Source: https://www.hipaaguide.net/hhs-makes-changes-to-42-cfr-part-substance-use-disorder-privacy-provisions/
Timestamp: 2020-08-10 22:27:54
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HHS Makes Changes to 42 CFR Part Substance Use Disorder Privacy Provisions - HIPAA Guide
HHS Makes Changes to 42 CFR Part Substance Use Disorder Privacy Provisions
July 14, 2020HIPAA guideHIPAA Updates0
The Department of Health and Human Services Substance Abuse and Mental Health Administration (SAMHSA) has announced that certain proposed provisions related to the sharing of records of patients that are receiving treatment through federally assisted substance use disorder programs have now been changed.
Confidentiality of Substance Use Disorder Patient Records regulation, 42 CFR Part 2, was promulgated in 1975 and was intended to protect patients’ privacy and shield them from any stigma associated with substance use disorder. 42 CFR Part 2 treats substance use disorder diagnoses and treatment information differently to other health information.
Information related to substance use disorder is not included as a part of a patient’s viewable medical records and restrictions are placed on the use and sharing of that information. Generally, a federally assisted substance use disorder program is only permitted to disclose personally identifiable information if consent is obtained from a patient in writing or if a court order is received that requires the patient’s information to be disclosed without consent. Without 42 CFR Part 2, patients may be deterred from seeking treatment for substance use disorder. 42 CFR Part 2 makes sure that patients seeking treatment for substance use disorder are not treated differently to patients who do not seek treatment.
For many years there have been calls from industry stakeholders and trade associations to change the ‘outdated’ 42 CFR Part 2 regulation, which can put patient safety at risk. A treating physician would not be able to see that a patient has a history of substance use disorder and could prescribe opiates for instance. If that information was available, a different treatment regimen could be prescribed instead.
The Health Insurance Portability and Accountability Act (HIPAA) has rules that limit the sharing of protected health information and healthcare industry leaders have been pressing the HHS to align 42 CFR Part 2 more closely with HIPAA to improve patient safety and reduce the compliance burden on physicians. Treating substance use disorder records differently from other types of protected health information also contributes to the stigmatization of mental and behavioral health conditions.
Around a year ago, the HHS announced that changes were being considered to 42 CFR Part 2 and comment was sought from industry stakeholders. The feedback has been considered and, as part of the HHS Regulatory Sprint to Coordinated Care, some of the proposed changes have now been adopted. According to the HHS, the changes “advance the integration of healthcare for individuals with substance use disorders while maintaining critical privacy and confidentiality protections.”
The basic framework of 42 CFR Part 2 remains in place and it is still necessary for written consent to be obtained from patients before their records can be shared. The HHS confirmed that “a federally assisted substance use disorder program may only disclose patient identifying information with the individual’s written consent, as part of a court order, or under a few limited exceptions.” Those exceptions have been clarified as cases of a bone fide medical emergency, for scientific research, and if required for an audit or program evaluation. Substance abuse disorder records can still not be used by law enforcement in criminal prosecutions against patients, unless a court order is obtained.
“This reform will help make it easier for Americans to discuss substance use disorders with their doctors, seek treatment, and find the road to recovery,” said HHS Secretary Alex Azar. “Thanks to the valuable input of stakeholders, our final rule will make it easier for Americans to seek and receive treatment while lifting burdens on providers and maintaining important privacy protections.”
Changes to 42 CFR Part 2
The changes to 42 CFR Part 2 are detailed in a fact sheet published by the HHS, which has been reproduced below: