By Fred Donovan

June 21, 2018 - By a vote of 357-57, the US House passed the Overdose Prevention and Patient Safety Act (HR 6082) on June 20, which would align privacy protections for substance use disorder (SUD) patients with the HIPAA Privacy Rule.

HR 6082 would authorize the disclosure of SUD patient records without the patient’s written consent to a covered entity for the purposes of treatment, payment, healthcare operations and to a public health authority, as long as the disclosure is in line with HIPAA.

Under the HIPAA Privacy Rule, health information may be used or disclosed by covered entities for the purposes of treatment, payment, and other healthcare operations — including case management, care coordination, and outcomes evaluation — without patient consent.

Current law (42 CFR Part 2) authorizes disclosure of SUD patient records without a patient’s written consent only to medical personnel in a medical emergency, to specified personnel for research or program evaluations, or pursuant to a court order.

“Doctors must have the whole picture on a patient’s medical history in order to safely and effectively treat that patient. This includes any history of substance use disorder,” said Rep. Markwayne Mullin (R-OK), the bill’s sponsor.

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The bill would also repeal criminal penalties for violations involving SUD patient records and replace them with the HIPAA civil penalty structure.

It also would prohibit discrimination based on the release of SUD information and expand the current prohibition against using SUD patient records in criminal proceedings to include any use in specified federal, state, and local criminal and civil actions.

“The Overdose Prevention and Patient Safety Act (HR 6082) would enhance care coordination and improve patient safety by aligning the outdated 42 CFR Part 2 regulations with HIPAA, allowing the responsible sharing of substance use disorder treatment records for purposes of treatment, payment, and healthcare operations,” said American Hospital Association Executive Vice President Tom Nickels in a statement.

“This bill will facilitate integrated care for individuals with an opioid or other substance use disorder while maintaining, and in fact enhancing, the protections that currently exist for SUD records,” commented Pamela Greenberg, president and CEO of the Association for Behavioral Health and Wellness, which is a founding member of the Partnership to Amend 42 CFR Part 2.

“Clinicians need access to a patient’s full medical history, including substance use disorder records, to assess risks and adequately care for a patient,” Greenberg said in a statement emailed to HealthITSecurity.com.*

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A nearly identical bill, HR 5795, passed the House Energy and Commerce Committee on May 17.

“The OPPS Act will update an antiquated regulation — 42 CFR Part 2 — which requires a person to sign a special release to allow his or her alcohol or drug use history to be included in their medical record — a practice the healthcare industry requires from no other disease state,” said Centerstone CEO David Guth in a statement emailed to HealthITSecurity.com.

“For decades, healthcare providers have been trying to change this stringent regulation so that our dedicated healthcare professionals can treat those suffering from addiction more safely, effectively, and efficiently,” Guth added.

Centerstone is a not-for-profit healthcare provider that offers mental health and substance abuse treatment, education, and support to communities in Florida, Illinois, Indiana, Kentucky, and Tennessee.

In an interview with HealthITSecurity.com, Centerstone Vice President of Adult and Family Services Linda Grove-Paul said that this change in the law is necessary “because now it is difficult if not impossible to provide comprehensive care coordination in line with any other chronic medical or mental health conditions.”

READ MORE: House Debates Bill to Align SUD Rules with HIPAA Privacy Rule

“There is no doubt that stigma around substance use disorder still exists, but it shouldn’t be the major reason for preventing care coordination for patients with chronic illness…. [42 CFR Part 2] is continuing to stigmatize people with a substance use disorder,” Grove-Paul said.

Not everyone supports amending 42 CFR Part 2. During a May 9 hearing on an earlier version of the bill, Faces and Voices of Recovery Executive Director Patty McCarthy Metcalf warned that weakening 42 CFR Part 2 privacy protections will discourage individuals who need SUD treatment from seeking it.

“We do not want our highly sensitive personal information shared for the purposes of treatment payment, healthcare operations, or for any other purposes beyond the current rule without our expressed written consent,” she told the House Energy and Commerce Committee’s health subcommittee.

“The dismantling of 42 CFR Part 2 is the antithesis of the principle of patient-centered, integrated care, and is largely being pursued by groups who hold their own business interests ahead of the rights and interests of our community,” Metcalf said in her testimony.

The Senate is considering a number of bills, such as S 1850, which are similar to HR 6082. The Senate could either vote on the House bill or on one of the Senate versions. Whether the Senate Republican leadership has any desired to do so remains to be seen.

*This article has been updated to included comments by the Association for Behavioral Health and Wellness.