                                 CODE OF VIRGINIA

CONFIDENTIALITY OF DATA; DISCLOSURE OF INFORMATION; DISCRETIONARY AUTHORITY OF
DIRECTOR (§ 54.1-2523)

A. All data, records, and reports relating to the prescribing and dispensing of
covered substances to recipients and any abstracts from such data, records, and
reports that are in the possession of the Prescription Monitoring Program
pursuant to this chapter and any material relating to the operation or security
of the program shall be confidential and shall be exempt from the Virginia
Freedom of Information Act (&#xA7; 2.2-3700 et seq.) pursuant to subdivision 2
of &#xA7; 2.2-3705.5. Records in possession of the Prescription Monitoring
Program shall not be available for civil subpoena, nor shall such records be
disclosed, discoverable, or compelled to be produced in any civil proceeding,
nor shall such records be deemed admissible as evidence in any civil proceeding
for any reason. Further, the Director shall only have discretion to disclose any
such information as provided in subsections B and C.

B. Upon receiving a request for information in accordance with the
Department&#8217;s regulations and in compliance with applicable federal law and
regulations, the Director shall disclose the following:

   1. Information relevant to a specific investigation of a specific recipient or
   of a specific dispenser or prescriber to an agent who has completed the
   Virginia State Police Drug Diversion School designated by the superintendent
   of the Department of State Police or designated by the chief law-enforcement
   officer of any county, city, or town or campus police department to conduct
   drug diversion investigations pursuant to &#xA7; 54.1-3405.

   2. Information relevant to an investigation or inspection of or allegation of
   misconduct by a specific person licensed, certified, or registered by or an
   applicant for licensure, certification, or registration by a health regulatory
   board; information relevant to a disciplinary proceeding before a health
   regulatory board or in any subsequent trial or appeal of an action or board
   order to designated employees of the Department of Health Professions; or to
   designated persons operating the Health Practitioners&#8217; Monitoring
   Program pursuant to Chapter 25.1 (&#xA7; 54.1-2515 et seq.).

   3. Information relevant to the proceedings of any investigatory grand jury or
   special grand jury that has been properly impaneled in accordance with the
   provisions of Chapter 13 (&#xA7; 19.2-191 et seq.) of Title 19.2.

   4. Information relevant to a specific investigation of a specific recipient,
   dispenser, or prescriber to an agent of a federal law-enforcement agency with
   authority to conduct drug diversion investigations.

   5. Information relevant to a specific investigation, supervision, or
   monitoring of a specific recipient for purposes of the administration of
   criminal justice pursuant to Chapter 1 (&#xA7; 9.1-100 et seq.) of Title 9.1
   to a probation or parole officer as described in Article 2 (&#xA7; 53.1-141 et
   seq.) of Chapter 4 of Title 53.1, a local community-based probation officer as
   described in &#xA7; 9.1-176.1, a drug court administrator as described in
   &#xA7; 18.2-254.1, or a behavioral health docket administrator as described in
   &#xA7; 18.2-254.3 who has completed the Virginia State Police Drug Diversion
   School designated by the Director of the Department of Corrections or his
   designee.

   6. Information relevant to a specific investigation of a specific individual
   into a possible delivery of a controlled substance in violation of &#xA7;
   18.2-474.1 to an investigator for the Department of Corrections who has
   completed the Virginia State Police Drug Diversion School and who has been
   designated by the Director of the Department of Corrections or his designee.

   7. Information about a specific recipient to the Smartchart Network Program in
   accordance with subdivision B 7 of &#xA7; 32.1-372.

C. In accordance with the Department&#8217;s regulations and applicable federal
law and regulations, the Director may, in his discretion, disclose:

   1. Information in the possession of the Prescription Monitoring Program
   concerning a recipient who is over the age of 18 to that recipient. The
   information shall be mailed to the street or mailing address indicated on the
   recipient request form.

   2. Information on a specific recipient to a prescriber, as defined in this
   chapter, for the purpose of establishing the treatment history of the specific
   recipient when such recipient is either under care and treatment by the
   prescriber or the prescriber is consulting on or initiating treatment of such
   recipient. In a manner specified by the Director in regulation, notice shall
   be given to patients that information may be requested by the prescriber from
   the Prescription Monitoring Program.

   3. Information on a specific recipient to a dispenser for the purpose of
   establishing a prescription history to assist the dispenser in (i) determining
   the validity of a prescription in accordance with &#xA7; 54.1-3303 or (ii)
   providing clinical consultation on the care and treatment of the recipient. In
   a manner specified by the Director in regulation, notice shall be given to
   patients that information may be requested by the dispenser from the
   Prescription Monitoring Program.

   4. Information relevant to an investigation or regulatory proceeding of a
   specific dispenser or prescriber to other regulatory authorities concerned
   with granting, limiting or denying licenses, certificates or registrations to
   practice a health profession when such regulatory authority licenses such
   dispenser or prescriber or such dispenser or prescriber is seeking licensure
   by such other regulatory authority.

   5. Information relevant to an investigation relating to a specific dispenser
   or prescriber who is a participating provider in the Virginia Medicaid program
   or information relevant to an investigation relating to a specific recipient
   who is currently eligible for and receiving or who has been eligible for and
   has received medical assistance services to the Medicaid Fraud Control Unit of
   the Office of the Attorney General or to designated employees of the
   Department of Medical Assistance Services, as appropriate.

   6. Information relevant to determination of the cause of death of a specific
   recipient to the designated employees of the Office of the Chief Medical
   Examiner.

   7. Information for the purpose of bona fide research or education to qualified
   personnel; however, data elements that would reasonably identify a specific
   recipient, prescriber, or dispenser shall be deleted or redacted from such
   information prior to disclosure. Further, release of the information shall
   only be made pursuant to a written agreement between such qualified personnel
   and the Director in order to ensure compliance with this subdivision.

   8. Information relating to prescriptions for covered substances issued by a
   specific prescriber, which have been dispensed and reported to the
   Prescription Monitoring Program, to that prescriber.

   9. Information about a specific recipient who is a member of a Virginia
   Medicaid managed care program to a physician or pharmacist licensed in the
   Commonwealth and employed by the Virginia Medicaid managed care program or to
   his clinical designee who holds a multistate licensure privilege to practice
   nursing or a license issued by a health regulatory board within the Department
   of Health Professions and is employed by the Virginia Medicaid managed care
   program. Such information shall only be used to determine eligibility for and
   to manage the care of the specific recipient in a Patient Utilization
   Management Safety or similar program. Notice shall be given to recipients that
   information may be requested by a licensed physician or pharmacist employed by
   the Virginia Medicaid managed care program from the Prescription Monitoring
   Program.

   10. [Expired.]

   11. Information about a specific recipient who is currently eligible for and
   receiving medical assistance from the Department of Medical Assistance
   Services to a physician or pharmacist licensed in the Commonwealth or to his
   clinical designee who holds a multistate licensure privilege to practice
   nursing or a license issued by a health regulatory board within the Department
   of Health Professions and is employed by the Department of Medical Assistance
   Services.
   				Such information shall be used only to determine eligibility for and to
   manage the care of the specific recipient in a Patient Utilization Management
   Safety or similar program. Notice shall be given to recipients that
   information may be requested by a licensed physician or pharmacist employed by
   the Department of Medical Assistance Services from the Prescription Monitoring
   Program.

D. The Director may enter into agreements for mutual exchange of information
among prescription monitoring programs in other jurisdictions, which shall only
use the information for purposes allowed by this chapter.

E. This section shall not be construed to supersede the provisions of &#xA7;
54.1-3406 concerning the divulging of confidential records relating to
investigative information.

F. Confidential information that has been received, maintained or developed by
any board or disclosed by the board pursuant to subsection A shall not, under
any circumstances, be available for discovery or court subpoena or introduced
into evidence in any medical malpractice suit or other action for damages
arising out of the provision of or failure to provide services. However, this
subsection shall not be construed to inhibit any investigation or prosecution
conducted pursuant to Article 1 (&#xA7; 18.2-247 et seq.) of Chapter 7 of Title
18.2.

HISTORY: 2002, c. 481; 2004, c. 690; 2005, cc. 637, 678; 2009, cc. 158, 162,
472; 2012, cc. 21, 71; 2013, c. 739; 2014, cc. 12, 97; 2015, cc. 118, 507; 2016,
cc. 309, 410, 447, 568; 2017, cc. 186, 778; 2018, c. 108; 2019, c. 679; 2020,
cc. 1066, 1067; 2023, cc. 628, 629; 2024, c. 33.