§ 5100.34. Consensual release to third parties.

 (a)  Access to records, as defined in §  5100.33(b) (relating to patient’s access to records and control over release of records) will be granted to persons other than the patient upon written consent of the client/patient. With the consent, copies of excerpts or a summary of a record may be provided to specific persons at the discretion of the director. If copies of excerpts or summaries are provided, a charge may be made against the patient or person receiving the record for the cost of making the copies. The facility may require payment for the copies in advance.

 (b)  When a patient designates a third party as either a payor or copayor for mental health services, this designation carries with it his consent to release information to representatives of that payor which is necessary to establish reimbursement eligibility. Unless otherwise consented to by the patient, information released to the third-party payors shall be limited to that necessary to establish the claims for which reimbursement is sought.

 (c)  Clients, patients, or other persons consenting to release of records are to be informed of their right, subject to §  5100.33 to inspect material to be released.

 (d)  When records are released or disclosed under §  5100.32 (relating to nonconsenual release of information) or subsections (a) and (b) the written or oral disclosure shall be accompanied by a written statement which reads as follows:

 ‘‘This information has been disclosed to you from records whose confidentiality is protected by State statute. State regulations limit your right to make any further disclosure of this information without prior written consent of the person to whom it pertains.’’

 (e)  The limitation in subsection (d) does not prohibit the re-release of information in accordance with §  5100.32.

 (f)  Each facility shall prepare a form for use in the voluntary release of records which shall meet the following requirements:

   (1)  A time limit on its validity which shows starting and ending dates.

   (2)  Identification of the agency or person to whom the records are to be released.

   (3)  A statement of the specific purposes for which the released records are to be used.

   (4)  A statement identifying the specific relevant and timely information to be released.

   (5)  A place for the signature of the client/patient or parent or guardian and the date, following a statement that the person understands the nature of his release.

   (6)  A place for the signature of a staff person obtaining the consent of the client/patient or parent or guardian and the date.

   (7)  A place to record a verbal consent to release of information given by a person physically unable to provide a signature and a place for the signatures of two responsible persons who witnessed that the person understood the nature of the release and freely gave his verbal consent.

   (8)  Indication that the consent is revocable at the written request of the person giving consent, or oral request as in paragraph (7).

 (g)  A mental health facility receiving a request for information from a governmental agency may accept that agency’s release of information form if signed by the patient/client or the person legally responsible for the control of information unless the patient has specifically expressed opposition to that agency receiving information.

Cross References

   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 §  5100.32 (relating to nonconsensual release of information); 55 Pa. Code §  5200.41 (relating to records); 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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