As leading healthcare stakeholder groups remain on different sides of the fence regarding patient privacy laws in a sweeping opioids legislation, it’s looking like privacy advocates will win the battle as the bill nears its completion.
According to a report in Politico’s Morning eHealth Newsletter today, “The federal law known as 42 CFR Part 2 prevents the sharing of the sensitive treatment records without a patient's explicit consent. While the House had approved changes in its original legislation, H.R. 6082 (115), they didn’t make it into the Senate version and were ultimately dropped in negotiations.”Last week, the U.S. Senate passed The Opioid Crisis Response Act of 2018, which includes numerous important health IT provisions. The House passed its version of the legislation in June, and a committee to reconcile the differences between the two is nearing a resolution.
One of the key issues that has remained is whether or not patient privacy laws should be changed so providers could more easily share information about a patient’s history of substance use. According to an article in STAT News, “The AMA [American Medical Association] said it believed there was a ‘fundamental misunderstanding’ among groups working to incorporate the proposal into a sprawling opioids bill. Relaxing restrictions on patient privacy, the AMA wrote, could prevent individuals with addiction from seeking medical treatment in the first place.”However, other health IT groups, such as the College of Healthcare Information Management Executives (CHIME), the American Hospital Association (AHA), and various major health insurers, feel differently about this significant privacy issue. In a letter from CHIME to Senate and House representatives, obtained by Fierce Healthcare, the group’s President and CEO, Russell Branzell, wrote, “It is essential that healthcare providers have a complete medical history with all relevant information that will help them make clinical decisions. To ensure the highest quality of care, information pertaining to substance use disorder (SUD) is pertinent.”The CHIME letter continued, “Unfortunately, under current law, 42 CFR Part 2, SUD treatment and diagnoses are kept confidential from providers which can be extremely problematic when a clinician is attempting to treat someone but is unaware of their prior addiction history. Our members strongly support synchronizing these consent policies, which will reduce the burdens imposed by these two different sets of rules and facilitate consent for the purposes of treatment, payment and healthcare operations pursuant to HIPAA [the Health Insurance Portability and Accountability Act].”
Indeed, the federal law, 42 CFR Part 2, keeps mental health records separate from other health records and prevents the sharing of these confidential treatment records without a patient's one-time consent. But many people believe the law is severely outdated since it doesn’t always give providers the whole picture of a patient’s medical history.
According to the STAT piece, “The groups pushing the measure say that the current restrictions inhibit providers from accessing information critical to providing quality treatment—giving a common example in which a doctor, not knowing a patient has a history of addiction, unknowingly prescribing opioids for pain treatment.”Another letter to lawmakers, this one from The Partnership to Amend 42 CFR Part 2—inclusive of more than 40 organizations that are committed to aligning Part 2 with HIPAA—expressed similar concerns as the CHIME message, urging the 42 CFR Part 2 amendments to be included in the final version of the opioids bill.
The organizations wrote, “Alignment of Part 2 with HIPAA will allow appropriate access to patient information that is essential for providing safe, effective, whole-person care, while protecting this information with enhanced penalties for unlawful disclosure and use.” It continued, “The Partnership strongly believes that the modernization of privacy regulations and medical records for persons with substance use disorders is a critical component for tackling the opioid crisis and will improve the overall coordination of care in the United States.”
As the debate over patient privacy continues, Politico has reported that the final opioids package could drop as soon as tonight.
