Confidentiality

Federal and Pennsylvania laws protect the confidentiality of substance use disorder patient records and establish requirements for how that information may be used and disclosed.

The federal Confidentiality of Substance Use Disorder Patient Records regulations (42 CFR Part 2) protect the privacy of patient records maintained by covered substance use disorder programs.

The regulations establish requirements for the use and disclosure of patient information, including when patient consent is required.

The Pennsylvania Drug and Alcohol Abuse and Control Act, also known as Act 1972-63, governs the confidentiality of client records prepared or obtained under the Act. It applies to records of substance use disorder treatment prepared or obtained by substance use disorder or medical providers.

In 2022, the law was amended through Act 33 of 2022. Act 33 aligned Pennsylvania's substance use disorder confidentiality requirements with federal law. It also prohibits the Pennsylvania Department of Drug and Alcohol Programs from issuing or enforcing regulations that restrict disclosures permitted by federal law.

28 Pa. Code § 709.28 establishes confidentiality standards for treatment activities licensed by the Pennsylvania Department of Drug and Alcohol Programs.

The following licensing alerts provide guidance on how the department applies confidentiality requirements under Act 33 and related federal regulations:

• Information Bulletin 02-2022: Act 33 of 2022 – Confidentiality of Substance Use Disorder Records — Explains changes under Act 33, including federal and state confidentiality requirements and the department's enforcement approach.
• Licensing Alert 2022-03: Act 33 of 2022 – Confidentiality of Substance Use Disorder Requirements — Explains how the department measures and enforces compliance with confidentiality-related licensing requirements under Act 33.
• Licensing Alert 2024-04: Identification of Recipients of Information in Consent to Release Information Forms — Provides guidance on identifying recipients of confidential information on consent forms for treatment, payment and health care operations.

The Pennsylvania Department of Drug and Alcohol Programs offers training to help professionals understand confidentiality requirements for substance use disorder patient records.

The Confidentiality Webinar Series, developed for the substance use disorder field, addresses Act 33, common regulatory citations, and frequently asked questions. 

This two-part series is a supplement to the Substance Use Disorder Confidentiality Training available from DDAP's Training Management System.