Reintroduction of Legislation Again Pushes for 42 CFR Part 2, HIPAA Alignment

April 5, 2019
Aligning 42 CFR Part 2 with HIPAA has been a key point of contention in healthcare circles

Health IT groups are applauding the reintroduction of legislation that would reform 42 CFR Part 2 by aligning it with the Health Insurance Portability and Accountability Act (HIPAA).

Two bills—the Overdose Prevention and Patient Safety (OPPS) Act in the House of Representatives and the Protecting Jessica Grubb's Legacy Act in the Senate—are sponsored by Representatives Earl Blumenauer (D-OR) and Markwayne Mullin (R-OK); and Senators Shelley Moore Capito (R-WV) and Joe Manchin (D-WV), respectively.

According to the Opioid Safety Alliance—a working group of prescribers, health systems, technology companies, pharmacies and pharmacists, professional societies, and patients united against inappropriate opioid use—the legislations, if signed into law, “would reform the flawed patient privacy law known as 42 CFR Part 2 that silos addiction treatment information from the rest of an individual's medical record, thereby preventing prescribers from making fully informed clinical decisions.”

Indeed, many stakeholders have been pushing for 42 CFR Part 2—which keeps mental health records separate from other health records and prevents the sharing of these confidential treatment records without a patient's explicit consent—to be amended and be aligned with HIPAA. But others believe that the privacy laws ought to remain intact. The American Medical Association (AMA), for one, has previously said that relaxing restrictions on patient privacy could prevent individuals with addiction from seeking medical treatment in the first place.

Last fall, as part of an opioid crisis package, the House passed a bill committed to aligning 42 CFR Part 2 with HIPAA, but it didn’t make it through the Senate. Politico has reported that Sen. Patty Murray (D-Wash), ranking member of the Senate HELP (Health, Education Labor & Pensions) Committee, was a key person in blocking this provision, despite support by other Democrats, including her state's governor. “She has reservations about a change that would make it easier for doctors to see a patient's substance abuse records,” Politico has previously reported.

However, The Partnership to Amend 42 CFR Part 2—coalition of more than 40 national healthcare organizations committed to aligning Part 2 with HIPAA—recently issued a statement in response to the reintroduction of the bills that included the support of some of the industry’s leading associations. 

The College of Healthcare Information Management Executives (CHIME), for instance, noted, “It is essential that healthcare providers have a complete medical history with all relevant information that will help them treat patients. To ensure the highest quality of care, information pertaining to substance use disorder (SUD) history must be shared. Unfortunately, under current law, 42 CFR Part 2, SUD treatment and diagnoses are kept confidential from other providers, which can be extremely problematic when a clinician is attempting to treat someone but is unaware of their prior addiction history.”

CHIME CEO and President Russell Branzell added in his statement, “Our members strongly support synchronizing these consent policies, which will save lives, reduce the burdens imposed by these two different sets of rules and facilitate consent for the purposes of treatment, payment and healthcare operations under HIPAA.”

Meanwhile, the Opioid Safety Alliance’s Executive Director Joel White said, “By aligning laws governing addiction treatment records with HIPAA, these bills represent a smart step in the right direction that will protect the well-being of those recovering from substance misuse and ensure prescribers do not become unwitting aides to a patient’s relapse. Better information for a patient’s provider will help ensure better treatment and less addiction. We celebrate the introduction of these bipartisan measures and commit to work toward their swift passage.”

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