The Trump administration has revised privacy restrictions on patients' substance use treatment records to improve care coordination.
The updated rule from the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the Department of Health and Human Services (HHS), is designed to support better care coordination and reduce provider burden while maintaining privacy safeguards for patients, HHS officials said.
The revisions will help healthcare providers coordinate care and manage claims while also ensuring quality improvement, patient safety and proper training.
The rule will not alter the basic framework for confidentiality protection of substance abuse disorder patient records created by federally funded treatment programs, HHS officials said.
The regulation, called the Confidentiality of Substance Use Disorder Patient Records regulation, or 42 CFR Part 2, continues to prohibit law enforcement’s use of SUD patient records in criminal prosecutions against patients absent a court order.
Part 2 also continues to restrict the disclosure of SUD treatment records without patient consent, unless authorized in the event of a medical emergency, scientific research, audit, program evaluation or court order.
"This reform will help make it easier for Americans to discuss substance use disorders with their doctors, seek treatment, and find the road to recovery,” said HHS Secretary Alex Azar in a statement.
"Thanks to the valuable input of stakeholders, our final rule will make it easier for Americans to seek and receive treatment while lifting burdens on providers and maintaining important privacy protections," Azar said.
The new rule advances the integration of healthcare for individuals with substance use disorders while maintaining critical privacy and confidentiality protections. Under Part 2, a federally assisted substance use disorder program may only disclose patient identifying information with the individual’s written consent, as part of a court order or under a few limited exceptions.
The revised rule also is designed to increase alignment between 42 CFR Part 2 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations.
“The adoption of this rule means Americans will be better able to receive integrated and coordinated care in the treatment of their substance use disorders,” said HHS Assistant Secretary for Mental Health and Substance Use Elinore McCance-Katz, M.D., in a statement.
The rule will make it easier for primary care clinicians to treat individuals with substance use disorders, McCance-Katz said.
Many healthcare provider groups and health IT associations say current Part 2 regulations can hinder care coordination and patient access.
Initially promoted in 1975, Part 2 predates HIPAA and was designed to protect patients from the stigma associated with substance abuse, which can deter patients from entering treatment.
When the proposed rule was released in August, Azar said existing regulations and onerous legal requirements often discourage primary care providers from caring for SUD patients or recording SUD information.
Physicians have complained that complying with current Part 2 regulations can mean filling out 11 different kinds of paperwork, HHS officials said.
“We need an all-hands-on-deck approach to treating substance use disorders,” said McCance-Katz. “We must do all we can to ensure the greatest access and availability to care for individuals living with substance use disorders. Although well-intentioned, the non-disclosure of critical, lifesaving information the previous rule permitted is itself stigmatizing.”