FEDERAL AND FLORIDA STATUTES AND REGULATIONS ON
"SUPER-CONFIDENTIAL" MEDICAL RECORDS

MENTAL HEALTH, HIV, & DRUG/ALCOHOL TREATMENT RECORDS
(rev. 10/25/2005)

Although most medical information on patients is considered to be confidential, some types are considered to be even more confidential than regular types of health care information. This "super-confidentiality" may exist in certain situations including the following three major types of health records or information:

(1) Alcohol/Drug Treatment Records:
        - 42 U.S.C. sect. 290dd-2
        - 42 C.F.R. sect. 2.1
        - Florida Statutes, sect. 394.4615 (Florida Mental Health Act)
                (Note: modeled after 42 U.S.C., sect. 9501)
        - Florida Statutes, sect. 397.501(7) (The AMarchman Act@)
        - Florida Statutes, sect. 112.0455(11)(a) (Drug-Free Workplace Act)

(2) HIV/AIDS Testing Records or Results:
        - Florida Statutes, sect. 381.004(3)(e)

(3) Psychiatric and Mental Health Records
        - Psychiatrist/psychotherapist-Patient Privilege, pursuant to
                Federal Rule of Evidence 501 &
        - Jaffee v. Redmond, 518 U.S. 1, 116 S.Ct. 1923, 1927, 135 L.Ed.2d 337 (1996)
        - 42 U.S.C., sect. 9501(1)(H) & (2)(B)
        - Florida Statutes, sect. 90.503(2) & (3)(d) (Note: This merged the psychiatrist-
                patient privilege from Florida Statutes, sect. 490.242(1975) with the
                psychologist-patient privilege Florida Statutes, sect. 490.32(1975), both of
                which existed before the Evidence Code was enacted)
        - Russell v. Stardust Cruisers, Inc., 690 So.2d 743(Fla. 5th DCA 1997)
        - Community Psychiatric Centers of Fla., Inc. v. Bevelacqua, 673 So.2d 948
                (Fla. 4th DCA 1996)
        - Leonard v. Leonard, 673 So.2d 97 (Fla. 1st DCA 1996)
        - Florida Statutes, sect. 394.459(9)
        - Florida Statutes, sect. 490.0147 (psychologists= records)
        - Florida Statutes, sect. 491.0147 (clinical, counseling and psychotherapy services)

Although not technically Asuper-confidential,@ the following Federal Regulations apply to confidentiality in hospital records, if they are Medicare Program participants (as most are): 42 C.F.R., sect. 482.24(b)(3).

Also, JCAHO standards are applied and required to be followed via Federal Regulations for organizations that participate in the Medicare Program: 42 U.S.C., sect. 1395bb; 42 C.F.R., sect. 488.5(a). JCAHO standards and guidelines may require additional protections.

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