This regulation specifies the limited circumstances under which a court order may authorize disclosure of confidential communications made by a patient to a Part 2 program (substance use disorder treatment program) during diagnosis, treatment, or referral. Disclosure is permitted only to protect against threats to life or serious bodily injury (including child abuse/neglect), in connection with investigation or prosecution of extremely serious crimes, or when the patient themselves introduces the communications as evidence in a legal proceeding. Facility operators must ensure that patient communications are protected except under these narrowly defined court-ordered exceptions.
View official source§ 2.63 Confidential communications. (a) A court order under the regulations in this part may authorize disclosure of confidential communications made by a patient to a part 2 program in the course of diagnosis, treatment, or referral for treatment only if: (1) The disclosure is necessary to protect against an existing threat to life or of serious bodily injury, including circumstances which constitute suspected child abuse and neglect and verbal threats against third parties; (2) The disclosure is necessary in connection with investigation or prosecution of an extremely serious crime, such as one which directly threatens loss of life or serious bodily injury, including homicide, rape, kidnapping, armed robbery, assault with a deadly weapon, or child abuse and neglect; or (3) The disclosure is in connection with a civil, criminal, administrative, or legislative proceeding in which the patient offers testimony or other evidence pertaining to the content of the confidential communications. (b) [Reserved] [82 FR 6115, Jan. 18, 2017, as amended at 85 FR 80632, Dec. 14, 2020; 89 FR 12629, Feb. 16, 2024]