,,ii  #aafth ,,congress  #ast ,session  
,s4 #ajab  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,april #c1     
#bjai,mr4 ,manchin 7for himself1 ,mrs4  
,capito1 ,mr4 ,whitehouse1 ,ms4 ,harris1
 ,ms4 ,klobuchar1 ,mrs4 ,feinstein1 ,mr4
 ,king1 ,mr4 ,tillis1 ,ms4 ,collins1    
,mr4 ,cassidy1 and ,mr4 ,cramer7        
introduced the following bill2 which was
 read twice and referred to the         
,committee on ,health1 ,education1      
,labor1 and ,pensions  ,a ,,bill  ,to   
amend the ,public ,health ,service ,act 
to protect the confidentiality of       
substance use disorder patient records4 
#a4 ,short title ,this ,act may be cited
 as the ,protecting ,jessica ,grubb's   
,legacy ,act4  #b4 ,confidentiality and 
disclosure of records relating to       
substance use disorder  7a7 ,conforming 
changes relating to substance use       
disorder ,subsections 7a7 and 7h7 of    
section #edc of the ,public ,health     
,service ,act 7#db ,u4,s4,c4 #bij;dd-#b7
 are each amended by striking substance 

abuse and inserting substance use       
disorder4  7b7 ,disclosures to covered  
entities consistent with ,,hipaa        
,paragraph 7#b7 of section #edc7;b7 of  
the ,public ,health ,service ,act 7#db  
,u4,s4,c4 #bij;dd-#b7;b77 is amended by 
adding at the end the following3  7,d7  
,to a covered entity or to a program or 
activity described in subsection 7a71   
for the purposes of treatment1 payment1 
and health care operations1 so long as  
such disclosure is made in accordance   
with ,,hipaa privacy regulation4 ,any   
redisclosure of information so disclosed
 may only be made in accordance with    
this section4  4  7c7 ,disclosures of   
de-,identified health information to    
public health authorities ,paragraph    
7#b7 of section #edc7;b7 of the ,public 
,health ,service ,act 7#db ,u4,s4,c4    
#bij;dd-#b7;b771 as amended by          
subsection 7b71 is further amended by   
adding at the end the following3  7,e7  
,to a public health authority1 so long  
as such content meets the standards     

established in section #afd4ead7;b7 of  
title #de1 ,code of ,federal            
,regulations 7or successor regulations7 
for creating de-identified information4 
4  7d7 ,definitions ,subsection 7b7 of  
section #edc of the ,public ,health     
,service ,act 7#db ,u4,s4,c4 #bij;dd-#b7
 is amended by adding at the end the    
following3  7#c7 ,definitions ,for      
purposes of this subsection3 7,a7       
,covered entity ,the term covered entity
 has the meaning given such term for    
purposes of ,,hipaa privacy regulation4 
7,b7 ,health care operations ,the term  
health care operations has the meaning  
given such term for purposes of ,,hipaa 
privacy regulation4  7,c7 ,,hipaa       
privacy regulation ,the term ,,hipaa    
privacy regulation has the meaning given
 such term under section #aahj7;b77#c7  
of the ,social ,security ,act4  7,d7    
,individually identifiable health       
information ,the term individually      
identifiable health information has the 
meaning given such term for purposes of 

,,hipaa privacy regulation4  7,e7       
,payment ,the term payment has the      
meaning given such term for purposes of 
,,hipaa privacy regulation4  7,f7       
,public health authority ,the term      
public health authority has the meaning 
given such term for purposes of ,,hipaa 
privacy regulation4  7,g7 ,treatment    
,the term treatment has the meaning     
given such term for purposes of ,,hipaa 
privacy regulation4  4  7e7 ,use of     
records in criminal1 civil1 or          
administrative investigations1 actions1 
or proceedings ,subsection 7c7 of       
section #edc of the ,public ,health     
,service ,act 7#db ,u4,s4,c4 #bij;dd-#b7
 is amended to read as follows3  7c7    
,use of records in criminal1 civil1 or  
administrative contexts ,except as      
otherwise authorized by a court order   
under subsection 7b77#b77;,c7 or by the 
consent of the patient1 a record        
referred to in subsection 7a7 may not-- 
7#a7 be entered into evidence in any    
criminal prosecution or civil action    

before a ,federal or ,state court2  7#b7
 form part of the record for decision or
 otherwise be taken into account in any 
proceeding before a ,federal agency2    
7#c7 be used by any ,federal1 ,state1 or
 local agency for a law enforcement     
purpose or to conduct any law           
enforcement investigation of a patient2 
or  7#d7 be used in any application for 
a warrant4  4  7f7 ,penalties           
,subsection 7f7 of section #edc of the  
,public ,health ,service ,act 7#db      
,u4,s4,c4 #bij;dd-#b7 is amended to read
 as follows3  7f7 ,penalties ,the       
provisions of sections #aagf and #aagg  
of the ,social ,security ,act shall     
apply to a violation of this section to 
the extent and in the same manner as    
such provisions apply to a violation of 
part ,c of title ,,xi of such ,act4 ,in 
applying the previous sentence-- 7#a7   
the reference to this subsection in     
subsection 7a77#b7 of such section #aagf
 shall be treated as a reference to this
 subsection 7including as applied       

pursuant to section #edc7;f7 of the     
,public ,health ,service ,act72 and     
7#b7 in subsection 7b7 of such section  
#aagf-- 7,a7 each reference to a penalty
 imposed under subsection 7a7 shall be  
treated as a reference to a penalty     
imposed under subsection 7a7 7including 
as applied pursuant to section #edc7;f7 
of the ,public ,health ,service ,act72  
and  7,b7 each reference to no damages  
obtained under subsection 7d7 shall be  
treated as a reference to no damages    
obtained under subsection 7d7 7including
 as applied pursuant to section #edc7;f7
 of the ,public ,health ,service ,act74 
4  7g7 ,antidiscrimination ,section #edc
 of the ,public ,health ,service ,act   
7#db ,u4,s4,c4 #bij;dd-#b7 is amended by
 adding at the end the following3  7i7  
,antidiscrimination  7#a7 ,in general   
,no entity shall discriminate against an
 individual on the basis of information 
received by such entity pursuant to a   
disclosure made under subsection 7b7    
in-- 7,a7 admission or treatment for    

health care2  7,b7 hiring or terms of   
employment2  7,c7 the sale or rental of 
housing2 or  7,d7 access to ,federal1   
,state1 or local courts4  7#b7          
,recipients of ,federal funds ,no       
recipient of ,federal funds shall       
discriminate against an individual on   
the basis of information received by    
such recipient pursuant to a disclosure 
made under subsection 7b7 in affording  
access to the services provided with    
such funds4  4  7h7 ,notification in    
case of breach ,section #edc of the     
,public ,health ,service ,act 7#db      
,u4,s4,c4 #bij;dd-#b71 as amended by    
subsection 7g71 is further amended by   
adding at the end the following3  7j7   
,notification in case of breach  7#a7   
,application of ,,hitech notification of
 breach provisions ,the provisions of   
section #acdjb of the ,,hitech ,act 7#db
 ,u4,s4,c4 #agicb7 shall apply to a     
program or activity described in        
subsection 7a71 in case of a breach of  
records described in subsection 7a71 to 

the same extent and in the same manner  
as such provisions apply to a covered   
entity in the case of a breach of       
unsecured protected health information4 
7#b7 ,definitions ,in this subsection1  
the terms covered entity and unsecured  
protected health information have the   
meanings given to such terms for        
purposes of such section #acdjb4  4  7i7
 ,sense of ,congress ,it is the sense of
 the ,congress that any person treating 
a patient through a program or activity 
with respect to which the               
confidentiality requirements of section 
#edc of the ,public ,health ,service    
,act 7#db ,u4,s4,c4 #bij;dd-#b7 apply   
should access the applicable            
,state-based prescription drug          
monitoring program as a precaution      
against substance use disorder4  7j7    
,regulations  7#a7 ,in general ,the     
,secretary of ,health and ,human        
,services1 in consultation with         
appropriate ,federal agencies1 shall    
make such revisions to regulations as   

may be necessary for implementing and   
enforcing the amendments made by this   
section1 such that such amendments shall
 apply with respect to uses and         
disclosures of information occurring on 
or after the date that is #ab months    
after the date of enactment of this     
,act4  7#b7 ,easily understandable      
notice of privacy practices ,not later  
than #a year after the date of enactment
 of this ,act1 the ,secretary of ,health
 and ,human ,services1 in consultation  
with appropriate experts1 shall update  
section #afd4ebj of title #de1 ,code of 
,federal ,regulations1 so that covered  
entities provide notice1 written in     
plain language1 of privacy practices    
regarding patient records referred to in
 section #edc7;a7 of the ,public ,health
 ,service ,act 7#db ,u4,s4,c4           
#bij;dd-#b7;a771 including-- 7,a7 a     
statement of the patient's rights1      
including self-pay patients1 with       
respect to protected health information 
and a brief description of how the      

individual may exercise these rights 7as
 required by paragraph 7b77#a77;iv7 of  
such section #afd4ebj72 and  7,b7 a     
description of each purpose for which   
the covered entity is permitted or      
required to use or disclose protected   
health information without the patient's
 written authorization 7as required by  
paragraph 7b77#b7 of such section       
#afd4ebj74  7k7 ,development and        
dissemination of model training programs
 for substance use disorder patient     
records  7#a7 ,initial programs and     
materials ,not later than #a year after 
the date of the enactment of this ,act1 
the ,secretary of ,health and ,human    
,services 7referred to in this          
subsection as the ,secretary71 in       
consultation with appropriate experts1  
shall identify the following model      
programs and materials 7or if no such   
programs or materials exist1 recognize  
private or public entities to develop   
and disseminate such programs and       
materials73 7,a7 ,model programs and    

materials for training health care      
providers 7including physicians1        
emergency medical personnel1            
psychiatrists1 psychologists1           
counselors1 therapists1 nurse           
practitioners1 physician assistants1    
behavioral health facilities and        
clinics1 care managers1 and hospitals1  
including individuals such as general   
counsels or regulatory compliance staff 
who are responsible for establishing    
provider privacy policies7 concerning   
the permitted uses and disclosures1     
consistent with the standards and       
regulations governing the privacy and   
security of substance use disorder      
patient records promulgated by the      
,secretary under section #edc of the    
,public ,health ,service ,act 7#db      
,u4,s4,c4 #bij;dd-#b71 as amended by    
this section1 for the confidentiality of
 patient records4  7,b7 ,model programs 
and materials for training patients and 
their families regarding their rights to
 protect and obtain information under   

the standards and regulations described 
in subparagraph 7,a74  7#b7             
,requirements ,the model programs and   
materials described in subparagraphs    
7,a7 and 7,b7 of paragraph 7#a7 shall   
address circumstances under which       
disclosure of substance use disorder    
patient records is needed to-- 7,a7     
facilitate communication between        
substance use disorder treatment        
providers and other health care         
providers to promote and provide the    
best possible integrated care2  7,b7    
avoid inappropriate prescribing that can
 lead to dangerous drug interactions1   
overdose1 or relapse2 and  7,c7 notify  
and involve families and caregivers when
 individuals experience an overdose4    
7#c7 ,periodic updates ,the ,secretary  
shall-- 7,a7 periodically review and    
update the model programs and materials 
identified or developed under paragraph 
7#a72 and  7,b7 disseminate such updated
 programs and materials to the          
individuals described in paragraph      

7#a77;,a74  7#d7 ,input of certain      
entities ,in identifying1 reviewing1 or 
updating the model programs and         
materials under this subsection1 the    
,secretary shall solicit the input of   
relevant stakeholders4  7l7 ,rules of   
construction ,nothing in this ,act or   
the amendments made by this ,act shall  
be construed to limit-- 7#a7 a patient's
 right1 as described in section #afd4ebb
 of title #de1 ,code of ,federal        
,regulations1 or any successor          
regulation1 to request a restriction on 
the use or disclosure of a record       
referred to in section #edc7;a7 of the  
,public ,health ,service ,act 7#db      
,u4,s4,c4 #bij;dd-#b7;a77 for purposes  
of treatment1 payment1 or health care   
operations2 or  7#b7 a covered entity's 
choice1 as described in section #afd4ejf
 of title #de1 ,code of ,federal        
,regulations1 or any successor          
regulation1 to obtain the consent of the
 individual to use or disclose a record 
referred to in such section #edc7;a7 to 

carry out treatment1 payment1 or health 
care operation4  7m7 ,sense of ,congress
 ,it is the sense of the ,congress      
that-- 7#a7 patients have the right to  
request a restriction on the use or     
disclosure of a record referred to in   
section #edc7;a7 of the ,public ,health 
,service ,act 7#db ,u4,s4,c4            
#bij;dd-#b7;a77 for treatment1 payment1 
or health care operations2 and  7#b7    
covered entities should make every      
reasonable effort to the extent feasible
 to comply with a patient's request for 
a restriction regarding such use or     
disclosure4