Title 42, The Public Health and WelfareRelease 119-73not60

§299b–21 Definitions

Title 42 › Chapter 6A— PUBLIC HEALTH SERVICE › Subchapter VII— AGENCY FOR HEALTHCARE RESEARCH AND QUALITY › Part C— Patient Safety Improvement › § 299b–21

Last updated Apr 5, 2026|Official source

Summary

Defines key words used for patient safety reporting and protection. HIPAA confidentiality regulations means the privacy rules made under the 1996 HIPAA law. A patient safety organization is a public or private group that the federal Secretary lists. A patient safety evaluation system is the way information is collected, managed, or analyzed for reporting to or by such an organization. Patient safety activities cover efforts to make care safer, collecting and studying safety information, creating and sharing recommendations and best practices, protecting confidentiality and security, using qualified staff, and running the evaluation system and feedback to participants. Patient safety work product means reports, data, records, analyses, and related statements made for reporting to a patient safety organization or created by one, including the discussions and analysis of that work. Identifiable patient safety work product can be traced to a provider, include individually identifiable health information under HIPAA, or reveal who made a report; nonidentifiable is anything that does not. Work product does not include a patient’s medical record, billing or discharge records, or information kept separately from the evaluation system. Those excluded records can still be used in legal cases, reported to government agencies for public health or oversight, and must be kept as other laws require. Provider means people or organizations licensed to give health care (for example hospitals, clinics, pharmacies, doctors, nurses, therapists, psychologists, and others the Secretary names).

Full Legal Text

Title 42, §299b–21

The Public Health and Welfare, Source: USLM XML via OLRC

In this part:
(1)The term “HIPAA confidentiality regulations” means regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104–191; 110 Stat. 2033).
(2)The term “identifiable patient safety work product” means patient safety work product that—
(A)is presented in a form and manner that allows the identification of any provider that is a subject of the work product, or any providers that participate in activities that are a subject of the work product;
(B)constitutes individually identifiable health information as that term is defined in the HIPAA confidentiality regulations; or
(C)is presented in a form and manner that allows the identification of an individual who reported information in the manner specified in section 299b–22(e) of this title.
(3)The term “nonidentifiable patient safety work product” means patient safety work product that is not identifiable patient safety work product (as defined in paragraph (2)).
(4)The term “patient safety organization” means a private or public entity or component thereof that is listed by the Secretary pursuant to section 299b–24(d) of this title.
(5)The term “patient safety activities” means the following activities:
(A)Efforts to improve patient safety and the quality of health care delivery.
(B)The collection and analysis of patient safety work product.
(C)The development and dissemination of information with respect to improving patient safety, such as recommendations, protocols, or information regarding best practices.
(D)The utilization of patient safety work product for the purposes of encouraging a culture of safety and of providing feedback and assistance to effectively minimize patient risk.
(E)The maintenance of procedures to preserve confidentiality with respect to patient safety work product.
(F)The provision of appropriate security measures with respect to patient safety work product.
(G)The utilization of qualified staff.
(H)Activities related to the operation of a patient safety evaluation system and to the provision of feedback to participants in a patient safety evaluation system.
(6)The term “patient safety evaluation system” means the collection, management, or analysis of information for reporting to or by a patient safety organization.
(7)(A)Except as provided in subparagraph (B), the term “patient safety work product” means any data, reports, records, memoranda, analyses (such as root cause analyses), or written or oral statements—
(i)which—
(I)are assembled or developed by a provider for reporting to a patient safety organization and are reported to a patient safety organization; or
(II)are developed by a patient safety organization for the conduct of patient safety activities;
(ii)which identify or constitute the deliberations or analysis of, or identify the fact of reporting pursuant to, a patient safety evaluation system.
(B)(i)Information described in subparagraph (A) does not include a patient’s medical record, billing and discharge information, or any other original patient or provider record.
(ii)Information described in subparagraph (A) does not include information that is collected, maintained, or developed separately, or exists separately, from a patient safety evaluation system. Such separate information or a copy thereof reported to a patient safety organization shall not by reason of its reporting be considered patient safety work product.
(iii)Nothing in this part shall be construed to limit—
(I)the discovery of or admissibility of information described in this subparagraph in a criminal, civil, or administrative proceeding;
(II)the reporting of information described in this subparagraph to a Federal, State, or local governmental agency for public health surveillance, investigation, or other public health purposes or health oversight purposes; or
(III)a provider’s recordkeeping obligation with respect to information described in this subparagraph under Federal, State, or local law.
(8)The term “provider” means—
(A)an individual or entity licensed or otherwise authorized under State law to provide health care services, including—
(i)a hospital, nursing facility, comprehensive outpatient rehabilitation facility, home health agency, hospice program, renal dialysis facility, ambulatory surgical center, pharmacy, physician or health care practitioner’s office, long term care facility, behavior health residential treatment facility, clinical laboratory, or health center; or
(ii)a physician, physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse midwife, psychologist, certified social worker, registered dietitian or nutrition professional, physical or occupational therapist, pharmacist, or other individual health care practitioner; or
(B)any other individual or entity specified in regulations promulgated by the Secretary.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 264(c) of the Health Insurance Portability and Accountability Act of 1996, referred to in par. (1), is section 264(c) of Pub. L. 104–191, which is set out as a note under section 1320d–2 of this title.

Prior Provisions

A prior section 921 of act
July 1, 1944, was renumbered section 941 and is classified to section 299c of this title. Another prior section 921 of act
July 1, 1944, was classified to section 299c of this title prior to the general amendment of this subchapter by Pub. L. 106–129.

Reference

Citations & Metadata

Citation

42 U.S.C. § 299b–21

Title 42, The Public Health and Welfare

Last Updated

Apr 5, 2026

Release point: 119-73not60