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<section article="ghg" article_name="Health - General" number="4-302" title_number="4" title_name="Statistics and Records" subtitle_number="3" subtitle_name="Confidentiality of Medical Records">
  <level label="a">
    <text>A health care provider shall:</text>
    <level label="1">
      <text>Keep the medical record of a patient or recipient confidential; and</text>
    </level>
    <level label="2">
      <text>Disclose the medical record only:</text>
      <level label="i">
        <text>As provided by this subtitle; or</text>
      </level>
      <level label="ii">
        <text>As otherwise provided by law.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>The provisions of this subtitle do not apply to information:</text>
    <level label="1">
      <text>Not kept in the medical record of a patient or recipient that is related to the administration of a health care facility, including:</text>
      <level label="i">
        <text>Risk management;</text>
      </level>
      <level label="ii">
        <text>Quality assurance; and</text>
      </level>
      <level label="iii">
        <text>Any activities of a medical or dental review committee that are confidential under the provisions of § 1–401 and Title 4, Subtitle 5 of the Health Occupations Article and any activities of a pharmacy review committee;</text>
      </level>
    </level>
    <level label="2">
      <text>Governed by the federal confidentiality of alcohol and drug abuse patient records regulations, 42 C.F.R. Part 2 and the provisions of § 8–601(c) of this article; or</text>
    </level>
    <level label="3">
      <text>Governed by the developmental disability confidentiality provisions in §§ 7–1008 through 7–1011 of this article.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>Unless the patient has restricted or prohibited the disclosure of directory information, a health care provider may disclose directory information about a patient to an individual who has asked for the patient by name.</text>
    </level>
    <level label="2">
      <text>A health care provider shall:</text>
      <level label="i">
        <text>Inform a patient of the health care information that the health care provider may include in a directory and the persons to whom the health care provider may disclose the information; and</text>
      </level>
      <level label="ii">
        <text>As soon as practicable, provide the patient with the opportunity to restrict or prohibit disclosure of directory information.</text>
      </level>
    </level>
    <level label="3">
      <text>If providing an opportunity under paragraph (2)(ii) of this subsection to restrict or prohibit the disclosure of directory information is not practicable because of the patient’s incapacity or need for emergency care or treatment, a health care provider may disclose the patient’s directory information if the disclosure is:</text>
      <level label="i">
        <text>Consistent with a prior expressed preference of the patient that is known to the health care provider; and</text>
      </level>
      <level label="ii">
        <text>Determined to be, based on the health care provider’s professional judgment, in the patient’s best interest.</text>
      </level>
    </level>
  </level>
  <level label="d">
    <text>A person to whom a medical record is disclosed may not redisclose the medical record to any other person unless:</text>
    <level label="1">
      <text>The redisclosure is:</text>
      <level label="i">
        <text>Authorized by the person in interest;</text>
      </level>
      <level label="ii">
        <text>Otherwise permitted by this subtitle;</text>
      </level>
      <level label="iii">
        <text>Permitted under § 1–202(b) or (c) of the Human Services Article; or</text>
      </level>
      <level label="iv">
        <text>Directory information; or</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>The person to whom the medical record was disclosed is a guardian ad litem who received the medical record in accordance with § 4–306(b)(12) of this subtitle;</text>
      </level>
      <level label="ii">
        <text>A reasonable effort to secure a qualified protective order has been made in accordance with 42 C.F.R. § 164.512(e)(1)(v); and</text>
      </level>
      <level label="iii">
        <text>The guardian ad litem determines that it is necessary to redisclose the medical record to carry out the guardian ad litem’s official function to protect the best interests of a minor or a disabled or elderly individual in a criminal or juvenile delinquency court proceeding.</text>
      </level>
    </level>
  </level>
  <level label="e">
    <level label="1">
      <text>Except as provided in paragraph (2) of this subsection, a person may not disclose by sale, rental, or barter any medical record.</text>
    </level>
    <level label="2">
      <text>This subsection shall not prohibit the transfers of medical records relating to the transfer of ownership of a health care practice or facility if the transfer is in accord with the ethical guidelines of the applicable health care profession or professions.</text>
    </level>
  </level>
  <level label="f">
    <text>The provisions of this subtitle may not be construed to constitute an exception to the reporting requirements of Title 5, Subtitle 7 and Title 14, Subtitle 3 of the Family Law Article.</text>
  </level>
</section>
