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Health care organizations aim to align SUD treatment records, HIPAA

The Partnership to Amend 42 CFR Part 2 — which encompasses more than 50 health care organizations — continues its efforts to ensure patients with substance use disorders can receive high-level care while maintaining privacy, according to a press briefing.

The Partnership, which includes major organizations like the American Psychiatric Association, the American Society of Addiction Medicine and the National Alliance on Mental Illness, urges lawmakers to align Part 2 with HIPAA for treatment, payment and health care operations (TPO).

During a press briefing, the Partnership discussed the latest news on the issue, lingering problems Part 2 leaves and why they hope Congress will address the issue.

Currently, Part 2 requires multiple consents from patients to disclose their substance abuse treatment records for purposes of TPO, which can create barriers to care, hinder their ability to receive treatment and potentially exacerbate the opioid epidemic, according to the press release.

Although there have been some changes to the initial regulations in recent years, much more still needs to be done to integrate care and improve patient safety, Rebecca Murow Klein, MA, chair of the Partnership, and director of Government Affairs, Association for Behavioral Health and Wellness, said during the briefing.

“We would like to see Part 2 modernized and aligned with HIPAA TPO provisions to ensure patients receive safe, effective, coordinated care based on the ability to see a patient’s entire medical record while also continuing to protect them and their records,” Klein said. “This change would also help to reduce stigma that comes along with keeping physical and addiction records separate.”

R. Corey Waller, MD, chair of the legislative advocacy committee, American Society of Addiction Medicine, also offered his clinical perspective on the importance of aligning Part 2 with HIPAA.

“Those of us who see patients on a regular basis understand more than most the role that stigma and discrimination play in self-disclosure from patients with addiction, and we really work hard to protect our patients,” Waller said.

Waller explained that if a patient comes to the ED and they don’t disclose information about their substance use problems because they’re afraid of being stigmatized, the doctor may choose the wrong treatment pathway for pain management or may give them medication that interacts with other medications they’re taking.

“Without access to medical records in an integrated fashion we end up giving them only a partial risk assessment. The biggest side of this is the human toll it takes,” he said. “The way that Part 2 was written and the way that it is currently fully siloing out addiction treatment from the rest of health care, it is the last bastion of a large, brick barrier keeping us from implementing integrated care for patients with one of the most complex diseases.”

He also said that the “largest domino that needs to fall” to create adequate care for patients with addiction are the hospital systems.

“They will not budge until we have a compliant pathway for them to understand treatment payments and operations for the movement of information,” Waller added. “To ask them to spend billions of dollars to create new technology to do this is going to take decades in order for them to be able to move forward and we don’t have that time with 70,000 people a year dying from overdose, not counting the millions of people with other addictions who still need active identification and treatment.” – by Savannah Demko

Disclosure: Healio Psychiatry was unable to confirm any relevant financial disclosures at the time of publication.