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Privacy and Confidentiality in Washington

        Washington has taken steps to protect the privacy and confidentiality of patient health information.  Health care providers may not disclose a patient’s health information to any other person without the patient’s written authorization.1  A patient’s authorization must be signed and dated, identify the contents of the disclosure, to whom the disclosure is being made, the person disclosing the information, and have an expiration date.  The law allows patients the ability to revoke the authorization at any time.2  However, the law does outline exceptions that allow a health care provider to disclose health information without a patient’s authorization.  Patient authorization is not needed if the disclosure is for the patient’s health, health care treatment purposes, payment, or research purposes.  Other exceptions include, but are not limited to disclosure to public health officials or to law enforcement.3  Patients have the right to revoke their authorization for disclosure of confidential medical information at any time in writing.4  The law imposes a separate requirement on disclosure of minors’ health information.  It requires that for disclosure of information contained in a minor’s clinical record, the minor’s clinical record must be updated to include the circumstances of the disclosure, the persons that received the information, and their relationship to the patient.5  All communications pertaining to medical treatment between a patient and physician are privileged, and may not be used for trial purposes.6

        The presumption of health information privacy and confidentiality extends to resident health information in long term care facilities,7 nursing homes,8 and enhanced service facilities.9  Prescription information submitted to the Department of Health must remain confidential, and only be disclosed to pharmacists, providers, law enforcement, and other governmental agencies.10  The law provides civil, monetary sanctions for individuals who improperly disclose this information.11  In addition, adverse health event notifications are subject to confidentiality protections.  However, the notification of the adverse event itself is subject to public disclosure, including any contextual information the medical facility chose to provide.12

        Health information that is provided to a health insurance company is also subject to confidentiality provisions under the law.  Records held by a health plan cannot be disclosed.13  Furthermore, the state health insurance pool may not use or disclose personally identifiable data.14  In addition, records held for and by an independent review committee that investigates insurance denials, are confidential, but must be made accessible to the Insurance Commissioner.15  Health plans may disclose confidential information in accordance with disclosure laws for providers.16

        Washington law requires that the state’s Department of Health maintain the confidentiality of any individually identifiable data according to state and federal HIPAA standards.17  Vital records must be kept confidential and secure to prevent unauthorized use.18  However, vital records may be disclosed for research purposes, as long as there are confidentiality safeguards.19  The law also protects the confidentiality of certain disease specific information.  Generally, the law requires that all reports made for notifiable conditions and diseases that have patient identifying information remain confidential.20  Tuberculosis reports maintained by local health departments must remain confidential, but may be accessible to the Department.21  The law also protects HIV and other sexually transmitted disease test results or diagnoses, specifically, from disclosure.  The law does provide very limited exceptions for which disclosure is permissible, including to a person who may have been exposed to the disease, health care workers or law enforcement officials who came into contact with the patient, or to public health officials for reporting purposes.22  The confidentiality laws pertaining to cancer registry information are similar, and allow the information to only be used for statistical, scientific, medical research and public health purposes.23  The law also provides immunity from liability to individuals who report incidents of cancer to the registry.24

        State agencies that hold confidential health information may disclose identifying information for research purposes if the patient provides a written request to do so.  State agencies may disclose such personal information for research purposes with an individual’s consent when certain criteria have been meet, such as the disclosure request has scientific merit, the disclosure complies with federal laws and regulations, and the stage agency enters into a confidentiality agreement with the entity conducting the research.25

        Mental health treatment records are treated separately from other health records under Washington law.  The law allows mental health providers to disclose information regarding a person’s involuntary commitment or mental health services provided to a person in custody or in the department of corrections to “authorized persons.”26  However, the fact that a person has received mental health services is confidential, and may only be disclosed under certain circumstances.27  The law also requires an individual to have access to his or her own mental health treatment records, and has developed procedures allowing individuals to do so.28  Additionally, Washington has amended the law allowing a patient to release his or her mental health treatment records three times.  Primarily the law and its amendments dictate when treatment records may be released without the patient’s written consent.29  According to Washington’s rules of construction, each amended provision is valid unless there is a conflict in the purpose of the provisions. If such a conflict exists, then the last filed amendment will control.  Washington has separate laws concerning the release of information of a minor’s mental health treatment.  The law requires that this information remain confidential, and may be disclosed only under certain circumstances.30  It is a gross misdemeanor under Washington law, to request or access, under false pretenses, confidential information from mental health treatment records.31

 

Footnotes

  • 1. Wash. Rev. Code §70.02.020
  • 2. Wash. Rev. Code §70.02.030
  • 3. Wash. Rev. Code §4.24.250
  • 4. Wash. Rev. Code §70.02.040
  • 5. Wash. Rev. Code §71.34.350
  • 6. Wash. Rev. Code §5.60.060
  • 7. Wash. Rev. Code §70.129.050
  • 8. Wash. Rev. Code §74.42.080
  • 9. Wash. Rev. Code §70.97.200
  • 10. Wash. Rev. Code §70.225.040
  • 11. Wash. Rev. Code §70.225.060
  • 12. Wash. Rev. Code §70.56.050
  • 13. Wash. Rev. Code §70.47.150
  • 14. Wash. Rev. Code §48.43.021
  • 15. Wash. Rev. Code §48.43.535
  • 16. Wash. Rev. Code §70.02.045; Wash. Rev. Code §70.02.050
  • 17. Wash. Admin. Code §246-455-080
  • 18. Wash. Rev. Code §70.58.082
  • 19. Wash. Rev. Code §70.58.104
  • 20. Wash. Admin. Code §246-101-120
  • 21. Wash. Rev. Code §70.28.20
  • 22. Wash. Rev. Code §70.24.105
  • 23. Wash. Rev. Code §70.54.250; Wash. Admin. Code §246-102-070
  • 24. Wash. Rev. Code §70.54.260
  • 25. Wash. Rev. Code §42.48.020
  • 26. Wash. Rev. Code §71.05.385
  • 27. Wash. Rev. Code §71.05.390
  • 28. Wash. Rev. Code §71.05.640
  • 29. Wash. Rev. Code §71.05.630
  • 30. Wash. Rev. Code §71.34.340
  • 31. Wash. Rev. Code §71.05.680

 

Privacy and Confidentiality in Washington

Subtopic Statute/Regulation Description
Privacy and Confidentiality Health Care Providers—Confidential or Privileged Information--Disclosure - Wash. Rev. Code 70.02.230 Records and information relating to the mental health of an individual are confidential and privileged to the patient, and may only be disclosed in...
Wash. Admin. Code § 246-101-120 Handling of Notifiable Disease Case Reports and Medical Information All reports made for notifiable conditions and diseases that have patient...
Wash. Admin. Code § 246-102-070 Access and Release of Cancer Registry Information Cancer registry information may only be used for statistical, scientific, medical research and...
Wash. Admin. Code § 246-455-080 Security and Release of Reported Hospital Patient Discharge Data The Department of Health must maintain the confidentiality of any individually...
Wash. Admin. Code § 246-875-070 Confidentiality and Security of Pharmacy Patient Medication Record Systems Information that is contained in patient medication record systems must be...
Wash. Rev. Code § 18.71.340 Impaired physician program--Entity records protected The records maintained in connection to the Impaired Physician Program are not public records...
Wash. Rev. Code § 18.71.320 Impaired physician program—Procedures Washington has established the impaired physician program to provide assistance to physicians struggling...
Wash. Rev. Code § 42.48.020 Access to personal records Individuals, or their legal representatives, may authorize, in writing, a state agency to disclose records containing...
Wash. Rev. Code § 42.56.360 Health care Washington’s public records act prohibits disclosure of the following health care information:      ...
Wash. rev. code § 43.70.235 Health care disputes--Certifying independent review organizations--Application--Restrictions--Maximum fee schedule for conducting reviews—Rules...
Wash. Rev. Code § 48.102.110 General rules Providers may enter into life settlement contracts with terminally or chronically ill policy holders, but must comply with the...
Wash. Rev. Code § 48.43.021 Personally identifiable health information — Restrictions on release Carriers, the Washington State Health Insurance Pool, and their agents may...
Wash. Rev. Code § 48.43.535 Independent review of health care disputes--System for using certified independent review organizations—Rules An individual may obtain an...
Wash. Rev. Code § 5.60.060 Who are disqualified — Privileged communications Washington privileges any communication between a patient and their physician or surgeon that...
Wash. Rev. Code § 69.41.055 Electronic communication of prescription information — Board may adopt rules Practitioners may electronically communicate prescription refill...
Wash. Rev. Code § 70.02.020 Disclosure of Health Care Information by a Health Care Provider Health care providers, their agents, and any individuals who assist health care...
Wash. Rev. Code § 70.02.030 Patient Authorization of Disclosure Summary of Provision: A patient may authorize a health care provider or facility to disclose the patient’s...
Wash. Rev. Code § 70.02.040 Patient's revocation of authorization for disclosure A patient that authorizes their health care provider to disclose their medical information may...
Wash. Rev. Code § 70.02.045 Third-party payor release of information Third-party payors may release health care information in accordance to the rules established for health...
Wash. Rev. Code § 70.02.050 Disclosure without a Patient’s Authorization A health care provider or facility has the option of disclosing health care information about a...
Wash. Rev. Code § 70.02.060 Disclosure of Medical Records for a Discovery Request or Compulsory Process Before serving a discovery request or a compulsory process for health...
Wash. Rev. Code § 70.02.170 Civil remedies A person who has complied with the relevant requirements governing health care information access and disclosure may bring an action...
Wash. Rev. Code § 70.05.170 Child mortality review The Washington legislature intends to encourage the performance of child mortality reviews in an effort to address the “...
Wash. Rev. Code § 70.129.050 Privacy and confidentiality of personal and medical records Long-term care residents have the right to confidentiality of their personal and clinical...
Wash. Rev. Code § 70.168.090 Statewide data registry — Quality assurance program — Confidentiality The department must create a “statewide data registry to...
Wash. Rev. Code § 70.225.040 Confidentiality of prescription information — Procedures — Immunity when acting in good faith Prescription information submitted to the...
Wash. Rev. Code § 70.225.060 Violations — Penalties — Disclosure exemption for health care providers Dispensers that fail to report or knowingly report incorrect...
Wash. Rev. Code § 70.230.080 Coordinated quality improvement — Rules All ambulatory surgical facilities must implement a “coordinated quality improvement program...
Wash. Rev. Code § 70.24.022 Interviews, examination, counseling, or treatment of infected persons or persons believed to be infected — Dissemination of false information...
Wash. Rev. Code § 70.24.084 Violations of chapter — Aggrieved persons — Right of action Individuals harmed by another’s violation of Washington’s...
Wash. Rev. Code § 70.24.105 Disclosure of an HIV or Other Sexually Transmitted Disease Test No person may disclose the identity of any person who has investigated, considered,...
Wash. Rev. Code § 70.28.020 Record of reports Local health departments must keep records of the tuberculosis reports they receive pursuant to the requirements in 70.28.010....
Wash. Rev. Code § 70.41.200 Quality improvement and medical malpractice prevention program — Quality improvement committee — Sanction and grievance procedures...
Wash. Rev. Code § 70.47.150 Confidentiality Records obtained by a basic health plan that contain information regarding an individual’s medical treatment and formulas,...
Wash. Rev. Code § 70.54.250 Cancer registry program--Confidentiality The department of health may only use data from the cancer registry program for “statistical,...
Wash. Rev. Code § 70.54.260 Liability Individuals or entities that submit information to the cancer registry in compliance with the law are immune liability regarding a breach...
Wash. Rev. Code § 70.56.050 Confidentiality of Adverse Health Event Notifications When notification of an adverse event is made by a coordinated quality improvement program, a...
Wash. Rev. Code § 70.58.055 Certificates Generally Vital statistics certificates must contain, at minimum, social security numbers and other items recommended by the federal...
Wash. Rev. Code § 70.58.082 Vital records — Rules — Release of copies The department of health must establish rules for releasing copies of vital records. These...
Wash. Rev. Code § 70.58.104 Reproductions of vital records — Disclosure of information for research purposes — Furnishing of birth and death records by local...
Wash. Rev. Code § 70.96A.150 Records of alcoholics and intoxicated persons Substance abuse treatment records are confidential and privileged to the patient, and may only be...
Wash. Rev. Code § 70.97.200 Recordkeeping — Compliance with state, federal regulations — Health care information releases Enhanced service facilities must (1) keep...
Wash. Rev. Code § 71.05.385 Information subject to disclosure to authorized persons — Restrictions Mental health providers, or legal counsel, may disclose the following...
Wash. Rev. Code § 71.05.390 Confidential information and records — Disclosure The fact that an individual received voluntary or involuntary mental health services as well...
Wash. Rev. Code § 71.05.630 (as amended by 2009c 398) Treatment records — Confidential — Release Washington amended § 71.05.630 three times during the 2009 legislative session without...
Wash. Rev. Code § 71.05.660 Treatment records — Privileged communications unaffected The provisions in chapter 71.05 regarding disclosure of treatment records and...
Wash. Rev. Code § 71.05.680 Treatment records — Access under false pretenses, penalty It is a gross misdemeanor to request or access, under false pretenses, confidential...
Wash. Rev. Code § 71.06.135 Sexual psychopaths — Release of information authorized The department of social and health services may release any information regarding a...
Wash. Rev. Code § 71.09.120 Release of information authorized The department of social and health services may release any information regarding a sexually violent predator that...
Wash. Rev. Code § 71.34.340 Information concerning treatment of minors confidential — Disclosure — Admissible as evidence with written consent All information...
Wash. Rev. Code § 71.34.350 Disclosure of information or records — Required entries in minor's clinical record When information contained in a minor’s clinical...
Wash. Rev. Code § 74.09.290 Audits and investigations of providers — Patient records — Penalties The Secretary or Director of the department of social and health...
Wash. Rev. Code § 74.13.520 Disclosure of child welfare records — Information not to be disclosed The provisions contained in the law do not authorize the disclosure of...
Wash. Rev. Code § 74.42.080 Confidentiality of records Nursing home residents’ records are confidential. Facilities may only disclose the information with the consent of...
Wash. Rev. Code § 74.42.640 Quality assurance committee Nursing home facilities may establish quality assurance committees. These committees must include, at minimum, “the...
Wash. Rev. Code § 9.41.097 Supplying information on persons purchasing pistols or applying for concealed pistol licenses The department of social and health services, mental...