AHA: Mental Health Reform Bill Does Not Go Far Enough to Modernize “Part 2,” Eliminate Barriers to Data Sharing

June 20, 2016
The Helping Families in Mental Health Crisis Act, H.R. 2646, passed the U.S. House Energy and Commerce Committee this week and will move to the House floor, but the American Hospital Association voiced disappointment that the bill did not address patient privacy laws in 42 CFR Part 2.

The Helping Families in Mental Health Crisis Act, H.R. 2646, passed the U.S. House Energy and Commerce Committee this week and will move to the House floor, but the American Hospital Association voiced disappointment that the bill did not address patient privacy laws in 42 CFR Part 2.

In a letter to Committee Chairman Fred Upton and other ranking members of the committee, Thomas Nickels, AHA executive vice president, wrote that the AHA “applauds the bipartisan efforts to reform elements of the nation’s behavioral health system” and noted the bill, introduced by Rep. Tim Murphy, “represents a solid foundation for improving behavioral health care.”

However, Nickels, on behalf of AHA, wrote, “We are disappointed that the Substitute Amendment did not restore revisions to 42 CFR Part 2 that were included in H.R. 2646 as introduced. The original language authored by Rep. Murphy would have permitted the sharing of a patient’s alcohol- and drug-abuse treatment records within health information exchanges, health homes, and other integrated care networks, and it would have helped eliminate barriers to integrated care for our patients. Without access to a patient’s entire medical record, including information related to treatment for substance use disorders, health systems are hindered in their efforts to coordinate the patient’s care.”

And, AHA notes that the new draft provides only for a review after one year of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) revised 42 CFR part 2 regulations. “Those proposed regulations take some steps to modernize Part 2, but they do not go far enough. Absent revisions to Part 2 that go beyond what SAMHSA has proposed, persons with substance use disorders will not have access to fully coordinated care, and we look forward to working with Congress to modernize these rules.”

The bill includes a training program for providers intended to instruct on how to better share data under the Health Insurance Portability and Accountability Act.

The bill does address several other health IT issues, such as establishing a four-year grant to assist up to ten states in developing a tele-psychiatry and physician training program for treating and referring children and young adults with mental health disorders. The grant also would be used to connect primary care physicians with psychiatrists or psychologists through the use of tele-health technology, which is modeled on a successful state project in Massachusetts called the Child Psychiatry Access Project (MCPAP).

In its letter, AHA stated, given the nationwide shortage of mental health professionals, it supports the bill’s efforts to increase access to care, including through telehealth services for children and adolescents.

The bill also addressed extending health IT laws so mental health providers can coordinate care with primary care doctors using electronic medical records. The bill would extend Medicare and Medicaid reimbursement for meaningful use of EHRs to psychologists and mental health professionals who provide clinical care at psychiatric hospitals, mental health treatment facilities, and substance abuse treatment facilities.

The bill also clarifies the definition “health care provider” throughout the HITECH Act to include behavioral and mental health professionals, substance abuse professionals, psychiatric hospitals, behavioral and mental health clinics, and substance use treatment facilities. And, the bill would make behavioral health providers eligible for HITECH Act technical assistance to enhance HIT infrastructure, facilitate medical staff training, and improve the exchange of health information between mental health providers and other health care providers.

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