{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-127.1_03.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-127.1_03.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-127.1_03.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-127.1_03.html"}],"law_id":58930,"edition_id":1,"section_id":58930,"structure_id":12729,"section_number":"32.1-127.1:03","catch_line":"Health records privacy","history":"1997, c. 682; 1998, c. 470; 1999, cc. 812, 956, 1010; 2000, cc. 810, 813, 923, 927; 2001, c. 671; 2002, cc. 568, 658, 835, 860; 2003, cc. 471, 907, 983; 2004, cc. 49, 64, 65, 66, 67, 163, 773, 1014, 1021; 2005, cc. 39, 101, 642, 697; 2006, c. 433; 2007, c. 497; 2008, cc. 315, 782, 850, 870; 2009, cc. 606, 651, 813, 840; 2010, cc. 185, 340, 406, 456, 524, 778, 825; 2011, cc. 499, 668, 798, 812, 844, 871; 2012, cc. 386, 402, 479; 2016, c. 554; 2017, cc. 457, 712, 720; 2018, c. 165; 2020, c. 945; 2022, cc. 509, 534, 784; 2025, c. 182.","full_text":"A\n\nThere is hereby recognized an individual’s right of privacy in the content of his health records. Health records are the property of the health care entity maintaining them, and, except when permitted or required by this section or by other provisions of state law, no health care entity, or other person working in a health care setting, may disclose an individual’s health records.\n\t\t\tPursuant to this subsection:1\n\nHealth care entities shall disclose health records to the individual who is the subject of the health record, including an audit trail of any additions, deletions, or revisions to the health record, if specifically requested, except as provided in subsections E and F and subsection B of § 8.01-413.2\n\nHealth records shall not be removed from the premises where they are maintained without the approval of the health care entity that maintains such health records, except in accordance with a court order or subpoena consistent with subsection C of § 8.01-413 or with this section or in accordance with the regulations relating to change of ownership of health records promulgated by a health regulatory board established in Title 54.1.3\n\nNo person to whom health records are disclosed shall redisclose or otherwise reveal the health records of an individual, beyond the purpose for which such disclosure was made, without first obtaining the individual’s specific authorization to such redisclosure. This redisclosure prohibition shall not, however, prevent (i) any health care entity that receives health records from another health care entity from making subsequent disclosures as permitted under this section and the federal Department of Health and Human Services regulations relating to privacy of the electronic transmission of data and protected health information promulgated by the United States Department of Health and Human Services as required by the Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.) or (ii) any health care entity from furnishing health records and aggregate or other data, from which individually identifying prescription information has been removed, encoded or encrypted, to qualified researchers, including, but not limited to, pharmaceutical manufacturers and their agents or contractors, for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or other health services research.4\n\nHealth care entities shall, upon the request of the individual who is the subject of the health record, disclose health records to other health care entities, in any available format of the requester’s choosing, as provided in subsection E.B\n\nAs used in this section:\n\t\t\t“Agent” means a person who has been appointed as an individual’s agent under a power of attorney for health care or an advance directive under the Health Care Decisions Act (§ 54.1-2981 et seq.).\n\t\t\t“Certification” means a written representation that is delivered by hand, by first-class mail, by overnight delivery service, or by facsimile if the sender obtains a facsimile-machine-generated confirmation reflecting that all facsimile pages were successfully transmitted.\n\t\t\t“Guardian” means a court-appointed guardian of the person.\n\t\t\t“Health care clearinghouse” means, consistent with the definition set out in 45 C.F.R. § 160.103, a public or private entity, such as a billing service, repricing company, community health management information system or community health information system, and “value-added” networks and switches, that performs either of the following functions: (i) processes or facilitates the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction; or (ii) receives a standard transaction from another entity and processes or facilitates the processing of health information into nonstandard format or nonstandard data content for the receiving entity.\n\t\t\t“Health care entity” means any health care provider, health plan or health care clearinghouse.\n\t\t\t“Health care provider” means those entities listed in the definition of “health care provider” in § 8.01-581.1, except that state-operated facilities shall also be considered health care providers for the purposes of this section. Health care provider shall also include all persons who are licensed, certified, registered or permitted or who hold a multistate licensure privilege issued by any of the health regulatory boards within the Department of Health Professions, except persons regulated by the Board of Funeral Directors and Embalmers or the Board of Veterinary Medicine.\n\t\t\t“Health plan” means an individual or group plan that provides, or pays the cost of, medical care. “Health plan” includes any entity included in such definition as set out in 45 C.F.R. § 160.103.\n\t\t\t“Health record” means any written, printed or electronically recorded material maintained by a health care entity in the course of providing health services to an individual concerning the individual and the services provided. “Health record” also includes the substance of any communication made by an individual to a health care entity in confidence during or in connection with the provision of health services or information otherwise acquired by the health care entity about an individual in confidence and in connection with the provision of health services to the individual.\n\t\t\t“Health services” means, but shall not be limited to, examination, diagnosis, evaluation, treatment, pharmaceuticals, aftercare, habilitation or rehabilitation and mental health therapy of any kind, as well as payment or reimbursement for any such services.\n\t\t\t“Individual” means a patient who is receiving or has received health services from a health care entity.\n\t\t\t“Individually identifying prescription information” means all prescriptions, drug orders or any other prescription information that specifically identifies an individual.\n\t\t\t“Parent” means a biological, adoptive or foster parent.\n\t\t\t“Psychotherapy notes” means comments, recorded in any medium by a health care provider who is a mental health professional, documenting or analyzing the contents of conversation during a private counseling session with an individual or a group, joint, or family counseling session that are separated from the rest of the individual’s health record. “Psychotherapy notes” does not include annotations relating to medication and prescription monitoring, counseling session start and stop times, treatment modalities and frequencies, clinical test results, or any summary of any symptoms, diagnosis, prognosis, functional status, treatment plan, or the individual’s progress to date.C\n\nThe provisions of this section shall not apply to any of the following:1\n\nThe status of and release of information governed by §§ 65.2-604 and 65.2-607 of the Virginia Workers’ Compensation Act;2\n\nExcept where specifically provided herein, the health records of minors;3\n\nThe release of juvenile health records to a secure facility or a shelter care facility pursuant to § 16.1-248.3; or4\n\nThe release of health records to a state correctional facility pursuant to § 53.1-40.10 or a local or regional correctional facility pursuant to § 53.1-133.03.D\n\nHealth care entities may, and, when required by other provisions of state law, shall, disclose health records:1\n\nAs set forth in subsection E, pursuant to the written authorization of (i) the individual or (ii) in the case of a minor, (a) his custodial parent, guardian or other person authorized to consent to treatment of minors pursuant to § 54.1-2969 or (b) the minor himself, if he has consented to his own treatment pursuant to § 54.1-2969, or (iii) in emergency cases or situations where it is impractical to obtain an individual’s written authorization, pursuant to the individual’s oral authorization for a health care provider or health plan to discuss the individual’s health records with a third party specified by the individual;2\n\nIn compliance with a subpoena issued in accord with subsection H, pursuant to a search warrant or a grand jury subpoena, pursuant to court order upon good cause shown or in compliance with a subpoena issued pursuant to subsection C of § 8.01-413. Regardless of the manner by which health records relating to an individual are compelled to be disclosed pursuant to this subdivision, nothing in this subdivision shall be construed to prohibit any staff or employee of a health care entity from providing information about such individual to a law-enforcement officer in connection with such subpoena, search warrant, or court order;3\n\nIn accord with subsection F of § 8.01-399 including, but not limited to, situations where disclosure is reasonably necessary to establish or collect a fee or to defend a health care entity or the health care entity’s employees or staff against any accusation of wrongful conduct; also as required in the course of an investigation, audit, review or proceedings regarding a health care entity’s conduct by a duly authorized law-enforcement, licensure, accreditation, or professional review entity;4\n\nIn testimony in accordance with §§ 8.01-399 and 8.01-400.2;5\n\nIn compliance with the provisions of § 8.01-413;6\n\nAs required or authorized by law relating to public health activities, health oversight activities, serious threats to health or safety, or abuse, neglect or domestic violence, relating to contagious disease, public safety, and suspected child or adult abuse reporting requirements, including, but not limited to, those contained in §§ 16.1-248.3, 32.1-36, 32.1-36.1, 32.1-40, 32.1-41, 32.1-127.1:04, 32.1-276.5, 32.1-283, 32.1-283.1, 32.1-320, 37.2-710, 37.2-839, 53.1-40.10, 53.1-133.03, 54.1-2400.6, 54.1-2400.7, 54.1-2400.9, 54.1-2403.3, 54.1-2506, 54.1-2966, 54.1-2967, 54.1-2968, 54.1-3408.2, 63.2-1509, and 63.2-1606;7\n\nWhere necessary in connection with the care of the individual;8\n\nIn connection with the health care entity’s own health care operations or the health care operations of another health care entity, as specified in 45 C.F.R. § 164.501, or in the normal course of business in accordance with accepted standards of practice within the health services setting; however, the maintenance, storage, and disclosure of the mass of prescription dispensing records maintained in a pharmacy registered or permitted in Virginia shall only be accomplished in compliance with §§ 54.1-3410, 54.1-3411, and 54.1-3412;9\n\nWhen the individual has waived his right to the privacy of the health records;10\n\nWhen examination and evaluation of an individual are undertaken pursuant to judicial or administrative law order, but only to the extent as required by such order;11\n\nTo the guardian ad litem and any attorney representing the respondent in the course of a guardianship proceeding of an adult patient who is the respondent in a proceeding under Chapter 20 (§ 64.2-2000 et seq.) of Title 64.2;12\n\nTo the guardian ad litem and any attorney appointed by the court to represent an individual who is or has been a patient who is the subject of a commitment proceeding under § 19.2-169.6, Article 5 (§ 37.2-814 et seq.) of Chapter 8 of Title 37.2, Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1, or a judicial authorization for treatment proceeding pursuant to Chapter 11 (§ 37.2-1100 et seq.) of Title 37.2;13\n\nTo a magistrate, the court, the evaluator or examiner required under Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1 or § 37.2-815, a community services board or behavioral health authority or a designee of a community services board or behavioral health authority, or a law-enforcement officer participating in any proceeding under Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1, § 19.2-169.6, or Chapter 8 (§ 37.2-800 et seq.) of Title 37.2 regarding the subject of the proceeding, and to any health care provider evaluating or providing services to the person who is the subject of the proceeding or monitoring the person’s adherence to a treatment plan ordered under those provisions. Health records disclosed to a law-enforcement officer shall be limited to information necessary to protect the officer, the person, or the public from physical injury or to address the health care needs of the person. Information disclosed to a law-enforcement officer shall not be used for any other purpose, disclosed to others, or retained;14\n\nTo the attorney and\/or guardian ad litem of a minor who represents such minor in any judicial or administrative proceeding, if the court or administrative hearing officer has entered an order granting the attorney or guardian ad litem this right and such attorney or guardian ad litem presents evidence to the health care entity of such order;15\n\nWith regard to the Court-Appointed Special Advocate (CASA) program, a minor’s health records in accord with § 9.1-156;16\n\nTo an agent appointed under an individual’s power of attorney or to an agent or decision maker designated in an individual’s advance directive for health care or for decisions on anatomical gifts and organ, tissue or eye donation or to any other person consistent with the provisions of the Health Care Decisions Act (§ 54.1-2981 et seq.);17\n\nTo third-party payors and their agents for purposes of reimbursement;18\n\nAs is necessary to support an application for receipt of health care benefits from a governmental agency or as required by an authorized governmental agency reviewing such application or reviewing benefits already provided or as necessary to the coordination of prevention and control of disease, injury, or disability and delivery of such health care benefits pursuant to § 32.1-127.1:04;19\n\nUpon the sale of a medical practice as provided in § 54.1-2405; or upon a change of ownership or closing of a pharmacy pursuant to regulations of the Board of Pharmacy;20\n\nIn accord with subsection B of § 54.1-2400.1, to communicate an individual’s specific and immediate threat to cause serious bodily injury or death of an identified or readily identifiable person;21\n\nWhere necessary in connection with the implementation of a hospital’s routine contact process for organ donation pursuant to subdivision B 4 of § 32.1-127;22\n\nIn the case of substance abuse records, when permitted by and in conformity with requirements of federal law found in 42 U.S.C. § 290dd-2 and 42 C.F.R. Part 2;23\n\nIn connection with the work of any entity established as set forth in § 8.01-581.16 to evaluate the adequacy or quality of professional services or the competency and qualifications for professional staff privileges;24\n\nIf the health records are those of a deceased or mentally incapacitated individual to the personal representative or executor of the deceased individual or the legal guardian or committee of the incompetent or incapacitated individual or if there is no personal representative, executor, legal guardian or committee appointed, to the following persons in the following order of priority: a spouse, an adult son or daughter, either parent, an adult brother or sister, or any other relative of the deceased individual in order of blood relationship;25\n\nFor the purpose of conducting record reviews of inpatient hospital deaths to promote identification of all potential organ, eye, and tissue donors in conformance with the requirements of applicable federal law and regulations, including 42 C.F.R. § 482.45, (i) to the health care provider’s designated organ procurement organization certified by the United States Health Care Financing Administration and (ii) to any eye bank or tissue bank in Virginia certified by the Eye Bank Association of America or the American Association of Tissue Banks;26\n\nTo the Office of the State Inspector General pursuant to Chapter 3.2 (§ 2.2-307 et seq.) of Title 2.2;27\n\nTo an entity participating in the activities of a local health partnership authority established pursuant to Article 6.1 (§ 32.1-122.10:001 et seq.) of Chapter 4, pursuant to subdivision 1;28\n\nTo law-enforcement officials by each licensed emergency medical services agency, (i) when the individual is the victim of a crime or (ii) when the individual has been arrested and has received emergency medical services or has refused emergency medical services and the health records consist of the prehospital patient care report required by § 32.1-116.1;29\n\nTo law-enforcement officials, in response to their request, for the purpose of identifying or locating a suspect, fugitive, person required to register pursuant to § 9.1-901 of the Sex Offender and Crimes Against Minors Registry Act, material witness, or missing person, provided that only the following information may be disclosed: (i) name and address of the person, (ii) date and place of birth of the person, (iii) social security number of the person, (iv) blood type of the person, (v) date and time of treatment received by the person, (vi) date and time of death of the person, where applicable, (vii) description of distinguishing physical characteristics of the person, and (viii) type of injury sustained by the person;30\n\nTo law-enforcement officials regarding the death of an individual for the purpose of alerting law enforcement of the death if the health care entity has a suspicion that such death may have resulted from criminal conduct;31\n\nTo law-enforcement officials if the health care entity believes in good faith that the information disclosed constitutes evidence of a crime that occurred on its premises;32\n\nTo the State Health Commissioner pursuant to § 32.1-48.015 when such records are those of a person or persons who are subject to an order of quarantine or an order of isolation pursuant to Article 3.02 (§ 32.1-48.05 et seq.) of Chapter 2;33\n\nTo the Commissioner of the Department of Labor and Industry or his designee by each licensed emergency medical services agency when the records consist of the prehospital patient care report required by § 32.1-116.1 and the patient has suffered an injury or death on a work site while performing duties or tasks that are within the scope of his employment;34\n\nTo notify a family member or personal representative of an individual who is the subject of a proceeding pursuant to Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1 or Chapter 8 (§ 37.2-800 et seq.) of Title 37.2 of information that is directly relevant to such person’s involvement with the individual’s health care, which may include the individual’s location and general condition, when the individual has the capacity to make health care decisions and (i) the individual has agreed to the notification, (ii) the individual has been provided an opportunity to object to the notification and does not express an objection, or (iii) the health care provider can, on the basis of his professional judgment, reasonably infer from the circumstances that the individual does not object to the notification. If the opportunity to agree or object to the notification cannot practicably be provided because of the individual’s incapacity or an emergency circumstance, the health care provider may notify a family member or personal representative of the individual of information that is directly relevant to such person’s involvement with the individual’s health care, which may include the individual’s location and general condition if the health care provider, in the exercise of his professional judgment, determines that the notification is in the best interests of the individual. Such notification shall not be made if the provider has actual knowledge the family member or personal representative is currently prohibited by court order from contacting the individual;35\n\nTo a threat assessment team established by a local school board pursuant to § 22.1-79.4, by a public institution of higher education pursuant to § 23.1-805, or by a private nonprofit institution of higher education; and36\n\nTo a regional emergency medical services council pursuant to § 32.1-116.1, for purposes limited to monitoring and improving the quality of emergency medical services pursuant to § 32.1-111.3.\n\t\t\t\tNotwithstanding the provisions of subdivisions 1 through 35, a health care entity shall obtain an individual’s written authorization for any disclosure of psychotherapy notes, except when disclosure by the health care entity is (i) for its own training programs in which students, trainees, or practitioners in mental health are being taught under supervision to practice or to improve their skills in group, joint, family, or individual counseling; (ii) to defend itself or its employees or staff against any accusation of wrongful conduct; (iii) in the discharge of the duty, in accordance with subsection B of § 54.1-2400.1, to take precautions to protect third parties from violent behavior or other serious harm; (iv) required in the course of an investigation, audit, review, or proceeding regarding a health care entity’s conduct by a duly authorized law-enforcement, licensure, accreditation, or professional review entity; or (v) otherwise required by law.E\n\nHealth care records required to be disclosed pursuant to this section shall be made available electronically only to the extent and in the manner authorized by the federal Health Information Technology for Economic and Clinical Health Act (P.L. 111-5) and implementing regulations and the Health Insurance Portability and Accountability Act (42 U.S.C. § 1320d et seq.) and implementing regulations. Notwithstanding any other provision to the contrary, a health care entity shall not be required to provide records in an electronic format requested if (i) the electronic format is not reasonably available without additional cost to the health care entity, (ii) the records would be subject to modification in the format requested, or (iii) the health care entity determines that the integrity of the records could be compromised in the electronic format requested. Requests for copies of or electronic access to health records shall (a) be in writing, dated and signed by the requester; (b) identify the nature of the information requested; and (c) include evidence of the authority of the requester to receive such copies or access such records, and identification of the person to whom the information is to be disclosed; and (d) specify whether the requester would like the records in electronic format, if available, or in paper format. The health care entity shall accept a photocopy, facsimile, or other copy of the original signed by the requester as if it were an original. Within 30 days of receipt of a request for copies of or electronic access to health records, the health care entity shall do one of the following: (1) furnish such copies of or allow electronic access to the requested health records to any requester authorized to receive them in electronic format if so requested; (2) inform the requester if the information does not exist or cannot be found; (3) if the health care entity does not maintain a record of the information, so inform the requester and provide the name and address, if known, of the health care entity who maintains the record; or (4) deny the request (A) under subsection F, (B) on the grounds that the requester has not established his authority to receive such health records or proof of his identity, or (C) as otherwise provided by law. Procedures set forth in this section shall apply only to requests for health records not specifically governed by other provisions of state law.F\n\nExcept as provided in subsection B of § 8.01-413, copies of or electronic access to an individual’s health records shall not be furnished to such individual or anyone authorized to act on the individual’s behalf when the individual’s treating physician, clinical psychologist, clinical social worker, or licensed professional counselor has made a part of the individual’s record a written statement that, in the exercise of his professional judgment, the furnishing to or review by the individual of such health records would be reasonably likely to endanger the life or physical safety of the individual or another person, or that such health record makes reference to a person other than a health care provider and the access requested would be reasonably likely to cause substantial harm to such referenced person. If any health care entity denies a request for copies of or electronic access to health records based on such statement, the health care entity shall inform the individual of the individual’s right to designate, in writing, at his own expense, another reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor whose licensure, training and experience relative to the individual’s condition are at least equivalent to that of the physician, clinical psychologist, clinical social worker, or licensed professional counselor upon whose opinion the denial is based. The designated reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor shall make a judgment as to whether to make the health record available to the individual.\n\t\t\tThe health care entity denying the request shall also inform the individual of the individual’s right to request in writing that such health care entity designate, at its own expense, a physician, clinical psychologist, clinical social worker, or licensed professional counselor, whose licensure, training, and experience relative to the individual’s condition are at least equivalent to that of the physician, clinical psychologist, clinical social worker, or licensed professional counselor upon whose professional judgment the denial is based and who did not participate in the original decision to deny the health records, who shall make a judgment as to whether to make the health record available to the individual. The health care entity shall comply with the judgment of the reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor. The health care entity shall permit copying and examination of the health record by such other physician, clinical psychologist, clinical social worker, or licensed professional counselor designated by either the individual at his own expense or by the health care entity at its expense.\n\t\t\tAny health record copied for review by any such designated physician, clinical psychologist, clinical social worker, or licensed professional counselor shall be accompanied by a statement from the custodian of the health record that the individual’s treating physician, clinical psychologist, clinical social worker, or licensed professional counselor determined that the individual’s review of his health record would be reasonably likely to endanger the life or physical safety of the individual or would be reasonably likely to cause substantial harm to a person referenced in the health record who is not a health care provider.\n\t\t\tFurther, nothing herein shall be construed as giving, or interpreted to bestow the right to receive copies of, or otherwise obtain access to, psychotherapy notes to any individual or any person authorized to act on his behalf.G\n\nA written authorization to allow release of an individual’s health records shall substantially include the following information:\n\t\t\tAUTHORIZATION TO RELEASE CONFIDENTIAL HEALTH RECORDS\n\t\t\tIndividual’s Name ________\n\t\t\tHealth Care Entity’s Name ________\n\t\t\tPerson, Agency, or Health Care Entity to whom disclosure is to be made\n\t\t\t____\n\t\t\tInformation or Health Records to be disclosed\n\t\t\t____\n\t\t\tPurpose of Disclosure or at the Request of the Individual\n\t\t\t____\n\t\t\tAs the person signing this authorization, I understand that I am giving my permission to the above-named health care entity for disclosure of confidential health records. I understand that the health care entity may not condition treatment or payment on my willingness to sign this authorization unless the specific circumstances under which such conditioning is permitted by law are applicable and are set forth in this authorization. I also understand that I have the right to revoke this authorization at any time, but that my revocation is not effective until delivered in writing to the person who is in possession of my health records and is not effective as to health records already disclosed under this authorization. A copy of this authorization and a notation concerning the persons or agencies to whom disclosure was made shall be included with my original health records. I understand that health information disclosed under this authorization might be redisclosed by a recipient and may, as a result of such disclosure, no longer be protected to the same extent as such health information was protected by law while solely in the possession of the health care entity.\n\t\t\tThis authorization expires on (date) or (event) ____\n\t\t\tSignature of Individual or Individual’s Legal Representative if Individual is Unable to Sign\n\t\t\t____\n\t\t\tRelationship or Authority of Legal Representative\n\t\t\t____\n\t\t\tDate of Signature ____H\n\nPursuant to this subsection:1\n\nUnless excepted from these provisions in subdivision 9, no party to a civil, criminal or administrative action or proceeding shall request the issuance of a subpoena duces tecum for another party’s health records or cause a subpoena duces tecum to be issued by an attorney unless a copy of the request for the subpoena or a copy of the attorney-issued subpoena is provided to the other party’s counsel or to the other party if pro se, simultaneously with filing the request or issuance of the subpoena. No party to an action or proceeding shall request or cause the issuance of a subpoena duces tecum for the health records of a nonparty witness unless a copy of the request for the subpoena or a copy of the attorney-issued subpoena is provided to the nonparty witness simultaneously with filing the request or issuance of the attorney-issued subpoena.\n\t\t\t\tNo subpoena duces tecum for health records shall set a return date earlier than 15 days from the date of the subpoena except by order of a court or administrative agency for good cause shown. When a court or administrative agency directs that health records be disclosed pursuant to a subpoena duces tecum earlier than 15 days from the date of the subpoena, a copy of the order shall accompany the subpoena.\n\t\t\t\tAny party requesting a subpoena duces tecum for health records or on whose behalf the subpoena duces tecum is being issued shall have the duty to determine whether the individual whose health records are being sought is pro se or a nonparty.\n\t\t\t\tIn instances where health records being subpoenaed are those of a pro se party or nonparty witness, the party requesting or issuing the subpoena shall deliver to the pro se party or nonparty witness together with the copy of the request for subpoena, or a copy of the subpoena in the case of an attorney-issued subpoena, a statement informing them of their rights and remedies. The statement shall include the following language and the heading shall be in boldface capital letters:\n\t\t\t\tNOTICE TO INDIVIDUAL\n\t\t\t\tThe attached document means that ________(insert name of party requesting or causing issuance of the subpoena) has either asked the court or administrative agency to issue a subpoena or a subpoena has been issued by the other party’s attorney to your doctor, other health care providers ________(names of health care providers inserted here) or other health care entity ________(name of health care entity to be inserted here) requiring them to produce your health records. Your doctor, other health care provider or other health care entity is required to respond by providing a copy of your health records. If you believe your health records should not be disclosed and object to their disclosure, you have the right to file a motion with the clerk of the court or the administrative agency to quash the subpoena. If you elect to file a motion to quash, such motion must be filed within 15 days of the date of the request or of the attorney-issued subpoena. You may contact the clerk’s office or the administrative agency to determine the requirements that must be satisfied when filing a motion to quash and you may elect to contact an attorney to represent your interest. If you elect to file a motion to quash, you must notify your doctor, other health care provider(s), or other health care entity, that you are filing the motion so that the health care provider or health care entity knows to send the health records to the clerk of court or administrative agency in a sealed envelope or package for safekeeping while your motion is decided.2\n\nAny party filing a request for a subpoena duces tecum or causing such a subpoena to be issued for an individual’s health records shall include a Notice in the same part of the request in which the recipient of the subpoena duces tecum is directed where and when to return the health records. Such notice shall be in boldface capital letters and shall include the following language:\n\t\t\t\tNOTICE TO HEALTH CARE ENTITIES\n\t\t\t\tA COPY OF THIS SUBPOENA DUCES TECUM HAS BEEN PROVIDED TO THE INDIVIDUAL WHOSE HEALTH RECORDS ARE BEING REQUESTED OR HIS COUNSEL. YOU OR THAT INDIVIDUAL HAS THE RIGHT TO FILE A MOTION TO QUASH (OBJECT TO) THE ATTACHED SUBPOENA. IF YOU ELECT TO FILE A MOTION TO QUASH, YOU MUST FILE THE MOTION WITHIN 15 DAYS OF THE DATE OF THIS SUBPOENA.\n\t\t\t\tYOU MUST NOT RESPOND TO THIS SUBPOENA UNTIL YOU HAVE RECEIVED WRITTEN CERTIFICATION FROM THE PARTY ON WHOSE BEHALF THE SUBPOENA WAS ISSUED THAT THE TIME FOR FILING A MOTION TO QUASH HAS ELAPSED AND THAT:\n\t\t\t\tNO MOTION TO QUASH WAS FILED; OR\n\t\t\t\tANY MOTION TO QUASH HAS BEEN RESOLVED BY THE COURT OR THE ADMINISTRATIVE AGENCY AND THE DISCLOSURES SOUGHT ARE CONSISTENT WITH SUCH RESOLUTION.\n\t\t\t\tIF YOU RECEIVE NOTICE THAT THE INDIVIDUAL WHOSE HEALTH RECORDS ARE BEING REQUESTED HAS FILED A MOTION TO QUASH THIS SUBPOENA, OR IF YOU FILE A MOTION TO QUASH THIS SUBPOENA, YOU MUST SEND THE HEALTH RECORDS ONLY TO THE CLERK OF THE COURT OR ADMINISTRATIVE AGENCY THAT ISSUED THE SUBPOENA OR IN WHICH THE ACTION IS PENDING AS SHOWN ON THE SUBPOENA USING THE FOLLOWING PROCEDURE:\n\t\t\t\tPLACE THE HEALTH RECORDS IN A SEALED ENVELOPE AND ATTACH TO THE SEALED ENVELOPE A COVER LETTER TO THE CLERK OF COURT OR ADMINISTRATIVE AGENCY WHICH STATES THAT CONFIDENTIAL HEALTH RECORDS ARE ENCLOSED AND ARE TO BE HELD UNDER SEAL PENDING A RULING ON THE MOTION TO QUASH THE SUBPOENA. THE SEALED ENVELOPE AND THE COVER LETTER SHALL BE PLACED IN AN OUTER ENVELOPE OR PACKAGE FOR TRANSMITTAL TO THE COURT OR ADMINISTRATIVE AGENCY.3\n\nUpon receiving a valid subpoena duces tecum for health records, health care entities shall have the duty to respond to the subpoena in accordance with the provisions of subdivisions 4, 5, 6, 7, and 8.4\n\nExcept to deliver to a clerk of the court or administrative agency subpoenaed health records in a sealed envelope as set forth, health care entities shall not respond to a subpoena duces tecum for such health records until they have received a certification as set forth in subdivision 5 or 8 from the party on whose behalf the subpoena duces tecum was issued.\n\t\t\t\tIf the health care entity has actual receipt of notice that a motion to quash the subpoena has been filed or if the health care entity files a motion to quash the subpoena for health records, then the health care entity shall produce the health records, in a securely sealed envelope, to the clerk of the court or administrative agency issuing the subpoena or in whose court or administrative agency the action is pending. The court or administrative agency shall place the health records under seal until a determination is made regarding the motion to quash. The securely sealed envelope shall only be opened on order of the judge or administrative agency. In the event the court or administrative agency grants the motion to quash, the health records shall be returned to the health care entity in the same sealed envelope in which they were delivered to the court or administrative agency. In the event that a judge or administrative agency orders the sealed envelope to be opened to review the health records in camera, a copy of the order shall accompany any health records returned to the health care entity. The health records returned to the health care entity shall be in a securely sealed envelope.5\n\nIf no motion to quash is filed within 15 days of the date of the request or of the attorney-issued subpoena, the party on whose behalf the subpoena was issued shall have the duty to certify to the subpoenaed health care entity that the time for filing a motion to quash has elapsed and that no motion to quash was filed. Any health care entity receiving such certification shall have the duty to comply with the subpoena duces tecum by returning the specified health records by either the return date on the subpoena or five days after receipt of the certification, whichever is later.6\n\nIn the event that the individual whose health records are being sought files a motion to quash the subpoena, the court or administrative agency shall decide whether good cause has been shown by the discovering party to compel disclosure of the individual’s health records over the individual’s objections. In determining whether good cause has been shown, the court or administrative agency shall consider (i) the particular purpose for which the information was collected; (ii) the degree to which the disclosure of the records would embarrass, injure, or invade the privacy of the individual; (iii) the effect of the disclosure on the individual’s future health care; (iv) the importance of the information to the lawsuit or proceeding; and (v) any other relevant factor.7\n\nConcurrent with the court or administrative agency’s resolution of a motion to quash, if subpoenaed health records have been submitted by a health care entity to the court or administrative agency in a sealed envelope, the court or administrative agency shall: (i) upon determining that no submitted health records should be disclosed, return all submitted health records to the health care entity in a sealed envelope; (ii) upon determining that all submitted health records should be disclosed, provide all the submitted health records to the party on whose behalf the subpoena was issued; or (iii) upon determining that only a portion of the submitted health records should be disclosed, provide such portion to the party on whose behalf the subpoena was issued and return the remaining health records to the health care entity in a sealed envelope.8\n\nFollowing the court or administrative agency’s resolution of a motion to quash, the party on whose behalf the subpoena duces tecum was issued shall have the duty to certify in writing to the subpoenaed health care entity a statement of one of the following:\n\t\t\t\ta. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are consistent with such resolution; and, therefore, the health records previously delivered in a sealed envelope to the clerk of the court or administrative agency will not be returned to the health care entity;\n\t\t\t\tb. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are consistent with such resolution and that, since no health records have previously been delivered to the court or administrative agency by the health care entity, the health care entity shall comply with the subpoena duces tecum by returning the health records designated in the subpoena by the return date on the subpoena or five days after receipt of certification, whichever is later;\n\t\t\t\tc. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are not consistent with such resolution; therefore, no health records shall be disclosed and all health records previously delivered in a sealed envelope to the clerk of the court or administrative agency will be returned to the health care entity;\n\t\t\t\td. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are not consistent with such resolution and that only limited disclosure has been authorized. The certification shall state that only the portion of the health records as set forth in the certification, consistent with the court or administrative agency’s ruling, shall be disclosed. The certification shall also state that health records that were previously delivered to the court or administrative agency for which disclosure has been authorized will not be returned to the health care entity; however, all health records for which disclosure has not been authorized will be returned to the health care entity; or\n\t\t\t\te. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are not consistent with such resolution and, since no health records have previously been delivered to the court or administrative agency by the health care entity, the health care entity shall return only those health records specified in the certification, consistent with the court or administrative agency’s ruling, by the return date on the subpoena or five days after receipt of the certification, whichever is later.\n\t\t\t\tA copy of the court or administrative agency’s ruling shall accompany any certification made pursuant to this subdivision.9\n\nThe provisions of this subsection have no application to subpoenas for health records requested under § 8.01-413, or issued by a duly authorized administrative agency conducting an investigation, audit, review or proceedings regarding a health care entity’s conduct.\n\t\t\t\tThe provisions of this subsection shall apply to subpoenas for the health records of both minors and adults.\n\t\t\t\tNothing in this subsection shall have any effect on the existing authority of a court or administrative agency to issue a protective order regarding health records, including, but not limited to, ordering the return of health records to a health care entity, after the period for filing a motion to quash has passed.\n\t\t\t\tA subpoena for substance abuse records must conform to the requirements of federal law found in 42 C.F.R. Part 2, Subpart E.I\n\nHealth care entities may testify about the health records of an individual in compliance with §§ 8.01-399 and 8.01-400.2.J\n\nExcept as provided by subsection B7 of § 8.01-413, if an individual requests a copy of his health record from a health care entity, the health care entity may impose a reasonable cost-based fee, which shall include only the cost of supplies for and labor of copying the requested information, postage when the individual requests that such information be mailed, and preparation of an explanation or summary of such information as agreed to by the individual. For the purposes of this section, “individual” shall subsume a person with authority to act on behalf of the individual who is the subject of the health record in making decisions related to his health care.K\n\nNothing in this section shall prohibit a health care provider who prescribes or dispenses a controlled substance required to be reported to the Prescription Monitoring Program established pursuant to Chapter 25.2 (§ 54.1-2519 et seq.) of Title 54.1 to a patient from disclosing information obtained from the Prescription Monitoring Program and contained in a patient’s health care record to another health care provider when such disclosure is related to the care or treatment of the patient who is the subject of the record.L\n\nAn authorization for the disclosure of health records executed pursuant to this section shall remain in effect until (i) the authorization is revoked in writing and delivered to the health care entity maintaining the record that is subject to the authorization by the person who executed the authorization, (ii) any expiration date set forth in the authorization, or (iii) the health care entity maintaining the record becomes aware of any expiration event described in the authorization, whichever occurs first. However, any revocation of an authorization for the disclosure of health records executed pursuant to this section shall not be effective to the extent that the health care entity maintaining the record has disclosed health records prior to delivery of such revocation in reliance upon the authorization or as otherwise provided pursuant to 45 C.F.R. § 164.508. A statement in an authorization for the disclosure of health records pursuant to this section that the information to be used or disclosed is “all health records” is a sufficient description for the disclosure of all health records of the person maintained by the health care provider to whom the authorization was granted. If a health care provider receives a written revocation of an authorization for the disclosure of health records in accordance with this subsection, a copy of such written revocation shall be included in the person’s original health record maintained by the health care provider.\n\t\t\tAn authorization for the disclosure of health records executed pursuant to this section shall, unless otherwise expressly limited in the authorization, be deemed to include authorization for the person named in the authorization to assist the person who is the subject of the health record in accessing health care services, including scheduling appointments for the person who is the subject of the health record and attending appointments together with the person who is the subject of the health record.","order_by":null,"text":{"0":{"id":216044,"text":"There is hereby recognized an individual’s right of privacy in the content of his health records. Health records are the property of the health care entity maintaining them, and, except when permitted or required by this section or by other provisions of state law, no health care entity, or other person working in a health care setting, may disclose an individual’s health records.\n\t\t\tPursuant to this subsection:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":216045,"text":"Health care entities shall disclose health records to the individual who is the subject of the health record, including an audit trail of any additions, deletions, or revisions to the health record, if specifically requested, except as provided in subsections E and F and subsection B of § 8.01-413.","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":216046,"text":"Health records shall not be removed from the premises where they are maintained without the approval of the health care entity that maintains such health records, except in accordance with a court order or subpoena consistent with subsection C of § 8.01-413 or with this section or in accordance with the regulations relating to change of ownership of health records promulgated by a health regulatory board established in Title 54.1.","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":216047,"text":"No person to whom health records are disclosed shall redisclose or otherwise reveal the health records of an individual, beyond the purpose for which such disclosure was made, without first obtaining the individual’s specific authorization to such redisclosure. This redisclosure prohibition shall not, however, prevent (i) any health care entity that receives health records from another health care entity from making subsequent disclosures as permitted under this section and the federal Department of Health and Human Services regulations relating to privacy of the electronic transmission of data and protected health information promulgated by the United States Department of Health and Human Services as required by the Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.) or (ii) any health care entity from furnishing health records and aggregate or other data, from which individually identifying prescription information has been removed, encoded or encrypted, to qualified researchers, including, but not limited to, pharmaceutical manufacturers and their agents or contractors, for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or other health services research.","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":216048,"text":"Health care entities shall, upon the request of the individual who is the subject of the health record, disclose health records to other health care entities, in any available format of the requester’s choosing, as provided in subsection E.","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"B"},"5":{"id":216049,"text":"As used in this section:\n\t\t\t“Agent” means a person who has been appointed as an individual’s agent under a power of attorney for health care or an advance directive under the Health Care Decisions Act (§ 54.1-2981 et seq.).\n\t\t\t“Certification” means a written representation that is delivered by hand, by first-class mail, by overnight delivery service, or by facsimile if the sender obtains a facsimile-machine-generated confirmation reflecting that all facsimile pages were successfully transmitted.\n\t\t\t“Guardian” means a court-appointed guardian of the person.\n\t\t\t“Health care clearinghouse” means, consistent with the definition set out in 45 C.F.R. § 160.103, a public or private entity, such as a billing service, repricing company, community health management information system or community health information system, and “value-added” networks and switches, that performs either of the following functions: (i) processes or facilitates the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction; or (ii) receives a standard transaction from another entity and processes or facilitates the processing of health information into nonstandard format or nonstandard data content for the receiving entity.\n\t\t\t“Health care entity” means any health care provider, health plan or health care clearinghouse.\n\t\t\t“Health care provider” means those entities listed in the definition of “health care provider” in § 8.01-581.1, except that state-operated facilities shall also be considered health care providers for the purposes of this section. Health care provider shall also include all persons who are licensed, certified, registered or permitted or who hold a multistate licensure privilege issued by any of the health regulatory boards within the Department of Health Professions, except persons regulated by the Board of Funeral Directors and Embalmers or the Board of Veterinary Medicine.\n\t\t\t“Health plan” means an individual or group plan that provides, or pays the cost of, medical care. “Health plan” includes any entity included in such definition as set out in 45 C.F.R. § 160.103.\n\t\t\t“Health record” means any written, printed or electronically recorded material maintained by a health care entity in the course of providing health services to an individual concerning the individual and the services provided. “Health record” also includes the substance of any communication made by an individual to a health care entity in confidence during or in connection with the provision of health services or information otherwise acquired by the health care entity about an individual in confidence and in connection with the provision of health services to the individual.\n\t\t\t“Health services” means, but shall not be limited to, examination, diagnosis, evaluation, treatment, pharmaceuticals, aftercare, habilitation or rehabilitation and mental health therapy of any kind, as well as payment or reimbursement for any such services.\n\t\t\t“Individual” means a patient who is receiving or has received health services from a health care entity.\n\t\t\t“Individually identifying prescription information” means all prescriptions, drug orders or any other prescription information that specifically identifies an individual.\n\t\t\t“Parent” means a biological, adoptive or foster parent.\n\t\t\t“Psychotherapy notes” means comments, recorded in any medium by a health care provider who is a mental health professional, documenting or analyzing the contents of conversation during a private counseling session with an individual or a group, joint, or family counseling session that are separated from the rest of the individual’s health record. “Psychotherapy notes” does not include annotations relating to medication and prescription monitoring, counseling session start and stop times, treatment modalities and frequencies, clinical test results, or any summary of any symptoms, diagnosis, prognosis, functional status, treatment plan, or the individual’s progress to date.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A4","next_prefix":"C"},"6":{"id":216050,"text":"The provisions of this section shall not apply to any of the following:","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"C1"},"7":{"id":216051,"text":"The status of and release of information governed by §§ 65.2-604 and 65.2-607 of the Virginia Workers’ Compensation Act;","type":"section","prefixes":["C","1"],"prefix":"1","entire_prefix":"C1","prefix_anchor":"C1","level":2,"prior_prefix":"C","next_prefix":"C2"},"8":{"id":216052,"text":"Except where specifically provided herein, the health records of minors;","type":"section","prefixes":["C","2"],"prefix":"2","entire_prefix":"C2","prefix_anchor":"C2","level":2,"prior_prefix":"C1","next_prefix":"C3"},"9":{"id":216053,"text":"The release of juvenile health records to a secure facility or a shelter care facility pursuant to § 16.1-248.3; or","type":"section","prefixes":["C","3"],"prefix":"3","entire_prefix":"C3","prefix_anchor":"C3","level":2,"prior_prefix":"C2","next_prefix":"C4"},"10":{"id":216054,"text":"The release of health records to a state correctional facility pursuant to § 53.1-40.10 or a local or regional correctional facility pursuant to § 53.1-133.03.","type":"section","prefixes":["C","4"],"prefix":"4","entire_prefix":"C4","prefix_anchor":"C4","level":2,"prior_prefix":"C3","next_prefix":"D"},"11":{"id":216055,"text":"Health care entities may, and, when required by other provisions of state law, shall, disclose health records:","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C4","next_prefix":"D1"},"12":{"id":216056,"text":"As set forth in subsection E, pursuant to the written authorization of (i) the individual or (ii) in the case of a minor, (a) his custodial parent, guardian or other person authorized to consent to treatment of minors pursuant to § 54.1-2969 or (b) the minor himself, if he has consented to his own treatment pursuant to § 54.1-2969, or (iii) in emergency cases or situations where it is impractical to obtain an individual’s written authorization, pursuant to the individual’s oral authorization for a health care provider or health plan to discuss the individual’s health records with a third party specified by the individual;","type":"section","prefixes":["D","1"],"prefix":"1","entire_prefix":"D1","prefix_anchor":"D1","level":2,"prior_prefix":"D","next_prefix":"D2"},"13":{"id":216057,"text":"In compliance with a subpoena issued in accord with subsection H, pursuant to a search warrant or a grand jury subpoena, pursuant to court order upon good cause shown or in compliance with a subpoena issued pursuant to subsection C of § 8.01-413. Regardless of the manner by which health records relating to an individual are compelled to be disclosed pursuant to this subdivision, nothing in this subdivision shall be construed to prohibit any staff or employee of a health care entity from providing information about such individual to a law-enforcement officer in connection with such subpoena, search warrant, or court order;","type":"section","prefixes":["D","2"],"prefix":"2","entire_prefix":"D2","prefix_anchor":"D2","level":2,"prior_prefix":"D1","next_prefix":"D3"},"14":{"id":216058,"text":"In accord with subsection F of § 8.01-399 including, but not limited to, situations where disclosure is reasonably necessary to establish or collect a fee or to defend a health care entity or the health care entity’s employees or staff against any accusation of wrongful conduct; also as required in the course of an investigation, audit, review or proceedings regarding a health care entity’s conduct by a duly authorized law-enforcement, licensure, accreditation, or professional review entity;","type":"section","prefixes":["D","3"],"prefix":"3","entire_prefix":"D3","prefix_anchor":"D3","level":2,"prior_prefix":"D2","next_prefix":"D4"},"15":{"id":216059,"text":"In testimony in accordance with §§ 8.01-399 and 8.01-400.2;","type":"section","prefixes":["D","4"],"prefix":"4","entire_prefix":"D4","prefix_anchor":"D4","level":2,"prior_prefix":"D3","next_prefix":"D5"},"16":{"id":216060,"text":"In compliance with the provisions of § 8.01-413;","type":"section","prefixes":["D","5"],"prefix":"5","entire_prefix":"D5","prefix_anchor":"D5","level":2,"prior_prefix":"D4","next_prefix":"D6"},"17":{"id":216061,"text":"As required or authorized by law relating to public health activities, health oversight activities, serious threats to health or safety, or abuse, neglect or domestic violence, relating to contagious disease, public safety, and suspected child or adult abuse reporting requirements, including, but not limited to, those contained in §§ 16.1-248.3, 32.1-36, 32.1-36.1, 32.1-40, 32.1-41, 32.1-127.1:04, 32.1-276.5, 32.1-283, 32.1-283.1, 32.1-320, 37.2-710, 37.2-839, 53.1-40.10, 53.1-133.03, 54.1-2400.6, 54.1-2400.7, 54.1-2400.9, 54.1-2403.3, 54.1-2506, 54.1-2966, 54.1-2967, 54.1-2968, 54.1-3408.2, 63.2-1509, and 63.2-1606;","type":"section","prefixes":["D","6"],"prefix":"6","entire_prefix":"D6","prefix_anchor":"D6","level":2,"prior_prefix":"D5","next_prefix":"D7"},"18":{"id":216062,"text":"Where necessary in connection with the care of the individual;","type":"section","prefixes":["D","7"],"prefix":"7","entire_prefix":"D7","prefix_anchor":"D7","level":2,"prior_prefix":"D6","next_prefix":"D8"},"19":{"id":216063,"text":"In connection with the health care entity’s own health care operations or the health care operations of another health care entity, as specified in 45 C.F.R. § 164.501, or in the normal course of business in accordance with accepted standards of practice within the health services setting; however, the maintenance, storage, and disclosure of the mass of prescription dispensing records maintained in a pharmacy registered or permitted in Virginia shall only be accomplished in compliance with §§ 54.1-3410, 54.1-3411, and 54.1-3412;","type":"section","prefixes":["D","8"],"prefix":"8","entire_prefix":"D8","prefix_anchor":"D8","level":2,"prior_prefix":"D7","next_prefix":"D9"},"20":{"id":216064,"text":"When the individual has waived his right to the privacy of the health records;","type":"section","prefixes":["D","9"],"prefix":"9","entire_prefix":"D9","prefix_anchor":"D9","level":2,"prior_prefix":"D8","next_prefix":"D10"},"21":{"id":216065,"text":"When examination and evaluation of an individual are undertaken pursuant to judicial or administrative law order, but only to the extent as required by such order;","type":"section","prefixes":["D","10"],"prefix":"10","entire_prefix":"D10","prefix_anchor":"D10","level":2,"prior_prefix":"D9","next_prefix":"D11"},"22":{"id":216066,"text":"To the guardian ad litem and any attorney representing the respondent in the course of a guardianship proceeding of an adult patient who is the respondent in a proceeding under Chapter 20 (§ 64.2-2000 et seq.) of Title 64.2;","type":"section","prefixes":["D","11"],"prefix":"11","entire_prefix":"D11","prefix_anchor":"D11","level":2,"prior_prefix":"D10","next_prefix":"D12"},"23":{"id":216067,"text":"To the guardian ad litem and any attorney appointed by the court to represent an individual who is or has been a patient who is the subject of a commitment proceeding under § 19.2-169.6, Article 5 (§ 37.2-814 et seq.) of Chapter 8 of Title 37.2, Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1, or a judicial authorization for treatment proceeding pursuant to Chapter 11 (§ 37.2-1100 et seq.) of Title 37.2;","type":"section","prefixes":["D","12"],"prefix":"12","entire_prefix":"D12","prefix_anchor":"D12","level":2,"prior_prefix":"D11","next_prefix":"D13"},"24":{"id":216068,"text":"To a magistrate, the court, the evaluator or examiner required under Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1 or § 37.2-815, a community services board or behavioral health authority or a designee of a community services board or behavioral health authority, or a law-enforcement officer participating in any proceeding under Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1, § 19.2-169.6, or Chapter 8 (§ 37.2-800 et seq.) of Title 37.2 regarding the subject of the proceeding, and to any health care provider evaluating or providing services to the person who is the subject of the proceeding or monitoring the person’s adherence to a treatment plan ordered under those provisions. Health records disclosed to a law-enforcement officer shall be limited to information necessary to protect the officer, the person, or the public from physical injury or to address the health care needs of the person. Information disclosed to a law-enforcement officer shall not be used for any other purpose, disclosed to others, or retained;","type":"section","prefixes":["D","13"],"prefix":"13","entire_prefix":"D13","prefix_anchor":"D13","level":2,"prior_prefix":"D12","next_prefix":"D14"},"25":{"id":216069,"text":"To the attorney and\/or guardian ad litem of a minor who represents such minor in any judicial or administrative proceeding, if the court or administrative hearing officer has entered an order granting the attorney or guardian ad litem this right and such attorney or guardian ad litem presents evidence to the health care entity of such order;","type":"section","prefixes":["D","14"],"prefix":"14","entire_prefix":"D14","prefix_anchor":"D14","level":2,"prior_prefix":"D13","next_prefix":"D15"},"26":{"id":216070,"text":"With regard to the Court-Appointed Special Advocate (CASA) program, a minor’s health records in accord with § 9.1-156;","type":"section","prefixes":["D","15"],"prefix":"15","entire_prefix":"D15","prefix_anchor":"D15","level":2,"prior_prefix":"D14","next_prefix":"D16"},"27":{"id":216071,"text":"To an agent appointed under an individual’s power of attorney or to an agent or decision maker designated in an individual’s advance directive for health care or for decisions on anatomical gifts and organ, tissue or eye donation or to any other person consistent with the provisions of the Health Care Decisions Act (§ 54.1-2981 et seq.);","type":"section","prefixes":["D","16"],"prefix":"16","entire_prefix":"D16","prefix_anchor":"D16","level":2,"prior_prefix":"D15","next_prefix":"D17"},"28":{"id":216072,"text":"To third-party payors and their agents for purposes of reimbursement;","type":"section","prefixes":["D","17"],"prefix":"17","entire_prefix":"D17","prefix_anchor":"D17","level":2,"prior_prefix":"D16","next_prefix":"D18"},"29":{"id":216073,"text":"As is necessary to support an application for receipt of health care benefits from a governmental agency or as required by an authorized governmental agency reviewing such application or reviewing benefits already provided or as necessary to the coordination of prevention and control of disease, injury, or disability and delivery of such health care benefits pursuant to § 32.1-127.1:04;","type":"section","prefixes":["D","18"],"prefix":"18","entire_prefix":"D18","prefix_anchor":"D18","level":2,"prior_prefix":"D17","next_prefix":"D19"},"30":{"id":216074,"text":"Upon the sale of a medical practice as provided in § 54.1-2405; or upon a change of ownership or closing of a pharmacy pursuant to regulations of the Board of Pharmacy;","type":"section","prefixes":["D","19"],"prefix":"19","entire_prefix":"D19","prefix_anchor":"D19","level":2,"prior_prefix":"D18","next_prefix":"D20"},"31":{"id":216075,"text":"In accord with subsection B of § 54.1-2400.1, to communicate an individual’s specific and immediate threat to cause serious bodily injury or death of an identified or readily identifiable person;","type":"section","prefixes":["D","20"],"prefix":"20","entire_prefix":"D20","prefix_anchor":"D20","level":2,"prior_prefix":"D19","next_prefix":"D21"},"32":{"id":216076,"text":"Where necessary in connection with the implementation of a hospital’s routine contact process for organ donation pursuant to subdivision B 4 of § 32.1-127;","type":"section","prefixes":["D","21"],"prefix":"21","entire_prefix":"D21","prefix_anchor":"D21","level":2,"prior_prefix":"D20","next_prefix":"D22"},"33":{"id":216077,"text":"In the case of substance abuse records, when permitted by and in conformity with requirements of federal law found in 42 U.S.C. § 290dd-2 and 42 C.F.R. Part 2;","type":"section","prefixes":["D","22"],"prefix":"22","entire_prefix":"D22","prefix_anchor":"D22","level":2,"prior_prefix":"D21","next_prefix":"D23"},"34":{"id":216078,"text":"In connection with the work of any entity established as set forth in § 8.01-581.16 to evaluate the adequacy or quality of professional services or the competency and qualifications for professional staff privileges;","type":"section","prefixes":["D","23"],"prefix":"23","entire_prefix":"D23","prefix_anchor":"D23","level":2,"prior_prefix":"D22","next_prefix":"D24"},"35":{"id":216079,"text":"If the health records are those of a deceased or mentally incapacitated individual to the personal representative or executor of the deceased individual or the legal guardian or committee of the incompetent or incapacitated individual or if there is no personal representative, executor, legal guardian or committee appointed, to the following persons in the following order of priority: a spouse, an adult son or daughter, either parent, an adult brother or sister, or any other relative of the deceased individual in order of blood relationship;","type":"section","prefixes":["D","24"],"prefix":"24","entire_prefix":"D24","prefix_anchor":"D24","level":2,"prior_prefix":"D23","next_prefix":"D25"},"36":{"id":216080,"text":"For the purpose of conducting record reviews of inpatient hospital deaths to promote identification of all potential organ, eye, and tissue donors in conformance with the requirements of applicable federal law and regulations, including 42 C.F.R. § 482.45, (i) to the health care provider’s designated organ procurement organization certified by the United States Health Care Financing Administration and (ii) to any eye bank or tissue bank in Virginia certified by the Eye Bank Association of America or the American Association of Tissue Banks;","type":"section","prefixes":["D","25"],"prefix":"25","entire_prefix":"D25","prefix_anchor":"D25","level":2,"prior_prefix":"D24","next_prefix":"D26"},"37":{"id":216081,"text":"To the Office of the State Inspector General pursuant to Chapter 3.2 (§ 2.2-307 et seq.) of Title 2.2;","type":"section","prefixes":["D","26"],"prefix":"26","entire_prefix":"D26","prefix_anchor":"D26","level":2,"prior_prefix":"D25","next_prefix":"D27"},"38":{"id":216082,"text":"To an entity participating in the activities of a local health partnership authority established pursuant to Article 6.1 (§ 32.1-122.10:001 et seq.) of Chapter 4, pursuant to subdivision 1;","type":"section","prefixes":["D","27"],"prefix":"27","entire_prefix":"D27","prefix_anchor":"D27","level":2,"prior_prefix":"D26","next_prefix":"D28"},"39":{"id":216083,"text":"To law-enforcement officials by each licensed emergency medical services agency, (i) when the individual is the victim of a crime or (ii) when the individual has been arrested and has received emergency medical services or has refused emergency medical services and the health records consist of the prehospital patient care report required by § 32.1-116.1;","type":"section","prefixes":["D","28"],"prefix":"28","entire_prefix":"D28","prefix_anchor":"D28","level":2,"prior_prefix":"D27","next_prefix":"D29"},"40":{"id":216084,"text":"To law-enforcement officials, in response to their request, for the purpose of identifying or locating a suspect, fugitive, person required to register pursuant to § 9.1-901 of the Sex Offender and Crimes Against Minors Registry Act, material witness, or missing person, provided that only the following information may be disclosed: (i) name and address of the person, (ii) date and place of birth of the person, (iii) social security number of the person, (iv) blood type of the person, (v) date and time of treatment received by the person, (vi) date and time of death of the person, where applicable, (vii) description of distinguishing physical characteristics of the person, and (viii) type of injury sustained by the person;","type":"section","prefixes":["D","29"],"prefix":"29","entire_prefix":"D29","prefix_anchor":"D29","level":2,"prior_prefix":"D28","next_prefix":"D30"},"41":{"id":216085,"text":"To law-enforcement officials regarding the death of an individual for the purpose of alerting law enforcement of the death if the health care entity has a suspicion that such death may have resulted from criminal conduct;","type":"section","prefixes":["D","30"],"prefix":"30","entire_prefix":"D30","prefix_anchor":"D30","level":2,"prior_prefix":"D29","next_prefix":"D31"},"42":{"id":216086,"text":"To law-enforcement officials if the health care entity believes in good faith that the information disclosed constitutes evidence of a crime that occurred on its premises;","type":"section","prefixes":["D","31"],"prefix":"31","entire_prefix":"D31","prefix_anchor":"D31","level":2,"prior_prefix":"D30","next_prefix":"D32"},"43":{"id":216087,"text":"To the State Health Commissioner pursuant to § 32.1-48.015 when such records are those of a person or persons who are subject to an order of quarantine or an order of isolation pursuant to Article 3.02 (§ 32.1-48.05 et seq.) of Chapter 2;","type":"section","prefixes":["D","32"],"prefix":"32","entire_prefix":"D32","prefix_anchor":"D32","level":2,"prior_prefix":"D31","next_prefix":"D33"},"44":{"id":216088,"text":"To the Commissioner of the Department of Labor and Industry or his designee by each licensed emergency medical services agency when the records consist of the prehospital patient care report required by § 32.1-116.1 and the patient has suffered an injury or death on a work site while performing duties or tasks that are within the scope of his employment;","type":"section","prefixes":["D","33"],"prefix":"33","entire_prefix":"D33","prefix_anchor":"D33","level":2,"prior_prefix":"D32","next_prefix":"D34"},"45":{"id":216089,"text":"To notify a family member or personal representative of an individual who is the subject of a proceeding pursuant to Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1 or Chapter 8 (§ 37.2-800 et seq.) of Title 37.2 of information that is directly relevant to such person’s involvement with the individual’s health care, which may include the individual’s location and general condition, when the individual has the capacity to make health care decisions and (i) the individual has agreed to the notification, (ii) the individual has been provided an opportunity to object to the notification and does not express an objection, or (iii) the health care provider can, on the basis of his professional judgment, reasonably infer from the circumstances that the individual does not object to the notification. If the opportunity to agree or object to the notification cannot practicably be provided because of the individual’s incapacity or an emergency circumstance, the health care provider may notify a family member or personal representative of the individual of information that is directly relevant to such person’s involvement with the individual’s health care, which may include the individual’s location and general condition if the health care provider, in the exercise of his professional judgment, determines that the notification is in the best interests of the individual. Such notification shall not be made if the provider has actual knowledge the family member or personal representative is currently prohibited by court order from contacting the individual;","type":"section","prefixes":["D","34"],"prefix":"34","entire_prefix":"D34","prefix_anchor":"D34","level":2,"prior_prefix":"D33","next_prefix":"D35"},"46":{"id":216090,"text":"To a threat assessment team established by a local school board pursuant to § 22.1-79.4, by a public institution of higher education pursuant to § 23.1-805, or by a private nonprofit institution of higher education; and","type":"section","prefixes":["D","35"],"prefix":"35","entire_prefix":"D35","prefix_anchor":"D35","level":2,"prior_prefix":"D34","next_prefix":"D36"},"47":{"id":216091,"text":"To a regional emergency medical services council pursuant to § 32.1-116.1, for purposes limited to monitoring and improving the quality of emergency medical services pursuant to § 32.1-111.3.\n\t\t\t\tNotwithstanding the provisions of subdivisions 1 through 35, a health care entity shall obtain an individual’s written authorization for any disclosure of psychotherapy notes, except when disclosure by the health care entity is (i) for its own training programs in which students, trainees, or practitioners in mental health are being taught under supervision to practice or to improve their skills in group, joint, family, or individual counseling; (ii) to defend itself or its employees or staff against any accusation of wrongful conduct; (iii) in the discharge of the duty, in accordance with subsection B of § 54.1-2400.1, to take precautions to protect third parties from violent behavior or other serious harm; (iv) required in the course of an investigation, audit, review, or proceeding regarding a health care entity’s conduct by a duly authorized law-enforcement, licensure, accreditation, or professional review entity; or (v) otherwise required by law.","type":"section","prefixes":["D","36"],"prefix":"36","entire_prefix":"D36","prefix_anchor":"D36","level":2,"prior_prefix":"D35","next_prefix":"E"},"48":{"id":216092,"text":"Health care records required to be disclosed pursuant to this section shall be made available electronically only to the extent and in the manner authorized by the federal Health Information Technology for Economic and Clinical Health Act (P.L. 111-5) and implementing regulations and the Health Insurance Portability and Accountability Act (42 U.S.C. § 1320d et seq.) and implementing regulations. Notwithstanding any other provision to the contrary, a health care entity shall not be required to provide records in an electronic format requested if (i) the electronic format is not reasonably available without additional cost to the health care entity, (ii) the records would be subject to modification in the format requested, or (iii) the health care entity determines that the integrity of the records could be compromised in the electronic format requested. Requests for copies of or electronic access to health records shall (a) be in writing, dated and signed by the requester; (b) identify the nature of the information requested; and (c) include evidence of the authority of the requester to receive such copies or access such records, and identification of the person to whom the information is to be disclosed; and (d) specify whether the requester would like the records in electronic format, if available, or in paper format. The health care entity shall accept a photocopy, facsimile, or other copy of the original signed by the requester as if it were an original. Within 30 days of receipt of a request for copies of or electronic access to health records, the health care entity shall do one of the following: (1) furnish such copies of or allow electronic access to the requested health records to any requester authorized to receive them in electronic format if so requested; (2) inform the requester if the information does not exist or cannot be found; (3) if the health care entity does not maintain a record of the information, so inform the requester and provide the name and address, if known, of the health care entity who maintains the record; or (4) deny the request (A) under subsection F, (B) on the grounds that the requester has not established his authority to receive such health records or proof of his identity, or (C) as otherwise provided by law. Procedures set forth in this section shall apply only to requests for health records not specifically governed by other provisions of state law.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D36","next_prefix":"F"},"49":{"id":216093,"text":"Except as provided in subsection B of § 8.01-413, copies of or electronic access to an individual’s health records shall not be furnished to such individual or anyone authorized to act on the individual’s behalf when the individual’s treating physician, clinical psychologist, clinical social worker, or licensed professional counselor has made a part of the individual’s record a written statement that, in the exercise of his professional judgment, the furnishing to or review by the individual of such health records would be reasonably likely to endanger the life or physical safety of the individual or another person, or that such health record makes reference to a person other than a health care provider and the access requested would be reasonably likely to cause substantial harm to such referenced person. If any health care entity denies a request for copies of or electronic access to health records based on such statement, the health care entity shall inform the individual of the individual’s right to designate, in writing, at his own expense, another reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor whose licensure, training and experience relative to the individual’s condition are at least equivalent to that of the physician, clinical psychologist, clinical social worker, or licensed professional counselor upon whose opinion the denial is based. The designated reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor shall make a judgment as to whether to make the health record available to the individual.\n\t\t\tThe health care entity denying the request shall also inform the individual of the individual’s right to request in writing that such health care entity designate, at its own expense, a physician, clinical psychologist, clinical social worker, or licensed professional counselor, whose licensure, training, and experience relative to the individual’s condition are at least equivalent to that of the physician, clinical psychologist, clinical social worker, or licensed professional counselor upon whose professional judgment the denial is based and who did not participate in the original decision to deny the health records, who shall make a judgment as to whether to make the health record available to the individual. The health care entity shall comply with the judgment of the reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor. The health care entity shall permit copying and examination of the health record by such other physician, clinical psychologist, clinical social worker, or licensed professional counselor designated by either the individual at his own expense or by the health care entity at its expense.\n\t\t\tAny health record copied for review by any such designated physician, clinical psychologist, clinical social worker, or licensed professional counselor shall be accompanied by a statement from the custodian of the health record that the individual’s treating physician, clinical psychologist, clinical social worker, or licensed professional counselor determined that the individual’s review of his health record would be reasonably likely to endanger the life or physical safety of the individual or would be reasonably likely to cause substantial harm to a person referenced in the health record who is not a health care provider.\n\t\t\tFurther, nothing herein shall be construed as giving, or interpreted to bestow the right to receive copies of, or otherwise obtain access to, psychotherapy notes to any individual or any person authorized to act on his behalf.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"50":{"id":216094,"text":"A written authorization to allow release of an individual’s health records shall substantially include the following information:\n\t\t\tAUTHORIZATION TO RELEASE CONFIDENTIAL HEALTH RECORDS\n\t\t\tIndividual’s Name ________\n\t\t\tHealth Care Entity’s Name ________\n\t\t\tPerson, Agency, or Health Care Entity to whom disclosure is to be made\n\t\t\t____\n\t\t\tInformation or Health Records to be disclosed\n\t\t\t____\n\t\t\tPurpose of Disclosure or at the Request of the Individual\n\t\t\t____\n\t\t\tAs the person signing this authorization, I understand that I am giving my permission to the above-named health care entity for disclosure of confidential health records. I understand that the health care entity may not condition treatment or payment on my willingness to sign this authorization unless the specific circumstances under which such conditioning is permitted by law are applicable and are set forth in this authorization. I also understand that I have the right to revoke this authorization at any time, but that my revocation is not effective until delivered in writing to the person who is in possession of my health records and is not effective as to health records already disclosed under this authorization. A copy of this authorization and a notation concerning the persons or agencies to whom disclosure was made shall be included with my original health records. I understand that health information disclosed under this authorization might be redisclosed by a recipient and may, as a result of such disclosure, no longer be protected to the same extent as such health information was protected by law while solely in the possession of the health care entity.\n\t\t\tThis authorization expires on (date) or (event) ____\n\t\t\tSignature of Individual or Individual’s Legal Representative if Individual is Unable to Sign\n\t\t\t____\n\t\t\tRelationship or Authority of Legal Representative\n\t\t\t____\n\t\t\tDate of Signature ____","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"51":{"id":216095,"text":"Pursuant to this subsection:","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"H1"},"52":{"id":216096,"text":"Unless excepted from these provisions in subdivision 9, no party to a civil, criminal or administrative action or proceeding shall request the issuance of a subpoena duces tecum for another party’s health records or cause a subpoena duces tecum to be issued by an attorney unless a copy of the request for the subpoena or a copy of the attorney-issued subpoena is provided to the other party’s counsel or to the other party if pro se, simultaneously with filing the request or issuance of the subpoena. No party to an action or proceeding shall request or cause the issuance of a subpoena duces tecum for the health records of a nonparty witness unless a copy of the request for the subpoena or a copy of the attorney-issued subpoena is provided to the nonparty witness simultaneously with filing the request or issuance of the attorney-issued subpoena.\n\t\t\t\tNo subpoena duces tecum for health records shall set a return date earlier than 15 days from the date of the subpoena except by order of a court or administrative agency for good cause shown. When a court or administrative agency directs that health records be disclosed pursuant to a subpoena duces tecum earlier than 15 days from the date of the subpoena, a copy of the order shall accompany the subpoena.\n\t\t\t\tAny party requesting a subpoena duces tecum for health records or on whose behalf the subpoena duces tecum is being issued shall have the duty to determine whether the individual whose health records are being sought is pro se or a nonparty.\n\t\t\t\tIn instances where health records being subpoenaed are those of a pro se party or nonparty witness, the party requesting or issuing the subpoena shall deliver to the pro se party or nonparty witness together with the copy of the request for subpoena, or a copy of the subpoena in the case of an attorney-issued subpoena, a statement informing them of their rights and remedies. The statement shall include the following language and the heading shall be in boldface capital letters:\n\t\t\t\tNOTICE TO INDIVIDUAL\n\t\t\t\tThe attached document means that ________(insert name of party requesting or causing issuance of the subpoena) has either asked the court or administrative agency to issue a subpoena or a subpoena has been issued by the other party’s attorney to your doctor, other health care providers ________(names of health care providers inserted here) or other health care entity ________(name of health care entity to be inserted here) requiring them to produce your health records. Your doctor, other health care provider or other health care entity is required to respond by providing a copy of your health records. If you believe your health records should not be disclosed and object to their disclosure, you have the right to file a motion with the clerk of the court or the administrative agency to quash the subpoena. If you elect to file a motion to quash, such motion must be filed within 15 days of the date of the request or of the attorney-issued subpoena. You may contact the clerk’s office or the administrative agency to determine the requirements that must be satisfied when filing a motion to quash and you may elect to contact an attorney to represent your interest. If you elect to file a motion to quash, you must notify your doctor, other health care provider(s), or other health care entity, that you are filing the motion so that the health care provider or health care entity knows to send the health records to the clerk of court or administrative agency in a sealed envelope or package for safekeeping while your motion is decided.","type":"section","prefixes":["H","1"],"prefix":"1","entire_prefix":"H1","prefix_anchor":"H1","level":2,"prior_prefix":"H","next_prefix":"H2"},"53":{"id":216097,"text":"Any party filing a request for a subpoena duces tecum or causing such a subpoena to be issued for an individual’s health records shall include a Notice in the same part of the request in which the recipient of the subpoena duces tecum is directed where and when to return the health records. Such notice shall be in boldface capital letters and shall include the following language:\n\t\t\t\tNOTICE TO HEALTH CARE ENTITIES\n\t\t\t\tA COPY OF THIS SUBPOENA DUCES TECUM HAS BEEN PROVIDED TO THE INDIVIDUAL WHOSE HEALTH RECORDS ARE BEING REQUESTED OR HIS COUNSEL. YOU OR THAT INDIVIDUAL HAS THE RIGHT TO FILE A MOTION TO QUASH (OBJECT TO) THE ATTACHED SUBPOENA. IF YOU ELECT TO FILE A MOTION TO QUASH, YOU MUST FILE THE MOTION WITHIN 15 DAYS OF THE DATE OF THIS SUBPOENA.\n\t\t\t\tYOU MUST NOT RESPOND TO THIS SUBPOENA UNTIL YOU HAVE RECEIVED WRITTEN CERTIFICATION FROM THE PARTY ON WHOSE BEHALF THE SUBPOENA WAS ISSUED THAT THE TIME FOR FILING A MOTION TO QUASH HAS ELAPSED AND THAT:\n\t\t\t\tNO MOTION TO QUASH WAS FILED; OR\n\t\t\t\tANY MOTION TO QUASH HAS BEEN RESOLVED BY THE COURT OR THE ADMINISTRATIVE AGENCY AND THE DISCLOSURES SOUGHT ARE CONSISTENT WITH SUCH RESOLUTION.\n\t\t\t\tIF YOU RECEIVE NOTICE THAT THE INDIVIDUAL WHOSE HEALTH RECORDS ARE BEING REQUESTED HAS FILED A MOTION TO QUASH THIS SUBPOENA, OR IF YOU FILE A MOTION TO QUASH THIS SUBPOENA, YOU MUST SEND THE HEALTH RECORDS ONLY TO THE CLERK OF THE COURT OR ADMINISTRATIVE AGENCY THAT ISSUED THE SUBPOENA OR IN WHICH THE ACTION IS PENDING AS SHOWN ON THE SUBPOENA USING THE FOLLOWING PROCEDURE:\n\t\t\t\tPLACE THE HEALTH RECORDS IN A SEALED ENVELOPE AND ATTACH TO THE SEALED ENVELOPE A COVER LETTER TO THE CLERK OF COURT OR ADMINISTRATIVE AGENCY WHICH STATES THAT CONFIDENTIAL HEALTH RECORDS ARE ENCLOSED AND ARE TO BE HELD UNDER SEAL PENDING A RULING ON THE MOTION TO QUASH THE SUBPOENA. THE SEALED ENVELOPE AND THE COVER LETTER SHALL BE PLACED IN AN OUTER ENVELOPE OR PACKAGE FOR TRANSMITTAL TO THE COURT OR ADMINISTRATIVE AGENCY.","type":"section","prefixes":["H","2"],"prefix":"2","entire_prefix":"H2","prefix_anchor":"H2","level":2,"prior_prefix":"H1","next_prefix":"H3"},"54":{"id":216098,"text":"Upon receiving a valid subpoena duces tecum for health records, health care entities shall have the duty to respond to the subpoena in accordance with the provisions of subdivisions 4, 5, 6, 7, and 8.","type":"section","prefixes":["H","3"],"prefix":"3","entire_prefix":"H3","prefix_anchor":"H3","level":2,"prior_prefix":"H2","next_prefix":"H4"},"55":{"id":216099,"text":"Except to deliver to a clerk of the court or administrative agency subpoenaed health records in a sealed envelope as set forth, health care entities shall not respond to a subpoena duces tecum for such health records until they have received a certification as set forth in subdivision 5 or 8 from the party on whose behalf the subpoena duces tecum was issued.\n\t\t\t\tIf the health care entity has actual receipt of notice that a motion to quash the subpoena has been filed or if the health care entity files a motion to quash the subpoena for health records, then the health care entity shall produce the health records, in a securely sealed envelope, to the clerk of the court or administrative agency issuing the subpoena or in whose court or administrative agency the action is pending. The court or administrative agency shall place the health records under seal until a determination is made regarding the motion to quash. The securely sealed envelope shall only be opened on order of the judge or administrative agency. In the event the court or administrative agency grants the motion to quash, the health records shall be returned to the health care entity in the same sealed envelope in which they were delivered to the court or administrative agency. In the event that a judge or administrative agency orders the sealed envelope to be opened to review the health records in camera, a copy of the order shall accompany any health records returned to the health care entity. The health records returned to the health care entity shall be in a securely sealed envelope.","type":"section","prefixes":["H","4"],"prefix":"4","entire_prefix":"H4","prefix_anchor":"H4","level":2,"prior_prefix":"H3","next_prefix":"H5"},"56":{"id":216100,"text":"If no motion to quash is filed within 15 days of the date of the request or of the attorney-issued subpoena, the party on whose behalf the subpoena was issued shall have the duty to certify to the subpoenaed health care entity that the time for filing a motion to quash has elapsed and that no motion to quash was filed. Any health care entity receiving such certification shall have the duty to comply with the subpoena duces tecum by returning the specified health records by either the return date on the subpoena or five days after receipt of the certification, whichever is later.","type":"section","prefixes":["H","5"],"prefix":"5","entire_prefix":"H5","prefix_anchor":"H5","level":2,"prior_prefix":"H4","next_prefix":"H6"},"57":{"id":216101,"text":"In the event that the individual whose health records are being sought files a motion to quash the subpoena, the court or administrative agency shall decide whether good cause has been shown by the discovering party to compel disclosure of the individual’s health records over the individual’s objections. In determining whether good cause has been shown, the court or administrative agency shall consider (i) the particular purpose for which the information was collected; (ii) the degree to which the disclosure of the records would embarrass, injure, or invade the privacy of the individual; (iii) the effect of the disclosure on the individual’s future health care; (iv) the importance of the information to the lawsuit or proceeding; and (v) any other relevant factor.","type":"section","prefixes":["H","6"],"prefix":"6","entire_prefix":"H6","prefix_anchor":"H6","level":2,"prior_prefix":"H5","next_prefix":"H7"},"58":{"id":216102,"text":"Concurrent with the court or administrative agency’s resolution of a motion to quash, if subpoenaed health records have been submitted by a health care entity to the court or administrative agency in a sealed envelope, the court or administrative agency shall: (i) upon determining that no submitted health records should be disclosed, return all submitted health records to the health care entity in a sealed envelope; (ii) upon determining that all submitted health records should be disclosed, provide all the submitted health records to the party on whose behalf the subpoena was issued; or (iii) upon determining that only a portion of the submitted health records should be disclosed, provide such portion to the party on whose behalf the subpoena was issued and return the remaining health records to the health care entity in a sealed envelope.","type":"section","prefixes":["H","7"],"prefix":"7","entire_prefix":"H7","prefix_anchor":"H7","level":2,"prior_prefix":"H6","next_prefix":"H8"},"59":{"id":216103,"text":"Following the court or administrative agency’s resolution of a motion to quash, the party on whose behalf the subpoena duces tecum was issued shall have the duty to certify in writing to the subpoenaed health care entity a statement of one of the following:\n\t\t\t\ta. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are consistent with such resolution; and, therefore, the health records previously delivered in a sealed envelope to the clerk of the court or administrative agency will not be returned to the health care entity;\n\t\t\t\tb. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are consistent with such resolution and that, since no health records have previously been delivered to the court or administrative agency by the health care entity, the health care entity shall comply with the subpoena duces tecum by returning the health records designated in the subpoena by the return date on the subpoena or five days after receipt of certification, whichever is later;\n\t\t\t\tc. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are not consistent with such resolution; therefore, no health records shall be disclosed and all health records previously delivered in a sealed envelope to the clerk of the court or administrative agency will be returned to the health care entity;\n\t\t\t\td. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are not consistent with such resolution and that only limited disclosure has been authorized. The certification shall state that only the portion of the health records as set forth in the certification, consistent with the court or administrative agency’s ruling, shall be disclosed. The certification shall also state that health records that were previously delivered to the court or administrative agency for which disclosure has been authorized will not be returned to the health care entity; however, all health records for which disclosure has not been authorized will be returned to the health care entity; or\n\t\t\t\te. All filed motions to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum are not consistent with such resolution and, since no health records have previously been delivered to the court or administrative agency by the health care entity, the health care entity shall return only those health records specified in the certification, consistent with the court or administrative agency’s ruling, by the return date on the subpoena or five days after receipt of the certification, whichever is later.\n\t\t\t\tA copy of the court or administrative agency’s ruling shall accompany any certification made pursuant to this subdivision.","type":"section","prefixes":["H","8"],"prefix":"8","entire_prefix":"H8","prefix_anchor":"H8","level":2,"prior_prefix":"H7","next_prefix":"H9"},"60":{"id":216104,"text":"The provisions of this subsection have no application to subpoenas for health records requested under § 8.01-413, or issued by a duly authorized administrative agency conducting an investigation, audit, review or proceedings regarding a health care entity’s conduct.\n\t\t\t\tThe provisions of this subsection shall apply to subpoenas for the health records of both minors and adults.\n\t\t\t\tNothing in this subsection shall have any effect on the existing authority of a court or administrative agency to issue a protective order regarding health records, including, but not limited to, ordering the return of health records to a health care entity, after the period for filing a motion to quash has passed.\n\t\t\t\tA subpoena for substance abuse records must conform to the requirements of federal law found in 42 C.F.R. Part 2, Subpart E.","type":"section","prefixes":["H","9"],"prefix":"9","entire_prefix":"H9","prefix_anchor":"H9","level":2,"prior_prefix":"H8","next_prefix":"I"},"61":{"id":216105,"text":"Health care entities may testify about the health records of an individual in compliance with §§ 8.01-399 and 8.01-400.2.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H9","next_prefix":"J"},"62":{"id":216106,"text":"Except as provided by subsection B7 of § 8.01-413, if an individual requests a copy of his health record from a health care entity, the health care entity may impose a reasonable cost-based fee, which shall include only the cost of supplies for and labor of copying the requested information, postage when the individual requests that such information be mailed, and preparation of an explanation or summary of such information as agreed to by the individual. For the purposes of this section, “individual” shall subsume a person with authority to act on behalf of the individual who is the subject of the health record in making decisions related to his health care.","type":"section","prefixes":["J"],"prefix":"J","entire_prefix":"J","prefix_anchor":"J","level":1,"prior_prefix":"I","next_prefix":"K"},"63":{"id":216107,"text":"Nothing in this section shall prohibit a health care provider who prescribes or dispenses a controlled substance required to be reported to the Prescription Monitoring Program established pursuant to Chapter 25.2 (§ 54.1-2519 et seq.) of Title 54.1 to a patient from disclosing information obtained from the Prescription Monitoring Program and contained in a patient’s health care record to another health care provider when such disclosure is related to the care or treatment of the patient who is the subject of the record.","type":"section","prefixes":["K"],"prefix":"K","entire_prefix":"K","prefix_anchor":"K","level":1,"prior_prefix":"J","next_prefix":"L"},"64":{"id":216108,"text":"An authorization for the disclosure of health records executed pursuant to this section shall remain in effect until (i) the authorization is revoked in writing and delivered to the health care entity maintaining the record that is subject to the authorization by the person who executed the authorization, (ii) any expiration date set forth in the authorization, or (iii) the health care entity maintaining the record becomes aware of any expiration event described in the authorization, whichever occurs first. However, any revocation of an authorization for the disclosure of health records executed pursuant to this section shall not be effective to the extent that the health care entity maintaining the record has disclosed health records prior to delivery of such revocation in reliance upon the authorization or as otherwise provided pursuant to 45 C.F.R. § 164.508. A statement in an authorization for the disclosure of health records pursuant to this section that the information to be used or disclosed is “all health records” is a sufficient description for the disclosure of all health records of the person maintained by the health care provider to whom the authorization was granted. If a health care provider receives a written revocation of an authorization for the disclosure of health records in accordance with this subsection, a copy of such written revocation shall be included in the person’s original health record maintained by the health care provider.\n\t\t\tAn authorization for the disclosure of health records executed pursuant to this section shall, unless otherwise expressly limited in the authorization, be deemed to include authorization for the person named in the authorization to assist the person who is the subject of the health record in accessing health care services, including scheduling appointments for the person who is the subject of the health record and attending appointments together with the person who is the subject of the health record.","type":"section","prefixes":["L"],"prefix":"L","entire_prefix":"L","prefix_anchor":"L","level":1,"prior_prefix":"K"}},"ancestry":[{"id":12729,"edition_id":1,"name":"Hospital and Nursing Home Licensure and Inspection","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":12728,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":202857,"object_type":"structure","relational_id":12729,"identifier":"1","token":"32.1\/5\/1","url":"\/32.1\/5\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12728,"edition_id":1,"name":"Regulation of Medical Care Facilities and Services","identifier":"5","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":202855,"object_type":"structure","relational_id":12728,"identifier":"5","token":"32.1\/5","url":"\/32.1\/5\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":80727,"structure_id":12729,"section_number":"32.1-123","catch_line":"(Effective January 1, 2026) Definitions","url":"\/32.1-123\/","token":"32.1\/5\/1\/32.1-123","metadata":false},{"id":75042,"structure_id":12729,"section_number":"32.1-124","catch_line":"Exemptions","url":"\/32.1-124\/","token":"32.1\/5\/1\/32.1-124","metadata":false},{"id":58545,"structure_id":12729,"section_number":"32.1-125","catch_line":"Establishment or operation of hospitals and nursing homes prohibited without license or certification; 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This law was first created in 1997. The record of its establishment is cataloged in chapter 682<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 21 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1998, chapter 470<\/a>; in 1999, chapters 812<\/a>, 956<\/a>, and 1010<\/a>; in 2000, chapters 810<\/a>, 813<\/a>, 923<\/a>, and 927<\/a>; in 2001, chapter 671<\/a>; in 2002, chapters 568<\/a>, 658<\/a>, 835<\/a>, and 860<\/a>; in 2003, chapters 471<\/a>, 907<\/a>, and 983<\/a>; in 2004, chapters 49<\/a>, 64<\/a>, 65<\/a>, 66<\/a>, 67<\/a>, 163<\/a>, 773<\/a>, 1014<\/a>, and 1021<\/a>; in 2005, chapters 39<\/a>, 101<\/a>, 642<\/a>, and 697<\/a>; in 2006, chapter 433<\/a>; in 2007, chapter 497<\/a>; in 2008, chapters 315<\/a>, 782<\/a>, 850<\/a>, and 870<\/a>; in 2009, chapters 606<\/a>, 651<\/a>, 813<\/a>, and 840<\/a>; in 2010, chapters 185<\/a>, 340<\/a>, 406<\/a>, 456<\/a>, 524<\/a>, 778<\/a>, and 825<\/a>; in 2011, chapters 499<\/a>, 668<\/a>, 798<\/a>, 812<\/a>, 844<\/a>, and 871<\/a>; in 2012, chapters 386<\/a>, 402<\/a>, and 479<\/a>; in 2016, chapter 554<\/a>; in 2017, chapters 457<\/a>, 712<\/a>, and 720<\/a>; in 2018, chapter 165<\/a>; in 2020, chapter 945<\/a>; in 2022, chapters 509<\/a>, 534<\/a>, and 784<\/a>; in 2025, chapter 182<\/a>.<\/p>","references":[{"id":77469,"section_number":"16.1-248.3","catch_line":"Medical records of juveniles in secure facility","order_by":null,"url":"\/16.1-248.3\/"},{"id":76322,"section_number":"16.1-265","catch_line":"Subpoena; attorney-issued subpoena","order_by":null,"url":"\/16.1-265\/"},{"id":81231,"section_number":"16.1-337","catch_line":"Inpatient treatment of minors; general applicability; disclosure of records","order_by":null,"url":"\/16.1-337\/"},{"id":73502,"section_number":"16.1-89","catch_line":"Subpoena duces tecum; attorney-issued subpoena duces tecum","order_by":null,"url":"\/16.1-89\/"},{"id":78807,"section_number":"18.2-61.1","catch_line":"Testing of certain persons for sexually transmitted infections","order_by":null,"url":"\/18.2-61.1\/"},{"id":74594,"section_number":"19.2-10.4","catch_line":"Subpoena duces tecum; attorney-issued subpoena duces tecum","order_by":null,"url":"\/19.2-10.4\/"},{"id":74002,"section_number":"19.2-169.6","catch_line":"Inpatient psychiatric hospital admission from local correctional facility","order_by":null,"url":"\/19.2-169.6\/"},{"id":69909,"section_number":"2.2-3705.4","catch_line":"Exclusions to application of chapter; educational records and certain records of educational institutions","order_by":null,"url":"\/2.2-3705.4\/"},{"id":60253,"section_number":"2.2-3705.5","catch_line":"Exclusions to application of chapter; health and social services records","order_by":null,"url":"\/2.2-3705.5\/"},{"id":77145,"section_number":"20-124.6","catch_line":"Access to minor's records","order_by":null,"url":"\/20-124.6\/"},{"id":58943,"section_number":"22.1-79.4","catch_line":"Threat assessment teams and oversight committees","order_by":null,"url":"\/22.1-79.4\/"},{"id":68118,"section_number":"23.1-805","catch_line":"Violence prevention committee; threat assessment team","order_by":null,"url":"\/23.1-805\/"},{"id":79931,"section_number":"23.1-806","catch_line":"Reporting of acts of sexual violence","order_by":null,"url":"\/23.1-806\/"},{"id":85883,"section_number":"32.1-127","catch_line":"(Effective January 1, 2026) Regulations","order_by":null,"url":"\/32.1-127\/"},{"id":81314,"section_number":"32.1-127.1:01","catch_line":"Record storage","order_by":null,"url":"\/32.1-127.1_01\/"},{"id":85887,"section_number":"32.1-276.7:1","catch_line":"All-Payer Claims Database created; 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A.<\/span> There is hereby recognized an individual<\/span>’s right of privacy in the content of his health records<\/span>. Health records<\/span> are the property of the health care entity<\/span> maintaining them, and, except when permitted or required by this section or by other provisions of state law<\/span>, no health care entity<\/span>, or other person<\/span> working in a health care setting, may disclose an individual<\/span>’s health records<\/span>.\n\t\t\tPursuant to this subsection: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Health care entities shall disclose health records<\/span> to the individual<\/span> who is the subject of the health record<\/span>, including an audit trail of any additions, deletions, or revisions to the health record<\/span>, if specifically requested, except as provided in subsections E and F and subsection B of § 8.01-413<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Health records<\/span> shall not be removed from the premises where they are maintained without the approval of the health care entity<\/span> that maintains such health records<\/span>, except in accordance with a court order<\/span> or subpoena<\/span> consistent with subsection C of § 8.01-413<\/a> or with this section or in accordance with the regulations relating to change of ownership of health records<\/span> promulgated by a health regulatory board<\/span> established in Title 54.1. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> No person<\/span> to whom health records<\/span> are disclosed shall redisclose or otherwise reveal the health records<\/span> of an individual<\/span>, beyond the purpose for which such disclosure was made, without first obtaining the individual<\/span>’s specific authorization to such redisclosure. This redisclosure prohibition shall not, however, prevent (i) any health care entity<\/span> that receives health records<\/span> from another health care entity<\/span> from making subsequent disclosures as permitted under this section and the federal Department<\/span> of Health and Human Services regulations relating to privacy of the electronic transmission of data and protected health information promulgated by the United States Department<\/span> of Health and Human Services as required by the Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.) or (ii) any health care entity<\/span> from furnishing health records<\/span> and aggregate or other data, from which individually identifying prescription information<\/span> has been removed, encoded or encrypted, to qualified researchers, including, but not limited to, pharmaceutical manufacturers and their agents<\/span> or contractors, for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or other health services research. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Health care entities shall, upon the request of the individual<\/span> who is the subject of the health record<\/span>, disclose health records<\/span> to other health care entities, in any available format of the requester’s choosing, as provided in subsection E. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> As used in this section:\n\t\t\t“Agent<\/span>” means a person<\/span> who has been appointed as an individual<\/span>’s agent<\/span> under a power of attorney<\/span> for health care or an advance directive under the Health Care Decisions Act (§ 54.1-2981<\/a> et seq.).\n\t\t\t“Certification<\/span>” means a written representation that is delivered by hand, by first-class mail, by overnight delivery service, or by facsimile if the sender obtains a facsimile-machine-generated confirmation reflecting that all facsimile pages were successfully transmitted.\n\t\t\t“Guardian<\/span>” means a court-appointed guardian<\/span> of the person<\/span>.\n\t\t\t“Health care clearinghouse” means, consistent with the definition set out in 45 C.F.R. § 160.103, a public or private entity, such as a billing service, repricing company, community health management information system or community health information system, and “value-added” networks and switches, that performs either of the following functions: (i) processes or facilitates the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction; or (ii) receives a standard transaction from another entity and processes or facilitates the processing of health information into nonstandard format or nonstandard data content for the receiving entity.\n\t\t\t“Health care entity<\/span>” means any health care provider<\/span>, health plan<\/span> or health care clearinghouse.\n\t\t\t“Health care provider<\/span>” means those entities listed in the definition of “health care provider<\/span>” in § 8.01-581.1<\/a>, except that state-operated facilities shall also be considered health care providers<\/span> for the purposes of this section. Health care provider<\/span> shall also include all persons<\/span> who are licensed, certified, registered or permitted or who hold a multistate licensure privilege<\/span> issued by any of the health regulatory boards<\/span> within the Department<\/span> of Health Professions, except persons<\/span> regulated by the Board<\/span> of Funeral Directors and Embalmers or the Board<\/span> of Veterinary Medicine.\n\t\t\t“Health plan<\/span>” means an individual<\/span> or group plan that provides, or pays the cost of, medical care. “Health plan<\/span>” includes any entity included in such definition as set out in 45 C.F.R. § 160.103.\n\t\t\t“Health record<\/span>” means any written, printed or electronically recorded material<\/span> maintained by a health care entity<\/span> in the course of providing health services to an individual<\/span> concerning the individual<\/span> and the services provided. “Health record<\/span>” also includes the substance of any communication made by an individual<\/span> to a health care entity<\/span> in confidence during or in connection with the provision of health services or information otherwise acquired by the health care entity<\/span> about an individual<\/span> in confidence and in connection with the provision of health services to the individual<\/span>.\n\t\t\t“Health services” means, but shall not be limited to, examination, diagnosis, evaluation, treatment, pharmaceuticals, aftercare, habilitation or rehabilitation and mental health therapy of any kind, as well as payment or reimbursement for any such services.\n\t\t\t“Individual<\/span>” means a patient who is receiving or has received health services from a health care entity<\/span>.\n\t\t\t“Individually identifying prescription information<\/span>” means all prescriptions, drug orders<\/span> or any other prescription information that specifically identifies an individual<\/span>.\n\t\t\t“Parent<\/span>” means a biological, adoptive or foster parent<\/span>.\n\t\t\t“Psychotherapy notes<\/span>” means comments, recorded in any medium by a health care provider<\/span> who is a mental health professional, documenting or analyzing the contents of conversation during a private counseling session with an individual<\/span> or a group, joint, or family counseling session that are separated from the rest of the individual<\/span>’s health record<\/span>. “Psychotherapy notes<\/span>” does not include annotations relating to medication and prescription monitoring, counseling session start and stop times, treatment modalities and frequencies, clinical test results, or any summary of any symptoms, diagnosis, prognosis, functional status, treatment plan, or the individual<\/span>’s progress to date. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The provisions of this section shall not apply to any of the following: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> The status of and release of information governed by §§ 65.2-604<\/a> and 65.2-607<\/a> of the Virginia Workers’ Compensation Act; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Except where specifically provided herein, the health records<\/span> of minors<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The release of juvenile health records<\/span> to a secure facility or a shelter care facility pursuant to § 16.1-248.3<\/a>; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> The release of health records<\/span> to a state correctional facility pursuant to § 53.1-40.10<\/a> or a local or regional correctional facility pursuant to § 53.1-133.03<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Health care entities may, and, when required by other provisions of state law<\/span>, shall, disclose health records<\/span>: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> As set forth in subsection E, pursuant to the written authorization of (i) the individual<\/span> or (ii) in the case of a minor<\/span>, (a) his custodial parent<\/span>, guardian<\/span> or other person<\/span> authorized to consent to treatment of minors<\/span> pursuant to § 54.1-2969<\/a> or (b) the minor<\/span> himself, if he has consented to his own treatment pursuant to § 54.1-2969<\/a>, or (iii) in emergency cases or situations where it is impractical to obtain an individual<\/span>’s written authorization, pursuant to the individual<\/span>’s oral authorization for a health care provider<\/span> or health plan<\/span> to discuss the individual<\/span>’s health records<\/span> with a third party<\/span> specified by the individual<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> In compliance with a subpoena<\/span> issued in accord with subsection H, pursuant to a search warrant<\/span> or a grand jury<\/span> subpoena<\/span>, pursuant to court order<\/span> upon good cause shown or in compliance with a subpoena<\/span> issued pursuant to subsection C of § 8.01-413<\/a>. Regardless of the manner by which health records<\/span> relating to an individual<\/span> are compelled to be disclosed pursuant to this subdivision, nothing in this subdivision shall be construed to prohibit any staff or employee of a health care entity<\/span> from providing information about such individual<\/span> to a law<\/span>-enforcement officer in connection with such subpoena<\/span>, search warrant<\/span>, or court order<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> In accord with subsection F of § 8.01-399<\/a> including, but not limited to, situations where disclosure is reasonably necessary to establish or collect a fee or to defend a health care entity<\/span> or the health care entity<\/span>’s employees or staff against any accusation of wrongful conduct; also as required in the course of an investigation, audit, review or proceedings regarding a health care entity<\/span>’s conduct by a duly authorized law<\/span>-enforcement, licensure, accreditation, or professional review entity; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> In testimony<\/span> in accordance with §§ 8.01-399<\/a> and 8.01-400.2<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> In compliance with the provisions of § 8.01-413<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> As required or authorized by law<\/span> relating to public health activities, health oversight activities, serious threats to health or safety, or abuse, neglect or domestic violence, relating to contagious disease, public safety, and suspected child or adult abuse reporting requirements, including, but not limited to, those contained in §§ 16.1-248.3<\/a>, 32.1-36<\/a>, 32.1-36.1<\/a>, 32.1-40<\/a>, 32.1-41<\/a>, 32.1-127.1:04<\/a>, 32.1-276.5<\/a>, 32.1-283<\/a>, 32.1-283.1<\/a>, 32.1-320<\/a>, 37.2-710<\/a>, 37.2-839<\/a>, 53.1-40.10<\/a>, 53.1-133.03<\/a>, 54.1-2400.6<\/a>, 54.1-2400.7<\/a>, 54.1-2400.9<\/a>, 54.1-2403.3<\/a>, 54.1-2506<\/a>, 54.1-2966<\/a>, 54.1-2967<\/a>, 54.1-2968<\/a>, 54.1-3408.2<\/a>, 63.2-1509<\/a>, and 63.2-1606<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Where necessary in connection with the care of the individual<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> In connection with the health care entity<\/span>’s own health care operations or the health care operations of another health care entity<\/span>, as specified in 45 C.F.R. § 164.501, or in the normal course of business in accordance with accepted standards of practice within the health services setting; however, the maintenance, storage, and disclosure of the mass of prescription dispensing records maintained in a pharmacy registered or permitted in Virginia shall only be accomplished in compliance with §§ 54.1-3410<\/a>, 54.1-3411<\/a>, and 54.1-3412<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

9.<\/span> When the individual<\/span> has waived his right to the privacy of the health records<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

10.<\/span> When examination and evaluation of an individual<\/span> are undertaken pursuant to judicial or administrative law<\/span> order, but only to the extent as required by such order; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

11.<\/span> To the guardian ad litem<\/span> and any attorney representing the respondent in the course of a guardianship proceeding of an adult patient who is the respondent in a proceeding under Chapter 20 (§ 64.2-2000<\/a> et seq.) of Title 64.2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

12.<\/span> To the guardian ad litem<\/span> and any attorney appointed by the court to represent an individual<\/span> who is or has been a patient who is the subject of a commitment proceeding under § 19.2-169.6<\/a>, Article 5 (§ 37.2-814<\/a> et seq.) of Chapter 8 of Title 37.2, Article 16 (§ 16.1-335<\/a> et seq.) of Chapter 11 of Title 16.1, or a judicial authorization for treatment proceeding pursuant to Chapter 11 (§ 37.2-1100<\/a> et seq.) of Title 37.2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

13.<\/span> To a magistrate<\/span>, the court, the evaluator or examiner required under Article 16 (§ 16.1-335<\/a> et seq.) of Chapter 11 of Title 16.1 or § 37.2-815<\/a>, a community services<\/span> board<\/span> or behavioral health authority or a designee of a community services<\/span> board<\/span> or behavioral health authority, or a law<\/span>-enforcement officer participating in any proceeding under Article 16 (§ 16.1-335<\/a> et seq.) of Chapter 11 of Title 16.1, § 19.2-169.6<\/a>, or Chapter 8 (§ 37.2-800<\/a> et seq.) of Title 37.2 regarding the subject of the proceeding, and to any health care provider<\/span> evaluating or providing services to the person<\/span> who is the subject of the proceeding or monitoring the person<\/span>’s adherence to a treatment plan ordered under those provisions. Health records<\/span> disclosed to a law<\/span>-enforcement officer shall be limited to information necessary to protect the officer, the person<\/span>, or the public from physical injury or to address the health care needs of the person<\/span>. Information disclosed to a law<\/span>-enforcement officer shall not be used for any other purpose, disclosed to others, or retained; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

14.<\/span> To the attorney and\/or guardian ad litem<\/span> of a minor<\/span> who represents such minor<\/span> in any judicial or administrative proceeding, if the court or administrative hearing<\/span> officer has entered an order granting the attorney or guardian ad litem<\/span> this right and such attorney or guardian ad litem<\/span> presents evidence<\/span> to the health care entity<\/span> of such order; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

15.<\/span> With regard to the Court-Appointed Special Advocate (CASA) program, a minor<\/span>’s health records<\/span> in accord with § 9.1-156<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

16.<\/span> To an agent<\/span> appointed under an individual<\/span>’s power of attorney<\/span> or to an agent<\/span> or decision maker designated in an individual<\/span>’s advance directive for health care or for decisions on anatomical gifts and organ, tissue or eye donation or to any other person<\/span> consistent with the provisions of the Health Care Decisions Act (§ 54.1-2981<\/a> et seq.); <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

17.<\/span> To third-party<\/span> payors and their agents<\/span> for purposes of reimbursement; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

18.<\/span> As is necessary to support an application for receipt of health care benefits from a governmental agency or as required by an authorized governmental agency reviewing such application or reviewing benefits already provided or as necessary to the coordination of prevention and control of disease, injury, or disability and delivery of such health care benefits pursuant to § 32.1-127.1:04<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

19.<\/span> Upon the sale of a medical practice as provided in § 54.1-2405<\/a>; or upon a change of ownership or closing of a pharmacy pursuant to regulations of the Board<\/span> of Pharmacy; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

20.<\/span> In accord with subsection B of § 54.1-2400.1<\/a>, to communicate an individual<\/span>’s specific and immediate threat to cause serious bodily injury or death of an identified or readily identifiable person<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

21.<\/span> Where necessary in connection with the implementation of a hospital<\/span>’s routine contact process for organ donation pursuant to subdivision B 4 of § 32.1-127<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

22.<\/span> In the case of substance abuse records, when permitted by and in conformity with requirements of federal law<\/span> found in 42 U.S.C. § 290dd-2 and 42 C.F.R. Part 2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

23.<\/span> In connection with the work of any entity established as set forth in § 8.01-581.16<\/a> to evaluate the adequacy or quality of professional services or the competency and qualifications for professional staff privileges<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

24.<\/span> If the health records<\/span> are those of a deceased or mentally incapacitated individual<\/span> to the personal representative or executor of the deceased individual<\/span> or the legal guardian or committee of the incompetent or incapacitated individual<\/span> or if there is no personal representative, executor, legal guardian or committee appointed, to the following persons<\/span> in the following order of priority: a spouse, an adult son or daughter, either parent<\/span>, an adult brother or sister, or any other relative of the deceased individual<\/span> in order of blood relationship; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

25.<\/span> For the purpose of conducting record reviews of inpatient hospital<\/span> deaths to promote identification of all potential organ, eye, and tissue donors in conformance with the requirements of applicable federal law<\/span> and regulations, including 42 C.F.R. § 482.45, (i) to the health care provider<\/span>’s designated organ procurement organization certified by the United States Health Care Financing Administration and (ii) to any eye bank or tissue bank in Virginia certified by the Eye Bank Association of America or the American Association of Tissue Banks; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

26.<\/span> To the Office of the State Inspector General pursuant to Chapter 3.2 (§ 2.2-307<\/a> et seq.) of Title 2.2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

27.<\/span> To an entity participating in the activities of a local health partnership authority established pursuant to Article 6.1 (§ 32.1-122.10:001<\/a> et seq.) of Chapter 4, pursuant to subdivision 1; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

28.<\/span> To law<\/span>-enforcement officials by each licensed emergency medical services agency, (i) when the individual<\/span> is the victim of a crime<\/span> or (ii) when the individual<\/span> has been arrested and has received emergency medical services or has refused emergency medical services and the health records<\/span> consist of the prehospital patient care report required by § 32.1-116.1<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

29.<\/span> To law<\/span>-enforcement officials, in response to their request, for the purpose of identifying or locating a suspect, fugitive, person<\/span> required to register pursuant to § 9.1-901<\/a> of the Sex Offender and Crimes<\/span> Against Minors<\/span> Registry Act, material witness<\/span>, or missing person<\/span>, provided that only the following information may be disclosed: (i) name and address of the person<\/span>, (ii) date and place of birth of the person<\/span>, (iii) social security number of the person<\/span>, (iv) blood type of the person<\/span>, (v) date and time of treatment received by the person<\/span>, (vi) date and time of death of the person<\/span>, where applicable, (vii) description of distinguishing physical characteristics of the person<\/span>, and (viii) type of injury sustained by the person<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

30.<\/span> To law<\/span>-enforcement officials regarding the death of an individual<\/span> for the purpose of alerting law<\/span> enforcement of the death if the health care entity<\/span> has a suspicion that such death may have resulted from criminal conduct; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

31.<\/span> To law<\/span>-enforcement officials if the health care entity<\/span> believes in good faith that the information disclosed constitutes evidence<\/span> of a crime<\/span> that occurred on its premises; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

32.<\/span> To the State Health Commissioner<\/span> pursuant to § 32.1-48.015<\/a> when such records are those of a person<\/span> or persons<\/span> who are subject to an order of quarantine or an order of isolation pursuant to Article 3.02 (§ 32.1-48.05<\/a> et seq.) of Chapter 2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

33.<\/span> To the Commissioner<\/span> of the Department<\/span> of Labor and Industry or his designee by each licensed emergency medical services agency when the records consist of the prehospital patient care report required by § 32.1-116.1<\/a> and the patient has suffered an injury or death on a work site while performing duties or tasks that are within the scope of his employment; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

34.<\/span> To notify a family member or personal representative of an individual<\/span> who is the subject of a proceeding pursuant to Article 16 (§ 16.1-335<\/a> et seq.) of Chapter 11 of Title 16.1 or Chapter 8 (§ 37.2-800<\/a> et seq.) of Title 37.2 of information that is directly relevant to such person<\/span>’s involvement with the individual<\/span>’s health care, which may include the individual<\/span>’s location and general condition, when the individual<\/span> has the capacity to make health care decisions and (i) the individual<\/span> has agreed to the notification, (ii) the individual<\/span> has been provided an opportunity to object<\/span> to the notification and does not express an objection, or (iii) the health care provider<\/span> can, on the basis of his professional judgment<\/span>, reasonably infer from the circumstances that the individual<\/span> does not object<\/span> to the notification. If the opportunity to agree or object<\/span> to the notification cannot practicably be provided because of the individual<\/span>’s incapacity or an emergency circumstance, the health care provider<\/span> may notify a family member or personal representative of the individual<\/span> of information that is directly relevant to such person<\/span>’s involvement with the individual<\/span>’s health care, which may include the individual<\/span>’s location and general condition if the health care provider<\/span>, in the exercise of his professional judgment<\/span>, determines that the notification is in the best interests of the individual<\/span>. Such notification shall not be made if the provider has actual knowledge the family member or personal representative is currently prohibited by court order<\/span> from contacting the individual<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

35.<\/span> To a threat assessment team established by a local school board<\/span> pursuant to § 22.1-79.4<\/a>, by a public institution of higher education pursuant to § 23.1-805<\/a>, or by a private nonprofit institution of higher education; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

36.<\/span> To a regional emergency medical services council pursuant to § 32.1-116.1<\/a>, for purposes limited to monitoring and improving the quality of emergency medical services pursuant to § 32.1-111.3<\/a>.\n\t\t\t\tNotwithstanding the provisions of subdivisions 1 through 35, a health care entity<\/span> shall obtain an individual<\/span>’s written authorization for any disclosure of psychotherapy notes<\/span>, except when disclosure by the health care entity<\/span> is (i) for its own training programs in which students, trainees, or practitioners in mental health are being taught under supervision to practice or to improve their skills in group, joint, family, or individual<\/span> counseling; (ii) to defend itself or its employees or staff against any accusation of wrongful conduct; (iii) in the discharge of the duty, in accordance with subsection B of § 54.1-2400.1<\/a>, to take precautions to protect third parties from violent behavior or other serious harm; (iv) required in the course of an investigation, audit, review, or proceeding regarding a health care entity<\/span>’s conduct by a duly authorized law<\/span>-enforcement, licensure, accreditation, or professional review entity; or (v) otherwise required by law<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Health care records required to be disclosed pursuant to this section shall be made available electronically only to the extent and in the manner authorized by the federal Health Information Technology for Economic and Clinical Health Act (P.L. 111-5) and implementing regulations and the Health Insurance Portability and Accountability Act (42 U.S.C. § 1320d et seq.) and implementing regulations. Notwithstanding any other provision to the contrary, a health care entity<\/span> shall not be required to provide records in an electronic format requested if (i) the electronic format is not reasonably available without additional cost to the health care entity<\/span>, (ii) the records would be subject to modification in the format requested, or (iii) the health care entity<\/span> determines that the integrity of the records could be compromised in the electronic format requested. Requests for copies of or electronic access to health records<\/span> shall (a) be in writing, dated and signed by the requester; (b) identify the nature of the information requested; and (c) include evidence<\/span> of the authority of the requester to receive such copies or access such records, and identification of the person<\/span> to whom the information is to be disclosed; and (d) specify whether the requester would like the records in electronic format, if available, or in paper format. The health care entity<\/span> shall accept a photocopy, facsimile, or other copy of the original signed by the requester as if it were an original. Within 30 days of receipt of a request for copies of or electronic access to health records<\/span>, the health care entity<\/span> shall do one of the following: (1) furnish such copies of or allow electronic access to the requested health records<\/span> to any requester authorized to receive them in electronic format if so requested; (2) inform the requester if the information does not exist or cannot be found; (3) if the health care entity<\/span> does not maintain a record of the information, so inform the requester and provide the name and address, if known, of the health care entity<\/span> who maintains the record; or (4) deny the request (A) under subsection F, (B) on the grounds that the requester has not established his authority to receive such health records<\/span> or proof of his identity, or (C) as otherwise provided by law<\/span>. Procedures set forth in this section shall apply only to requests for health records<\/span> not specifically governed by other provisions of state law<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> Except as provided in subsection B of § 8.01-413<\/a>, copies of or electronic access to an individual<\/span>’s health records<\/span> shall not be furnished to such individual<\/span> or anyone authorized to act on the individual<\/span>’s behalf when the individual<\/span>’s treating physician, clinical psychologist, clinical social worker, or licensed professional counselor has made a part of the individual<\/span>’s record a written statement that, in the exercise of his professional judgment<\/span>, the furnishing to or review by the individual<\/span> of such health records<\/span> would be reasonably likely to endanger the life or physical safety of the individual<\/span> or another person<\/span>, or that such health record<\/span> makes reference to a person<\/span> other than a health care provider<\/span> and the access requested would be reasonably likely to cause substantial harm to such referenced person<\/span>. If any health care entity<\/span> denies a request for copies of or electronic access to health records<\/span> based on such statement, the health care entity<\/span> shall inform the individual<\/span> of the individual<\/span>’s right to designate, in writing, at his own expense, another reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor whose licensure, training and experience relative to the individual<\/span>’s condition are at least equivalent to that of the physician, clinical psychologist, clinical social worker, or licensed professional counselor upon whose opinion<\/span> the denial is based. The designated reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor shall make a judgment<\/span> as to whether to make the health record<\/span> available to the individual<\/span>.\n\t\t\tThe health care entity<\/span> denying the request shall also inform the individual<\/span> of the individual<\/span>’s right to request in writing that such health care entity<\/span> designate, at its own expense, a physician, clinical psychologist, clinical social worker, or licensed professional counselor, whose licensure, training, and experience relative to the individual<\/span>’s condition are at least equivalent to that of the physician, clinical psychologist, clinical social worker, or licensed professional counselor upon whose professional judgment<\/span> the denial is based and who did not participate in the original decision to deny the health records<\/span>, who shall make a judgment<\/span> as to whether to make the health record<\/span> available to the individual<\/span>. The health care entity<\/span> shall comply with the judgment<\/span> of the reviewing physician, clinical psychologist, clinical social worker, or licensed professional counselor. The health care entity<\/span> shall permit copying and examination of the health record<\/span> by such other physician, clinical psychologist, clinical social worker, or licensed professional counselor designated by either the individual<\/span> at his own expense or by the health care entity<\/span> at its expense.\n\t\t\tAny health record<\/span> copied for review by any such designated physician, clinical psychologist, clinical social worker, or licensed professional counselor shall be accompanied by a statement from the custodian of the health record<\/span> that the individual<\/span>’s treating physician, clinical psychologist, clinical social worker, or licensed professional counselor determined that the individual<\/span>’s review of his health record<\/span> would be reasonably likely to endanger the life or physical safety of the individual<\/span> or would be reasonably likely to cause substantial harm to a person<\/span> referenced in the health record<\/span> who is not a health care provider<\/span>.\n\t\t\tFurther, nothing herein shall be construed as giving, or interpreted to bestow the right to receive copies of, or otherwise obtain access to, psychotherapy notes<\/span> to any individual<\/span> or any person<\/span> authorized to act on his behalf. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> A written authorization to allow release of an individual<\/span>’s health records<\/span> shall substantially include the following information:\n\t\t\tAUTHORIZATION TO RELEASE CONFIDENTIAL HEALTH RECORDS<\/span>\n\t\t\tIndividual<\/span>’s Name ________\n\t\t\tHealth Care Entity<\/span>’s Name ________\n\t\t\tPerson<\/span>, Agency, or Health Care Entity<\/span> to whom disclosure is to be made\n\t\t\t____\n\t\t\tInformation or Health Records<\/span> to be disclosed\n\t\t\t____\n\t\t\tPurpose of Disclosure or at the Request of the Individual<\/span>\n\t\t\t____\n\t\t\tAs the person<\/span> signing this authorization, I understand that I am giving my permission to the above-named health care entity<\/span> for disclosure of confidential health records<\/span>. I understand that the health care entity<\/span> may not condition treatment or payment on my willingness to sign this authorization unless the specific circumstances under which such conditioning is permitted by law<\/span> are applicable and are set forth in this authorization. I also understand that I have the right to revoke this authorization at any time, but that my revocation<\/span> is not effective until delivered in writing to the person<\/span> who is in possession<\/span> of my health records<\/span> and is not effective as to health records<\/span> already disclosed under this authorization. A copy of this authorization and a notation concerning the persons<\/span> or agencies to whom disclosure was made shall be included with my original health records<\/span>. I understand that health information disclosed under this authorization might be redisclosed by a recipient and may, as a result of such disclosure, no longer be protected to the same extent as such health information was protected by law<\/span> while solely in the possession<\/span> of the health care entity<\/span>.\n\t\t\tThis authorization expires on (date) or (event) ____\n\t\t\tSignature of Individual<\/span> or Individual<\/span>’s Legal Representative if Individual<\/span> is Unable to Sign\n\t\t\t____\n\t\t\tRelationship or Authority of Legal Representative\n\t\t\t____\n\t\t\tDate of Signature ____ <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> Pursuant to this subsection: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Unless excepted from these provisions in subdivision 9, no party<\/span> to a civil, criminal or administrative action or proceeding shall request the issuance of a subpoena duces tecum<\/span> for another party<\/span>’s health records<\/span> or cause a subpoena duces tecum<\/span> to be issued by an attorney unless a copy of the request for the subpoena or a copy of the attorney-issued subpoena is provided to the other party<\/span>’s counsel<\/span> or to the other party<\/span> if pro se<\/span>, simultaneously with filing the request or issuance of the subpoena. No party<\/span> to an action or proceeding shall request or cause the issuance of a subpoena duces tecum<\/span> for the health records<\/span> of a nonparty witness unless a copy of the request for the subpoena or a copy of the attorney-issued subpoena is provided to the nonparty witness simultaneously with filing the request or issuance of the attorney-issued subpoena.\n\t\t\t\tNo subpoena duces tecum<\/span> for health records<\/span> shall set a return date earlier than 15 days from the date of the subpoena except by order of a court or administrative agency for good cause shown. When a court or administrative agency directs that health records<\/span> be disclosed pursuant to a subpoena duces tecum<\/span> earlier than 15 days from the date of the subpoena, a copy of the order shall accompany the subpoena.\n\t\t\t\tAny party<\/span> requesting a subpoena duces tecum<\/span> for health records<\/span> or on whose behalf the subpoena duces tecum<\/span> is being issued shall have the duty to determine whether the individual<\/span> whose health records<\/span> are being sought is pro se<\/span> or a nonparty.\n\t\t\t\tIn instances where health records<\/span> being subpoenaed are those of a pro se<\/span> party<\/span> or nonparty witness, the party<\/span> requesting or issuing the subpoena shall deliver to the pro se<\/span> party<\/span> or nonparty witness together with the copy of the request for subpoena, or a copy of the subpoena in the case of an attorney-issued subpoena, a statement informing them of their rights and remedies. The statement shall include the following language and the heading shall be in boldface capital letters:\n\t\t\t\tNOTICE TO INDIVIDUAL<\/span>\n\t\t\t\tThe attached document means that ________(insert name of party<\/span> requesting or causing issuance of the subpoena) has either asked the court or administrative agency to issue<\/span> a subpoena or a subpoena has been issued by the other party<\/span>’s attorney to your doctor, other health care providers<\/span> ________(names of health care providers<\/span> inserted here) or other health care entity<\/span> ________(name of health care entity<\/span> to be inserted here) requiring them to produce your health records<\/span>. Your doctor, other health care provider<\/span> or other health care entity<\/span> is required to respond by providing a copy of your health records<\/span>. If you believe your health records<\/span> should not be disclosed and object<\/span> to their disclosure, you have the right to file a motion with the clerk of the court or the administrative agency to quash the subpoena. If you elect to file a motion to quash<\/span>, such motion must be filed within 15 days of the date of the request or of the attorney-issued subpoena. You may contact the clerk’s office or the administrative agency to determine the requirements that must be satisfied when filing a motion to quash<\/span> and you may elect to contact an attorney to represent your interest. If you elect to file a motion to quash<\/span>, you must notify your doctor, other health care provider<\/span>(s), or other health care entity<\/span>, that you are filing the motion so that the health care provider<\/span> or health care entity<\/span> knows to send the health records<\/span> to the clerk of court<\/span> or administrative agency in a sealed<\/span> envelope or package for safekeeping while your motion is decided. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Any party<\/span> filing a request for a subpoena duces tecum<\/span> or causing such a subpoena to be issued for an individual<\/span>’s health records<\/span> shall include a Notice in the same part of the request in which the recipient of the subpoena duces tecum<\/span> is directed where and when to return the health records<\/span>. Such notice shall be in boldface capital letters and shall include the following language:\n\t\t\t\tNOTICE TO HEALTH CARE ENTITIES\n\t\t\t\tA COPY OF THIS SUBPOENA DUCES TECUM<\/span> HAS BEEN PROVIDED TO THE INDIVIDUAL<\/span> WHOSE HEALTH RECORDS<\/span> ARE BEING REQUESTED OR HIS COUNSEL<\/span>. YOU OR THAT INDIVIDUAL<\/span> HAS THE RIGHT TO FILE A MOTION TO QUASH<\/span> (OBJECT<\/span> TO) THE ATTACHED SUBPOENA. IF YOU ELECT TO FILE A MOTION TO QUASH<\/span>, YOU MUST FILE THE MOTION WITHIN 15 DAYS OF THE DATE OF THIS SUBPOENA.\n\t\t\t\tYOU MUST NOT RESPOND TO THIS SUBPOENA UNTIL YOU HAVE RECEIVED WRITTEN CERTIFICATION<\/span> FROM THE PARTY<\/span> ON WHOSE BEHALF THE SUBPOENA WAS ISSUED THAT THE TIME FOR FILING A MOTION TO QUASH<\/span> HAS ELAPSED AND THAT:\n\t\t\t\tNO MOTION TO QUASH<\/span> WAS FILED; OR\n\t\t\t\tANY MOTION TO QUASH<\/span> HAS BEEN RESOLVED BY THE COURT OR THE ADMINISTRATIVE AGENCY AND THE DISCLOSURES SOUGHT ARE CONSISTENT WITH SUCH RESOLUTION.\n\t\t\t\tIF YOU RECEIVE NOTICE THAT THE INDIVIDUAL<\/span> WHOSE HEALTH RECORDS<\/span> ARE BEING REQUESTED HAS FILED A MOTION TO QUASH<\/span> THIS SUBPOENA, OR IF YOU FILE A MOTION TO QUASH<\/span> THIS SUBPOENA, YOU MUST SEND THE HEALTH RECORDS<\/span> ONLY TO THE CLERK OF THE COURT OR ADMINISTRATIVE AGENCY THAT ISSUED THE SUBPOENA OR IN WHICH THE ACTION IS PENDING AS SHOWN ON THE SUBPOENA USING THE FOLLOWING PROCEDURE:\n\t\t\t\tPLACE THE HEALTH RECORDS<\/span> IN A SEALED<\/span> ENVELOPE AND ATTACH TO THE SEALED<\/span> ENVELOPE A COVER LETTER TO THE CLERK OF COURT<\/span> OR ADMINISTRATIVE AGENCY WHICH STATES THAT CONFIDENTIAL HEALTH RECORDS<\/span> ARE ENCLOSED AND ARE TO BE HELD UNDER SEAL PENDING A RULING ON THE MOTION TO QUASH<\/span> THE SUBPOENA. THE SEALED<\/span> ENVELOPE AND THE COVER LETTER SHALL BE PLACED IN AN OUTER ENVELOPE OR PACKAGE FOR TRANSMITTAL TO THE COURT OR ADMINISTRATIVE AGENCY. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Upon receiving a valid subpoena duces tecum<\/span> for health records<\/span>, health care entities shall have the duty to respond to the subpoena in accordance with the provisions of subdivisions 4, 5, 6, 7, and 8. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Except to deliver to a clerk of the court or administrative agency subpoenaed health records<\/span> in a sealed<\/span> envelope as set forth, health care entities shall not respond to a subpoena duces tecum<\/span> for such health records<\/span> until they have received a certification<\/span> as set forth in subdivision 5 or 8 from the party<\/span> on whose behalf the subpoena duces tecum<\/span> was issued.\n\t\t\t\tIf the health care entity<\/span> has actual receipt of notice that a motion to quash<\/span> the subpoena has been filed or if the health care entity<\/span> files a motion to quash<\/span> the subpoena for health records<\/span>, then the health care entity<\/span> shall produce the health records<\/span>, in a securely sealed<\/span> envelope, to the clerk of the court or administrative agency issuing the subpoena or in whose court or administrative agency the action is pending. The court or administrative agency shall place the health records<\/span> under seal until a determination is made regarding the motion to quash<\/span>. The securely sealed<\/span> envelope shall only be opened on order of the judge<\/span> or administrative agency. In the event the court or administrative agency grants the motion to quash<\/span>, the health records<\/span> shall be returned to the health care entity<\/span> in the same sealed<\/span> envelope in which they were delivered to the court or administrative agency. In the event that a judge<\/span> or administrative agency orders<\/span> the sealed<\/span> envelope to be opened to review the health records<\/span> in camera<\/span>, a copy of the order shall accompany any health records<\/span> returned to the health care entity<\/span>. The health records<\/span> returned to the health care entity<\/span> shall be in a securely sealed<\/span> envelope. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> If no motion to quash<\/span> is filed within 15 days of the date of the request or of the attorney-issued subpoena, the party<\/span> on whose behalf the subpoena was issued shall have the duty to certify to the subpoenaed health care entity<\/span> that the time for filing a motion to quash<\/span> has elapsed and that no motion to quash<\/span> was filed. Any health care entity<\/span> receiving such certification<\/span> shall have the duty to comply with the subpoena duces tecum<\/span> by returning the specified health records<\/span> by either the return date on the subpoena or five days after receipt of the certification<\/span>, whichever is later. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> In the event that the individual<\/span> whose health records<\/span> are being sought files a motion to quash<\/span> the subpoena, the court or administrative agency shall decide whether good cause has been shown by the discovering party<\/span> to compel disclosure of the individual<\/span>’s health records<\/span> over the individual<\/span>’s objections. In determining whether good cause has been shown, the court or administrative agency shall consider (i) the particular purpose for which the information was collected; (ii) the degree to which the disclosure of the records would embarrass, injure, or invade the privacy of the individual<\/span>; (iii) the effect of the disclosure on the individual<\/span>’s future health care; (iv) the importance of the information to the lawsuit<\/span> or proceeding; and (v) any other relevant factor. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Concurrent with the court or administrative agency’s resolution of a motion to quash<\/span>, if subpoenaed health records<\/span> have been submitted by a health care entity<\/span> to the court or administrative agency in a sealed<\/span> envelope, the court or administrative agency shall: (i) upon determining that no submitted health records<\/span> should be disclosed, return all submitted health records<\/span> to the health care entity<\/span> in a sealed<\/span> envelope; (ii) upon determining that all submitted health records<\/span> should be disclosed, provide all the submitted health records<\/span> to the party<\/span> on whose behalf the subpoena was issued; or (iii) upon determining that only a portion of the submitted health records<\/span> should be disclosed, provide such portion to the party<\/span> on whose behalf the subpoena was issued and return the remaining health records<\/span> to the health care entity<\/span> in a sealed<\/span> envelope. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> Following the court or administrative agency’s resolution of a motion to quash<\/span>, the party<\/span> on whose behalf the subpoena duces tecum<\/span> was issued shall have the duty to certify in writing to the subpoenaed health care entity<\/span> a statement of one of the following:\n\t\t\t\ta. All filed motions<\/span> to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum<\/span> are consistent with such resolution; and, therefore, the health records<\/span> previously delivered in a sealed<\/span> envelope to the clerk of the court or administrative agency will not be returned to the health care entity<\/span>;\n\t\t\t\tb. All filed motions<\/span> to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum<\/span> are consistent with such resolution and that, since no health records<\/span> have previously been delivered to the court or administrative agency by the health care entity<\/span>, the health care entity<\/span> shall comply with the subpoena duces tecum<\/span> by returning the health records<\/span> designated in the subpoena by the return date on the subpoena or five days after receipt of certification<\/span>, whichever is later;\n\t\t\t\tc. All filed motions<\/span> to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum<\/span> are not consistent with such resolution; therefore, no health records<\/span> shall be disclosed and all health records<\/span> previously delivered in a sealed<\/span> envelope to the clerk of the court or administrative agency will be returned to the health care entity<\/span>;\n\t\t\t\td. All filed motions<\/span> to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum<\/span> are not consistent with such resolution and that only limited disclosure has been authorized. The certification<\/span> shall state that only the portion of the health records<\/span> as set forth in the certification<\/span>, consistent with the court or administrative agency’s ruling, shall be disclosed. The certification<\/span> shall also state that health records<\/span> that were previously delivered to the court or administrative agency for which disclosure has been authorized will not be returned to the health care entity<\/span>; however, all health records<\/span> for which disclosure has not been authorized will be returned to the health care entity<\/span>; or\n\t\t\t\te. All filed motions<\/span> to quash have been resolved by the court or administrative agency and the disclosures sought in the subpoena duces tecum<\/span> are not consistent with such resolution and, since no health records<\/span> have previously been delivered to the court or administrative agency by the health care entity<\/span>, the health care entity<\/span> shall return only those health records<\/span> specified in the certification<\/span>, consistent with the court or administrative agency’s ruling, by the return date on the subpoena or five days after receipt of the certification<\/span>, whichever is later.\n\t\t\t\tA copy of the court or administrative agency’s ruling shall accompany any certification<\/span> made pursuant to this subdivision. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

9.<\/span> The provisions of this subsection have no application to subpoenas<\/span> for health records<\/span> requested under § 8.01-413<\/a>, or issued by a duly authorized administrative agency conducting an investigation, audit, review or proceedings regarding a health care entity<\/span>’s conduct.\n\t\t\t\tThe provisions of this subsection shall apply to subpoenas<\/span> for the health records<\/span> of both minors<\/span> and adults.\n\t\t\t\tNothing in this subsection shall have any effect on the existing authority of a court or administrative agency to issue<\/span> a protective order regarding health records<\/span>, including, but not limited to, ordering the return of health records<\/span> to a health care entity<\/span>, after the period for filing a motion to quash<\/span> has passed.\n\t\t\t\tA subpoena for substance abuse records must conform to the requirements of federal law<\/span> found in 42 C.F.R. Part 2, Subpart E. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> Health care entities may testify about the health records<\/span> of an individual<\/span> in compliance with §§ 8.01-399<\/a> and 8.01-400.2<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

J.<\/span> Except as provided by subsection B7 of § 8.01-413<\/a>, if an individual<\/span> requests a copy of his health record<\/span> from a health care entity<\/span>, the health care entity<\/span> may impose a reasonable cost-based fee, which shall include only the cost of supplies for and labor of copying the requested information, postage when the individual<\/span> requests that such information be mailed, and preparation of an explanation or summary of such information as agreed to by the individual<\/span>. For the purposes of this section, “individual<\/span>” shall subsume a person<\/span> with authority to act on behalf of the individual<\/span> who is the subject of the health record<\/span> in making decisions related to his health care. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

K.<\/span> Nothing in this section shall prohibit a health care provider<\/span> who prescribes or dispenses a controlled substance required to be reported to the Prescription Monitoring Program established pursuant to Chapter 25.2 (§ 54.1-2519<\/a> et seq.) of Title 54.1 to a patient from disclosing information obtained from the Prescription Monitoring Program and contained in a patient’s health care record to another health care provider<\/span> when such disclosure is related to the care or treatment of the patient who is the subject of the record. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

L.<\/span> An authorization for the disclosure of health records<\/span> executed pursuant to this section shall remain in effect until (i) the authorization is revoked in writing and delivered to the health care entity<\/span> maintaining the record that is subject to the authorization by the person<\/span> who executed the authorization, (ii) any expiration date set forth in the authorization, or (iii) the health care entity<\/span> maintaining the record becomes aware of any expiration event described in the authorization, whichever occurs first. However, any revocation<\/span> of an authorization for the disclosure of health records<\/span> executed pursuant to this section shall not be effective to the extent that the health care entity<\/span> maintaining the record has disclosed health records<\/span> prior to delivery of such revocation<\/span> in reliance upon the authorization or as otherwise provided pursuant to 45 C.F.R. § 164.508. A statement in an authorization for the disclosure of health records<\/span> pursuant to this section that the information to be used or disclosed is “all health records<\/span>” is a sufficient description for the disclosure of all health records<\/span> of the person<\/span> maintained by the health care provider<\/span> to whom the authorization was granted. If a health care provider<\/span> receives a written revocation<\/span> of an authorization for the disclosure of health records<\/span> in accordance with this subsection, a copy of such written revocation<\/span> shall be included in the person<\/span>’s original health record<\/span> maintained by the health care provider<\/span>.\n\t\t\tAn authorization for the disclosure of health records<\/span> executed pursuant to this section shall, unless otherwise expressly limited in the authorization, be deemed to include authorization for the person<\/span> named in the authorization to assist the person<\/span> who is the subject of the health record<\/span> in accessing health care services, including scheduling appointments for the person<\/span> who is the subject of the health record<\/span> and attending appointments together with the person<\/span> who is the subject of the health record<\/span>. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nHEALTH RECORDS PRIVACY (\u00a7 32.1-127.1:03)\n\nA. There is hereby recognized an individual’s right of privacy in the\ncontent of his health records. Health records are the property of the health\ncare entity maintaining them, and, except when permitted or required by this\nsection or by other provisions of state law, no health care entity, or other\nperson working in a health care setting, may disclose an individual’s\nhealth records.\n\t\t\tPursuant to this subsection:\n\n 1. Health care entities shall disclose health records to the individual who is\n the subject of the health record, including an audit trail of any additions,\n deletions, or revisions to the health record, if specifically requested,\n except as provided in subsections E and F and subsection B of § 8.01-413.\n\n 2. Health records shall not be removed from the premises where they are\n maintained without the approval of the health care entity that maintains such\n health records, except in accordance with a court order or subpoena consistent\n with subsection C of § 8.01-413 or with this section or in accordance\n with the regulations relating to change of ownership of health records\n promulgated by a health regulatory board established in Title 54.1.\n\n 3. No person to whom health records are disclosed shall redisclose or\n otherwise reveal the health records of an individual, beyond the purpose for\n which such disclosure was made, without first obtaining the individual’s\n specific authorization to such redisclosure. This redisclosure prohibition\n shall not, however, prevent (i) any health care entity that receives health\n records from another health care entity from making subsequent disclosures as\n permitted under this section and the federal Department of Health and Human\n Services regulations relating to privacy of the electronic transmission of\n data and protected health information promulgated by the United States\n Department of Health and Human Services as required by the Health Insurance\n Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.) or\n (ii) any health care entity from furnishing health records and aggregate or\n other data, from which individually identifying prescription information has\n been removed, encoded or encrypted, to qualified researchers, including, but\n not limited to, pharmaceutical manufacturers and their agents or contractors,\n for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or\n other health services research.\n\n 4. Health care entities shall, upon the request of the individual who is the\n subject of the health record, disclose health records to other health care\n entities, in any available format of the requester’s choosing, as\n provided in subsection E.\n\nB. As used in this section:\n\t\t\t“Agent” means a person who has been appointed as an\nindividual’s agent under a power of attorney for health care or an advance\ndirective under the Health Care Decisions Act (§ 54.1-2981 et seq.).\n\t\t\t“Certification” means a written representation that is delivered\nby hand, by first-class mail, by overnight delivery service, or by facsimile if\nthe sender obtains a facsimile-machine-generated confirmation reflecting that\nall facsimile pages were successfully transmitted.\n\t\t\t“Guardian” means a court-appointed guardian of the person.\n\t\t\t“Health care clearinghouse” means, consistent with the definition\nset out in 45 C.F.R. § 160.103, a public or private entity, such as a\nbilling service, repricing company, community health management information\nsystem or community health information system, and “value-added”\nnetworks and switches, that performs either of the following functions: (i)\nprocesses or facilitates the processing of health information received from\nanother entity in a nonstandard format or containing nonstandard data content\ninto standard data elements or a standard transaction; or (ii) receives a\nstandard transaction from another entity and processes or facilitates the\nprocessing of health information into nonstandard format or nonstandard data\ncontent for the receiving entity.\n\t\t\t“Health care entity” means any health care provider, health plan\nor health care clearinghouse.\n\t\t\t“Health care provider” means those entities listed in the\ndefinition of “health care provider” in § 8.01-581.1, except\nthat state-operated facilities shall also be considered health care providers\nfor the purposes of this section. Health care provider shall also include all\npersons who are licensed, certified, registered or permitted or who hold a\nmultistate licensure privilege issued by any of the health regulatory boards\nwithin the Department of Health Professions, except persons regulated by the\nBoard of Funeral Directors and Embalmers or the Board of Veterinary Medicine.\n\t\t\t“Health plan” means an individual or group plan that provides, or\npays the cost of, medical care. “Health plan” includes any entity\nincluded in such definition as set out in 45 C.F.R. § 160.103.\n\t\t\t“Health record” means any written, printed or electronically\nrecorded material maintained by a health care entity in the course of providing\nhealth services to an individual concerning the individual and the services\nprovided. “Health record” also includes the substance of any\ncommunication made by an individual to a health care entity in confidence during\nor in connection with the provision of health services or information otherwise\nacquired by the health care entity about an individual in confidence and in\nconnection with the provision of health services to the individual.\n\t\t\t“Health services” means, but shall not be limited to,\nexamination, diagnosis, evaluation, treatment, pharmaceuticals, aftercare,\nhabilitation or rehabilitation and mental health therapy of any kind, as well as\npayment or reimbursement for any such services.\n\t\t\t“Individual” means a patient who is receiving or has received\nhealth services from a health care entity.\n\t\t\t“Individually identifying prescription information” means all\nprescriptions, drug orders or any other prescription information that\nspecifically identifies an individual.\n\t\t\t“Parent” means a biological, adoptive or foster parent.\n\t\t\t“Psychotherapy notes” means comments, recorded in any medium by a\nhealth care provider who is a mental health professional, documenting or\nanalyzing the contents of conversation during a private counseling session with\nan individual or a group, joint, or family counseling session that are separated\nfrom the rest of the individual’s health record. “Psychotherapy\nnotes” does not include annotations relating to medication and\nprescription monitoring, counseling session start and stop times, treatment\nmodalities and frequencies, clinical test results, or any summary of any\nsymptoms, diagnosis, prognosis, functional status, treatment plan, or the\nindividual’s progress to date.\n\nC. The provisions of this section shall not apply to any of the following:\n\n 1. The status of and release of information governed by §§ 65.2-604\n and 65.2-607 of the Virginia Workers’ Compensation Act;\n\n 2. Except where specifically provided herein, the health records of minors;\n\n 3. The release of juvenile health records to a secure facility or a shelter\n care facility pursuant to § 16.1-248.3; or\n\n 4. The release of health records to a state correctional facility pursuant to\n § 53.1-40.10 or a local or regional correctional facility pursuant to\n § 53.1-133.03.\n\nD. Health care entities may, and, when required by other provisions of state\nlaw, shall, disclose health records:\n\n 1. As set forth in subsection E, pursuant to the written authorization of (i)\n the individual or (ii) in the case of a minor, (a) his custodial parent,\n guardian or other person authorized to consent to treatment of minors pursuant\n to § 54.1-2969 or (b) the minor himself, if he has consented to his own\n treatment pursuant to § 54.1-2969, or (iii) in emergency cases or\n situations where it is impractical to obtain an individual’s written\n authorization, pursuant to the individual’s oral authorization for a\n health care provider or health plan to discuss the individual’s health\n records with a third party specified by the individual;\n\n 2. In compliance with a subpoena issued in accord with subsection H, pursuant\n to a search warrant or a grand jury subpoena, pursuant to court order upon\n good cause shown or in compliance with a subpoena issued pursuant to\n subsection C of § 8.01-413. Regardless of the manner by which health\n records relating to an individual are compelled to be disclosed pursuant to\n this subdivision, nothing in this subdivision shall be construed to prohibit\n any staff or employee of a health care entity from providing information about\n such individual to a law-enforcement officer in connection with such subpoena,\n search warrant, or court order;\n\n 3. In accord with subsection F of § 8.01-399 including, but not limited\n to, situations where disclosure is reasonably necessary to establish or\n collect a fee or to defend a health care entity or the health care\n entity’s employees or staff against any accusation of wrongful conduct;\n also as required in the course of an investigation, audit, review or\n proceedings regarding a health care entity’s conduct by a duly\n authorized law-enforcement, licensure, accreditation, or professional review\n entity;\n\n 4. In testimony in accordance with §§ 8.01-399 and 8.01-400.2;\n\n 5. In compliance with the provisions of § 8.01-413;\n\n 6. As required or authorized by law relating to public health activities,\n health oversight activities, serious threats to health or safety, or abuse,\n neglect or domestic violence, relating to contagious disease, public safety,\n and suspected child or adult abuse reporting requirements, including, but not\n limited to, those contained in §§ 16.1-248.3, 32.1-36, 32.1-36.1,\n 32.1-40, 32.1-41, 32.1-127.1:04, 32.1-276.5, 32.1-283, 32.1-283.1, 32.1-320,\n 37.2-710, 37.2-839, 53.1-40.10, 53.1-133.03, 54.1-2400.6, 54.1-2400.7,\n 54.1-2400.9, 54.1-2403.3, 54.1-2506, 54.1-2966, 54.1-2967, 54.1-2968,\n 54.1-3408.2, 63.2-1509, and 63.2-1606;\n\n 7. Where necessary in connection with the care of the individual;\n\n 8. In connection with the health care entity’s own health care\n operations or the health care operations of another health care entity, as\n specified in 45 C.F.R. § 164.501, or in the normal course of business in\n accordance with accepted standards of practice within the health services\n setting; however, the maintenance, storage, and disclosure of the mass of\n prescription dispensing records maintained in a pharmacy registered or\n permitted in Virginia shall only be accomplished in compliance with\n §§ 54.1-3410, 54.1-3411, and 54.1-3412;\n\n 9. When the individual has waived his right to the privacy of the health\n records;\n\n 10. When examination and evaluation of an individual are undertaken pursuant\n to judicial or administrative law order, but only to the extent as required by\n such order;\n\n 11. To the guardian ad litem and any attorney representing the respondent in\n the course of a guardianship proceeding of an adult patient who is the\n respondent in a proceeding under Chapter 20 (§ 64.2-2000 et seq.) of\n Title 64.2;\n\n 12. To the guardian ad litem and any attorney appointed by the court to\n represent an individual who is or has been a patient who is the subject of a\n commitment proceeding under § 19.2-169.6, Article 5 (§ 37.2-814 et\n seq.) of Chapter 8 of Title 37.2, Article 16 (§ 16.1-335 et seq.) of\n Chapter 11 of Title 16.1, or a judicial authorization for treatment proceeding\n pursuant to Chapter 11 (§ 37.2-1100 et seq.) of Title 37.2;\n\n 13. To a magistrate, the court, the evaluator or examiner required under\n Article 16 (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1 or §\n 37.2-815, a community services board or behavioral health authority or a\n designee of a community services board or behavioral health authority, or a\n law-enforcement officer participating in any proceeding under Article 16\n (§ 16.1-335 et seq.) of Chapter 11 of Title 16.1, § 19.2-169.6, or\n Chapter 8 (§ 37.2-800 et seq.) of Title 37.2 regarding the subject of the\n proceeding, and to any health care provider evaluating or providing services\n to the person who is the subject of the proceeding or monitoring the\n person’s adherence to a treatment plan ordered under those provisions.\n Health records disclosed to a law-enforcement officer shall be limited to\n information necessary to protect the officer, the person, or the public from\n physical injury or to address the health care needs of the person. Information\n disclosed to a law-enforcement officer shall not be used for any other\n purpose, disclosed to others, or retained;\n\n 14. To the attorney and\/or guardian ad litem of a minor who represents such\n minor in any judicial or administrative proceeding, if the court or\n administrative hearing officer has entered an order granting the attorney or\n guardian ad litem this right and such attorney or guardian ad litem presents\n evidence to the health care entity of such order;\n\n 15. With regard to the Court-Appointed Special Advocate (CASA) program, a\n minor’s health records in accord with § 9.1-156;\n\n 16. To an agent appointed under an individual’s power of attorney or to\n an agent or decision maker designated in an individual’s advance\n directive for health care or for decisions on anatomical gifts and organ,\n tissue or eye donation or to any other person consistent with the provisions\n of the Health Care Decisions Act (§ 54.1-2981 et seq.);\n\n 17. To third-party payors and their agents for purposes of reimbursement;\n\n 18. As is necessary to support an application for receipt of health care\n benefits from a governmental agency or as required by an authorized\n governmental agency reviewing such application or reviewing benefits already\n provided or as necessary to the coordination of prevention and control of\n disease, injury, or disability and delivery of such health care benefits\n pursuant to § 32.1-127.1:04;\n\n 19. Upon the sale of a medical practice as provided in § 54.1-2405; or\n upon a change of ownership or closing of a pharmacy pursuant to regulations of\n the Board of Pharmacy;\n\n 20. In accord with subsection B of § 54.1-2400.1, to communicate an\n individual’s specific and immediate threat to cause serious bodily\n injury or death of an identified or readily identifiable person;\n\n 21. Where necessary in connection with the implementation of a\n hospital’s routine contact process for organ donation pursuant to\n subdivision B 4 of § 32.1-127;\n\n 22. In the case of substance abuse records, when permitted by and in\n conformity with requirements of federal law found in 42 U.S.C. § 290dd-2\n and 42 C.F.R. Part 2;\n\n 23. In connection with the work of any entity established as set forth in\n § 8.01-581.16 to evaluate the adequacy or quality of professional\n services or the competency and qualifications for professional staff\n privileges;\n\n 24. If the health records are those of a deceased or mentally incapacitated\n individual to the personal representative or executor of the deceased\n individual or the legal guardian or committee of the incompetent or\n incapacitated individual or if there is no personal representative, executor,\n legal guardian or committee appointed, to the following persons in the\n following order of priority: a spouse, an adult son or daughter, either\n parent, an adult brother or sister, or any other relative of the deceased\n individual in order of blood relationship;\n\n 25. For the purpose of conducting record reviews of inpatient hospital deaths\n to promote identification of all potential organ, eye, and tissue donors in\n conformance with the requirements of applicable federal law and regulations,\n including 42 C.F.R. § 482.45, (i) to the health care provider’s\n designated organ procurement organization certified by the United States\n Health Care Financing Administration and (ii) to any eye bank or tissue bank\n in Virginia certified by the Eye Bank Association of America or the American\n Association of Tissue Banks;\n\n 26. To the Office of the State Inspector General pursuant to Chapter 3.2\n (§ 2.2-307 et seq.) of Title 2.2;\n\n 27. To an entity participating in the activities of a local health partnership\n authority established pursuant to Article 6.1 (§ 32.1-122.10:001 et seq.)\n of Chapter 4, pursuant to subdivision 1;\n\n 28. To law-enforcement officials by each licensed emergency medical services\n agency, (i) when the individual is the victim of a crime or (ii) when the\n individual has been arrested and has received emergency medical services or\n has refused emergency medical services and the health records consist of the\n prehospital patient care report required by § 32.1-116.1;\n\n 29. To law-enforcement officials, in response to their request, for the\n purpose of identifying or locating a suspect, fugitive, person required to\n register pursuant to § 9.1-901 of the Sex Offender and Crimes Against\n Minors Registry Act, material witness, or missing person, provided that only\n the following information may be disclosed: (i) name and address of the\n person, (ii) date and place of birth of the person, (iii) social security\n number of the person, (iv) blood type of the person, (v) date and time of\n treatment received by the person, (vi) date and time of death of the person,\n where applicable, (vii) description of distinguishing physical characteristics\n of the person, and (viii) type of injury sustained by the person;\n\n 30. To law-enforcement officials regarding the death of an individual for the\n purpose of alerting law enforcement of the death if the health care entity has\n a suspicion that such death may have resulted from criminal conduct;\n\n 31. To law-enforcement officials if the health care entity believes in good\n faith that the information disclosed constitutes evidence of a crime that\n occurred on its premises;\n\n 32. To the State Health Commissioner pursuant to § 32.1-48.015 when such\n records are those of a person or persons who are subject to an order of\n quarantine or an order of isolation pursuant to Article 3.02 (§\n 32.1-48.05 et seq.) of Chapter 2;\n\n 33. To the Commissioner of the Department of Labor and Industry or his\n designee by each licensed emergency medical services agency when the records\n consist of the prehospital patient care report required by § 32.1-116.1\n and the patient has suffered an injury or death on a work site while\n performing duties or tasks that are within the scope of his employment;\n\n 34. To notify a family member or personal representative of an individual who\n is the subject of a proceeding pursuant to Article 16 (§ 16.1-335 et\n seq.) of Chapter 11 of Title 16.1 or Chapter 8 (§ 37.2-800 et seq.) of\n Title 37.2 of information that is directly relevant to such person’s\n involvement with the individual’s health care, which may include the\n individual’s location and general condition, when the individual has the\n capacity to make health care decisions and (i) the individual has agreed to\n the notification, (ii) the individual has been provided an opportunity to\n object to the notification and does not express an objection, or (iii) the\n health care provider can, on the basis of his professional judgment,\n reasonably infer from the circumstances that the individual does not object to\n the notification. If the opportunity to agree or object to the notification\n cannot practicably be provided because of the individual’s incapacity or\n an emergency circumstance, the health care provider may notify a family member\n or personal representative of the individual of information that is directly\n relevant to such person’s involvement with the individual’s health\n care, which may include the individual’s location and general condition\n if the health care provider, in the exercise of his professional judgment,\n determines that the notification is in the best interests of the individual.\n Such notification shall not be made if the provider has actual knowledge the\n family member or personal representative is currently prohibited by court\n order from contacting the individual;\n\n 35. To a threat assessment team established by a local school board pursuant\n to § 22.1-79.4, by a public institution of higher education pursuant to\n § 23.1-805, or by a private nonprofit institution of higher education;\n and\n\n 36. To a regional emergency medical services council pursuant to §\n 32.1-116.1, for purposes limited to monitoring and improving the quality of\n emergency medical services pursuant to § 32.1-111.3.\n \t\t\t\tNotwithstanding the provisions of subdivisions 1 through 35, a health care\n entity shall obtain an individual’s written authorization for any\n disclosure of psychotherapy notes, except when disclosure by the health care\n entity is (i) for its own training programs in which students, trainees, or\n practitioners in mental health are being taught under supervision to practice\n or to improve their skills in group, joint, family, or individual counseling;\n (ii) to defend itself or its employees or staff against any accusation of\n wrongful conduct; (iii) in the discharge of the duty, in accordance with\n subsection B of § 54.1-2400.1, to take precautions to protect third\n parties from violent behavior or other serious harm; (iv) required in the\n course of an investigation, audit, review, or proceeding regarding a health\n care entity’s conduct by a duly authorized law-enforcement, licensure,\n accreditation, or professional review entity; or (v) otherwise required by\n law.\n\nE. Health care records required to be disclosed pursuant to this section shall\nbe made available electronically only to the extent and in the manner authorized\nby the federal Health Information Technology for Economic and Clinical Health\nAct (P.L. 111-5) and implementing regulations and the Health Insurance\nPortability and Accountability Act (42 U.S.C. § 1320d et seq.) and\nimplementing regulations. Notwithstanding any other provision to the contrary, a\nhealth care entity shall not be required to provide records in an electronic\nformat requested if (i) the electronic format is not reasonably available\nwithout additional cost to the health care entity, (ii) the records would be\nsubject to modification in the format requested, or (iii) the health care entity\ndetermines that the integrity of the records could be compromised in the\nelectronic format requested. Requests for copies of or electronic access to\nhealth records shall (a) be in writing, dated and signed by the requester; (b)\nidentify the nature of the information requested; and (c) include evidence of\nthe authority of the requester to receive such copies or access such records,\nand identification of the person to whom the information is to be disclosed; and\n(d) specify whether the requester would like the records in electronic format,\nif available, or in paper format. The health care entity shall accept a\nphotocopy, facsimile, or other copy of the original signed by the requester as\nif it were an original. Within 30 days of receipt of a request for copies of or\nelectronic access to health records, the health care entity shall do one of the\nfollowing: (1) furnish such copies of or allow electronic access to the\nrequested health records to any requester authorized to receive them in\nelectronic format if so requested; (2) inform the requester if the information\ndoes not exist or cannot be found; (3) if the health care entity does not\nmaintain a record of the information, so inform the requester and provide the\nname and address, if known, of the health care entity who maintains the record;\nor (4) deny the request (A) under subsection F, (B) on the grounds that the\nrequester has not established his authority to receive such health records or\nproof of his identity, or (C) as otherwise provided by law. Procedures set forth\nin this section shall apply only to requests for health records not specifically\ngoverned by other provisions of state law.\n\nF. Except as provided in subsection B of § 8.01-413, copies of or\nelectronic access to an individual’s health records shall not be furnished\nto such individual or anyone authorized to act on the individual’s behalf\nwhen the individual’s treating physician, clinical psychologist, clinical\nsocial worker, or licensed professional counselor has made a part of the\nindividual’s record a written statement that, in the exercise of his\nprofessional judgment, the furnishing to or review by the individual of such\nhealth records would be reasonably likely to endanger the life or physical\nsafety of the individual or another person, or that such health record makes\nreference to a person other than a health care provider and the access requested\nwould be reasonably likely to cause substantial harm to such referenced person.\nIf any health care entity denies a request for copies of or electronic access to\nhealth records based on such statement, the health care entity shall inform the\nindividual of the individual’s right to designate, in writing, at his own\nexpense, another reviewing physician, clinical psychologist, clinical social\nworker, or licensed professional counselor whose licensure, training and\nexperience relative to the individual’s condition are at least equivalent\nto that of the physician, clinical psychologist, clinical social worker, or\nlicensed professional counselor upon whose opinion the denial is based. The\ndesignated reviewing physician, clinical psychologist, clinical social worker,\nor licensed professional counselor shall make a judgment as to whether to make\nthe health record available to the individual.\n\t\t\tThe health care entity denying the request shall also inform the individual\nof the individual’s right to request in writing that such health care\nentity designate, at its own expense, a physician, clinical psychologist,\nclinical social worker, or licensed professional counselor, whose licensure,\ntraining, and experience relative to the individual’s condition are at\nleast equivalent to that of the physician, clinical psychologist, clinical\nsocial worker, or licensed professional counselor upon whose professional\njudgment the denial is based and who did not participate in the original\ndecision to deny the health records, who shall make a judgment as to whether to\nmake the health record available to the individual. The health care entity shall\ncomply with the judgment of the reviewing physician, clinical psychologist,\nclinical social worker, or licensed professional counselor. The health care\nentity shall permit copying and examination of the health record by such other\nphysician, clinical psychologist, clinical social worker, or licensed\nprofessional counselor designated by either the individual at his own expense or\nby the health care entity at its expense.\n\t\t\tAny health record copied for review by any such designated physician,\nclinical psychologist, clinical social worker, or licensed professional\ncounselor shall be accompanied by a statement from the custodian of the health\nrecord that the individual’s treating physician, clinical psychologist,\nclinical social worker, or licensed professional counselor determined that the\nindividual’s review of his health record would be reasonably likely to\nendanger the life or physical safety of the individual or would be reasonably\nlikely to cause substantial harm to a person referenced in the health record who\nis not a health care provider.\n\t\t\tFurther, nothing herein shall be construed as giving, or interpreted to\nbestow the right to receive copies of, or otherwise obtain access to,\npsychotherapy notes to any individual or any person authorized to act on his\nbehalf.\n\nG. A written authorization to allow release of an individual’s health\nrecords shall substantially include the following information:\n\t\t\tAUTHORIZATION TO RELEASE CONFIDENTIAL HEALTH RECORDS\n\t\t\tIndividual’s Name ________\n\t\t\tHealth Care Entity’s Name ________\n\t\t\tPerson, Agency, or Health Care Entity to whom disclosure is to be made\n\t\t\t____\n\t\t\tInformation or Health Records to be disclosed\n\t\t\t____\n\t\t\tPurpose of Disclosure or at the Request of the Individual\n\t\t\t____\n\t\t\tAs the person signing this authorization, I understand that I am giving my\npermission to the above-named health care entity for disclosure of confidential\nhealth records. I understand that the health care entity may not condition\ntreatment or payment on my willingness to sign this authorization unless the\nspecific circumstances under which such conditioning is permitted by law are\napplicable and are set forth in this authorization. I also understand that I\nhave the right to revoke this authorization at any time, but that my revocation\nis not effective until delivered in writing to the person who is in possession\nof my health records and is not effective as to health records already disclosed\nunder this authorization. A copy of this authorization and a notation concerning\nthe persons or agencies to whom disclosure was made shall be included with my\noriginal health records. I understand that health information disclosed under\nthis authorization might be redisclosed by a recipient and may, as a result of\nsuch disclosure, no longer be protected to the same extent as such health\ninformation was protected by law while solely in the possession of the health\ncare entity.\n\t\t\tThis authorization expires on (date) or (event) ____\n\t\t\tSignature of Individual or Individual’s Legal Representative if\nIndividual is Unable to Sign\n\t\t\t____\n\t\t\tRelationship or Authority of Legal Representative\n\t\t\t____\n\t\t\tDate of Signature ____\n\nH. Pursuant to this subsection:\n\n 1. Unless excepted from these provisions in subdivision 9, no party to a\n civil, criminal or administrative action or proceeding shall request the\n issuance of a subpoena duces tecum for another party’s health records or\n cause a subpoena duces tecum to be issued by an attorney unless a copy of the\n request for the subpoena or a copy of the attorney-issued subpoena is provided\n to the other party’s counsel or to the other party if pro se,\n simultaneously with filing the request or issuance of the subpoena. No party\n to an action or proceeding shall request or cause the issuance of a subpoena\n duces tecum for the health records of a nonparty witness unless a copy of the\n request for the subpoena or a copy of the attorney-issued subpoena is provided\n to the nonparty witness simultaneously with filing the request or issuance of\n the attorney-issued subpoena.\n \t\t\t\tNo subpoena duces tecum for health records shall set a return date earlier\n than 15 days from the date of the subpoena except by order of a court or\n administrative agency for good cause shown. When a court or administrative\n agency directs that health records be disclosed pursuant to a subpoena duces\n tecum earlier than 15 days from the date of the subpoena, a copy of the order\n shall accompany the subpoena.\n \t\t\t\tAny party requesting a subpoena duces tecum for health records or on whose\n behalf the subpoena duces tecum is being issued shall have the duty to\n determine whether the individual whose health records are being sought is pro\n se or a nonparty.\n \t\t\t\tIn instances where health records being subpoenaed are those of a pro se\n party or nonparty witness, the party requesting or issuing the subpoena shall\n deliver to the pro se party or nonparty witness together with the copy of the\n request for subpoena, or a copy of the subpoena in the case of an\n attorney-issued subpoena, a statement informing them of their rights and\n remedies. The statement shall include the following language and the heading\n shall be in boldface capital letters:\n \t\t\t\tNOTICE TO INDIVIDUAL\n \t\t\t\tThe attached document means that ________(insert name of party requesting\n or causing issuance of the subpoena) has either asked the court or\n administrative agency to issue a subpoena or a subpoena has been issued by the\n other party’s attorney to your doctor, other health care providers\n ________(names of health care providers inserted here) or other health care\n entity ________(name of health care entity to be inserted here) requiring them\n to produce your health records. Your doctor, other health care provider or\n other health care entity is required to respond by providing a copy of your\n health records. If you believe your health records should not be disclosed and\n object to their disclosure, you have the right to file a motion with the clerk\n of the court or the administrative agency to quash the subpoena. If you elect\n to file a motion to quash, such motion must be filed within 15 days of the\n date of the request or of the attorney-issued subpoena. You may contact the\n clerk’s office or the administrative agency to determine the\n requirements that must be satisfied when filing a motion to quash and you may\n elect to contact an attorney to represent your interest. If you elect to file\n a motion to quash, you must notify your doctor, other health care provider(s),\n or other health care entity, that you are filing the motion so that the health\n care provider or health care entity knows to send the health records to the\n clerk of court or administrative agency in a sealed envelope or package for\n safekeeping while your motion is decided.\n\n 2. Any party filing a request for a subpoena duces tecum or causing such a\n subpoena to be issued for an individual’s health records shall include a\n Notice in the same part of the request in which the recipient of the subpoena\n duces tecum is directed where and when to return the health records. Such\n notice shall be in boldface capital letters and shall include the following\n language:\n \t\t\t\tNOTICE TO HEALTH CARE ENTITIES\n \t\t\t\tA COPY OF THIS SUBPOENA DUCES TECUM HAS BEEN PROVIDED TO THE INDIVIDUAL\n WHOSE HEALTH RECORDS ARE BEING REQUESTED OR HIS COUNSEL. YOU OR THAT\n INDIVIDUAL HAS THE RIGHT TO FILE A MOTION TO QUASH (OBJECT TO) THE ATTACHED\n SUBPOENA. IF YOU ELECT TO FILE A MOTION TO QUASH, YOU MUST FILE THE MOTION\n WITHIN 15 DAYS OF THE DATE OF THIS SUBPOENA.\n \t\t\t\tYOU MUST NOT RESPOND TO THIS SUBPOENA UNTIL YOU HAVE RECEIVED WRITTEN\n CERTIFICATION FROM THE PARTY ON WHOSE BEHALF THE SUBPOENA WAS ISSUED THAT THE\n TIME FOR FILING A MOTION TO QUASH HAS ELAPSED AND THAT:\n \t\t\t\tNO MOTION TO QUASH WAS FILED; OR\n \t\t\t\tANY MOTION TO QUASH HAS BEEN RESOLVED BY THE COURT OR THE ADMINISTRATIVE\n AGENCY AND THE DISCLOSURES SOUGHT ARE CONSISTENT WITH SUCH RESOLUTION.\n \t\t\t\tIF YOU RECEIVE NOTICE THAT THE INDIVIDUAL WHOSE HEALTH RECORDS ARE BEING\n REQUESTED HAS FILED A MOTION TO QUASH THIS SUBPOENA, OR IF YOU FILE A MOTION\n TO QUASH THIS SUBPOENA, YOU MUST SEND THE HEALTH RECORDS ONLY TO THE CLERK OF\n THE COURT OR ADMINISTRATIVE AGENCY THAT ISSUED THE SUBPOENA OR IN WHICH THE\n ACTION IS PENDING AS SHOWN ON THE SUBPOENA USING THE FOLLOWING PROCEDURE:\n \t\t\t\tPLACE THE HEALTH RECORDS IN A SEALED ENVELOPE AND ATTACH TO THE SEALED\n ENVELOPE A COVER LETTER TO THE CLERK OF COURT OR ADMINISTRATIVE AGENCY WHICH\n STATES THAT CONFIDENTIAL HEALTH RECORDS ARE ENCLOSED AND ARE TO BE HELD UNDER\n SEAL PENDING A RULING ON THE MOTION TO QUASH THE SUBPOENA. THE SEALED ENVELOPE\n AND THE COVER LETTER SHALL BE PLACED IN AN OUTER ENVELOPE OR PACKAGE FOR\n TRANSMITTAL TO THE COURT OR ADMINISTRATIVE AGENCY.\n\n 3. Upon receiving a valid subpoena duces tecum for health records, health care\n entities shall have the duty to respond to the subpoena in accordance with the\n provisions of subdivisions 4, 5, 6, 7, and 8.\n\n 4. Except to deliver to a clerk of the court or administrative agency\n subpoenaed health records in a sealed envelope as set forth, health care\n entities shall not respond to a subpoena duces tecum for such health records\n until they have received a certification as set forth in subdivision 5 or 8\n from the party on whose behalf the subpoena duces tecum was issued.\n \t\t\t\tIf the health care entity has actual receipt of notice that a motion to\n quash the subpoena has been filed or if the health care entity files a motion\n to quash the subpoena for health records, then the health care entity shall\n produce the health records, in a securely sealed envelope, to the clerk of the\n court or administrative agency issuing the subpoena or in whose court or\n administrative agency the action is pending. The court or administrative\n agency shall place the health records under seal until a determination is made\n regarding the motion to quash. The securely sealed envelope shall only be\n opened on order of the judge or administrative agency. In the event the court\n or administrative agency grants the motion to quash, the health records shall\n be returned to the health care entity in the same sealed envelope in which\n they were delivered to the court or administrative agency. In the event that a\n judge or administrative agency orders the sealed envelope to be opened to\n review the health records in camera, a copy of the order shall accompany any\n health records returned to the health care entity. The health records returned\n to the health care entity shall be in a securely sealed envelope.\n\n 5. If no motion to quash is filed within 15 days of the date of the request or\n of the attorney-issued subpoena, the party on whose behalf the subpoena was\n issued shall have the duty to certify to the subpoenaed health care entity\n that the time for filing a motion to quash has elapsed and that no motion to\n quash was filed. Any health care entity receiving such certification shall\n have the duty to comply with the subpoena duces tecum by returning the\n specified health records by either the return date on the subpoena or five\n days after receipt of the certification, whichever is later.\n\n 6. In the event that the individual whose health records are being sought\n files a motion to quash the subpoena, the court or administrative agency shall\n decide whether good cause has been shown by the discovering party to compel\n disclosure of the individual’s health records over the\n individual’s objections. In determining whether good cause has been\n shown, the court or administrative agency shall consider (i) the particular\n purpose for which the information was collected; (ii) the degree to which the\n disclosure of the records would embarrass, injure, or invade the privacy of\n the individual; (iii) the effect of the disclosure on the individual’s\n future health care; (iv) the importance of the information to the lawsuit or\n proceeding; and (v) any other relevant factor.\n\n 7. Concurrent with the court or administrative agency’s resolution of a\n motion to quash, if subpoenaed health records have been submitted by a health\n care entity to the court or administrative agency in a sealed envelope, the\n court or administrative agency shall: (i) upon determining that no submitted\n health records should be disclosed, return all submitted health records to the\n health care entity in a sealed envelope; (ii) upon determining that all\n submitted health records should be disclosed, provide all the submitted health\n records to the party on whose behalf the subpoena was issued; or (iii) upon\n determining that only a portion of the submitted health records should be\n disclosed, provide such portion to the party on whose behalf the subpoena was\n issued and return the remaining health records to the health care entity in a\n sealed envelope.\n\n 8. Following the court or administrative agency’s resolution of a motion\n to quash, the party on whose behalf the subpoena duces tecum was issued shall\n have the duty to certify in writing to the subpoenaed health care entity a\n statement of one of the following:\n \t\t\t\ta. All filed motions to quash have been resolved by the court or\n administrative agency and the disclosures sought in the subpoena duces tecum\n are consistent with such resolution; and, therefore, the health records\n previously delivered in a sealed envelope to the clerk of the court or\n administrative agency will not be returned to the health care entity;\n \t\t\t\tb. All filed motions to quash have been resolved by the court or\n administrative agency and the disclosures sought in the subpoena duces tecum\n are consistent with such resolution and that, since no health records have\n previously been delivered to the court or administrative agency by the health\n care entity, the health care entity shall comply with the subpoena duces tecum\n by returning the health records designated in the subpoena by the return date\n on the subpoena or five days after receipt of certification, whichever is\n later;\n \t\t\t\tc. All filed motions to quash have been resolved by the court or\n administrative agency and the disclosures sought in the subpoena duces tecum\n are not consistent with such resolution; therefore, no health records shall be\n disclosed and all health records previously delivered in a sealed envelope to\n the clerk of the court or administrative agency will be returned to the health\n care entity;\n \t\t\t\td. All filed motions to quash have been resolved by the court or\n administrative agency and the disclosures sought in the subpoena duces tecum\n are not consistent with such resolution and that only limited disclosure has\n been authorized. The certification shall state that only the portion of the\n health records as set forth in the certification, consistent with the court or\n administrative agency’s ruling, shall be disclosed. The certification\n shall also state that health records that were previously delivered to the\n court or administrative agency for which disclosure has been authorized will\n not be returned to the health care entity; however, all health records for\n which disclosure has not been authorized will be returned to the health care\n entity; or\n \t\t\t\te. All filed motions to quash have been resolved by the court or\n administrative agency and the disclosures sought in the subpoena duces tecum\n are not consistent with such resolution and, since no health records have\n previously been delivered to the court or administrative agency by the health\n care entity, the health care entity shall return only those health records\n specified in the certification, consistent with the court or administrative\n agency’s ruling, by the return date on the subpoena or five days after\n receipt of the certification, whichever is later.\n \t\t\t\tA copy of the court or administrative agency’s ruling shall\n accompany any certification made pursuant to this subdivision.\n\n 9. The provisions of this subsection have no application to subpoenas for\n health records requested under § 8.01-413, or issued by a duly authorized\n administrative agency conducting an investigation, audit, review or\n proceedings regarding a health care entity’s conduct.\n \t\t\t\tThe provisions of this subsection shall apply to subpoenas for the health\n records of both minors and adults.\n \t\t\t\tNothing in this subsection shall have any effect on the existing authority\n of a court or administrative agency to issue a protective order regarding\n health records, including, but not limited to, ordering the return of health\n records to a health care entity, after the period for filing a motion to quash\n has passed.\n \t\t\t\tA subpoena for substance abuse records must conform to the requirements of\n federal law found in 42 C.F.R. Part 2, Subpart E.\n\nI. Health care entities may testify about the health records of an individual in\ncompliance with §§ 8.01-399 and 8.01-400.2.\n\nJ. Except as provided by subsection B7 of § 8.01-413, if an individual\nrequests a copy of his health record from a health care entity, the health care\nentity may impose a reasonable cost-based fee, which shall include only the cost\nof supplies for and labor of copying the requested information, postage when the\nindividual requests that such information be mailed, and preparation of an\nexplanation or summary of such information as agreed to by the individual. For\nthe purposes of this section, “individual” shall subsume a person\nwith authority to act on behalf of the individual who is the subject of the\nhealth record in making decisions related to his health care.\n\nK. Nothing in this section shall prohibit a health care provider who prescribes\nor dispenses a controlled substance required to be reported to the Prescription\nMonitoring Program established pursuant to Chapter 25.2 (§ 54.1-2519 et\nseq.) of Title 54.1 to a patient from disclosing information obtained from the\nPrescription Monitoring Program and contained in a patient’s health care\nrecord to another health care provider when such disclosure is related to the\ncare or treatment of the patient who is the subject of the record.\n\nL. An authorization for the disclosure of health records executed pursuant to\nthis section shall remain in effect until (i) the authorization is revoked in\nwriting and delivered to the health care entity maintaining the record that is\nsubject to the authorization by the person who executed the authorization, (ii)\nany expiration date set forth in the authorization, or (iii) the health care\nentity maintaining the record becomes aware of any expiration event described in\nthe authorization, whichever occurs first. However, any revocation of an\nauthorization for the disclosure of health records executed pursuant to this\nsection shall not be effective to the extent that the health care entity\nmaintaining the record has disclosed health records prior to delivery of such\nrevocation in reliance upon the authorization or as otherwise provided pursuant\nto 45 C.F.R. § 164.508. A statement in an authorization for the disclosure\nof health records pursuant to this section that the information to be used or\ndisclosed is “all health records” is a sufficient description for\nthe disclosure of all health records of the person maintained by the health care\nprovider to whom the authorization was granted. If a health care provider\nreceives a written revocation of an authorization for the disclosure of health\nrecords in accordance with this subsection, a copy of such written revocation\nshall be included in the person’s original health record maintained by the\nhealth care provider.\n\t\t\tAn authorization for the disclosure of health records executed pursuant to\nthis section shall, unless otherwise expressly limited in the authorization, be\ndeemed to include authorization for the person named in the authorization to\nassist the person who is the subject of the health record in accessing health\ncare services, including scheduling appointments for the person who is the\nsubject of the health record and attending appointments together with the person\nwho is the subject of the health record.\n\nHISTORY: 1997, c. 682; 1998, c. 470; 1999, cc. 812, 956, 1010; 2000, cc. 810,\n813, 923, 927; 2001, c. 671; 2002, cc. 568, 658, 835, 860; 2003, cc. 471, 907,\n983; 2004, cc. 49, 64, 65, 66, 67, 163, 773, 1014, 1021; 2005, cc. 39, 101, 642,\n697; 2006, c. 433; 2007, c. 497; 2008, cc. 315, 782, 850, 870; 2009, cc. 606,\n651, 813, 840; 2010, cc. 185, 340, 406, 456, 524, 778, 825; 2011, cc. 499, 668,\n798, 812, 844, 871; 2012, cc. 386, 402, 479; 2016, c. 554; 2017, cc. 457, 712,\n720; 2018, c. 165; 2020, c. 945; 2022, cc. 509, 534, 784; 2025, c. 182.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}