneys assigned to represent the
 subject of a commitment hearing.

(b)
 Current patients or clients or the
 parents of patients under the age of 14 shall be notified of the specific
 conditions under which information may be released without their
 consent.

(c)
 Information made
 available under this section shall be limited to that information relevant and
 necessary to the purpose for which the information is sought. The information
 may not, without the patient's consent, be released to additional persons or
 entities, or used for additional purposes. Requests for information and the
 action taken should be recorded in the patient's records.

Notes

55

 Pa. Code §
 
5100.32

This section cited in 55 Pa. Code §
 
3800.20
 (relating to
 confidentiality of records); 55 Pa. Code §
 
5100.4
 (relating to scope); 55 Pa.
 Code §
 
5100.31
 (relating to scope and
 policy); 55 Pa. Code §
 
5100.34
 (relating to consensual
 release to third parties); 55 Pa. Code §
 
5100.90a
 (relating to State mental
 hospital admission of involuntarily committed individuals-statement of policy);
 55 Pa. Code §
 
5200.47
 (relating to other
 applicable regulations); 55 Pa. Code §
 
5210.26
 (relating to records); 55
 Pa. Code §
 
5210.56
 (relating to other
 applicable regulations); 55 Pa. Code §
 
5221.52
 (relating to notice of
 confidentiality and nondiscrimination); 55 Pa. Code §
 
5230.17
 (relating to
 confidentiality); and 55 Pa. Code §
 
5320.26
 (relating to
 confidentiality).

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