Senate takes step to modernize law on drug use disorder records

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The Senate health committee this week completed its markup of bills designed to address the opioid crisis, with the panel including terms that update a 40-year old law limiting the ability of providers to see medical records that contain information on substance use.

The Opioid Crisis Response Act of 2018, which the Senate health committee voted to approve on Tuesday, included the Protecting Jessica Grubb’s Legacy Act (S. 1850), which would align Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) with HIPAA for the purposes of healthcare treatment, payment and operations.

For its part, however, the House Energy and Commerce Health Subcommittee on Wednesday did not bring up for vote a similar bill, the Overdose Protection and Patient Safety Act (H.R. 3545), which also seeks the alignment of 42 CFR Part 2 with HIPAA.

On Monday, a coalition of more than 40 healthcare organizations—called the Partnership to Amend 42 CFR Part 2—sent letters to the Senate health committee and the House Energy and Commerce Committee urging them to include S. 1850 and H.R. 3545 in their respective opioid package markups. The coalition includes the American Health Information Management Association, American Hospital Association and Health IT Now.

“Part 2 was enacted more than 20 years before HIPAA and 40 years prior to the utilization of electronic healthcare records. While different treatment of substance use disorder (SUD) records were important in the 1970s, Congress went on to enact HIPAA in 1996, which allows for the sharing of medical records without an authorization for (treatment, payment and operations),” states the coalition’s letter. “We believe changing Part 2 to align with the HIPAA standard of care for TPO is essential in order to integrate care and stop opioid prescriptions from getting into the hands of individuals with a SUD.”

Also See: Addressing challenges of substance abuse data in the age of EHRs

Congress in 1975 passed 42 CFR Part 2 because of concerns about the potentially negative consequences—including discrimination—that could result from disclosing the patient records of individuals with substance use disorders. However, a 2017 report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis criticized 42 CFR Part 2 for being a hindrance to comprehensive healthcare and called it a misguided law preventing doctors from knowing their patients’ addiction treatment histories.

Premier, a healthcare alliance of 3,900 hospitals and 150,000 other providers, has been a big supporter of aligning 42 CFR Part 2 with HIPAA to “remove this roadblock that is getting in the way of healthcare providers delivering the coordinated, safe and informed care that people struggling with addiction need and deserve.” Premier is a member of the Partnership to Amend 42 CFR Part 2.

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