Monday, August 26, 2019

APA Welcomes Administration’s Proposal to Coordinate Care for SUD and General Medical Care

APA and a group of nearly 50 health care organizations are welcoming a proposed rule to change federal regulations that govern the confidentiality of patient records created by federally assisted substance use disorder treatment programs.

The Department of Health and Human Services (HHS) issued the proposed rule today in the Federal Register. It would revise regulations known as “42 CFR Part 2” to support coordinated care among different health care professionals who treat patients with substance use disorders (SUDs) while maintaining privacy safeguards (for instance, patients would still need to give consent in order for their records to be shared). APA is reviewing the rule and will be submitting comments.

First formulated in the 1970s, the 42 CFR Part 2 regulations restrict the sharing of medical records related to substance use treatment. The regulations were originally intended to protect patient confidentiality, but they make it difficult for health care professionals to know whether a patient is being treated for or has a history of substance use disorder.

As part of the Partnership to Amend 42 CFR Part 2, APA and the other health care organizations have been calling for alignment of 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (HIPAA) regulations to allow for information sharing by health care professionals involved in the care of a patient with SUD. The partnership hailed today’s proposed changes as an important step toward integrating mental health and substance use disorder treatment and general medical care for patients with SUD.

“We appreciate the support provided by the administration to align 42 CFR Part 2 with HIPAA and its efforts through regulation to better allow information to flow between health care professionals to provide safer and better care for our patients with substance use disorders,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A., in a press statement. “This is a good step forward in breaking down barriers for people with substance use disorders to receive effective integrated care. We will continue to work with the administration and Congress to address the remaining barriers.”

(In June, the AMA House of Delegates voted to support alignment of 42 CFR Part 2 with HIPAA, a significant victory for the APA delegation to the House.)

According to HHS, the proposed rule is the first of four regulations that have been identified in HHS's “Regulatory Sprint to Coordinated Care,” which seeks to promote value-based outcomes for patients by examining federal regulations that impede coordinated care among health care professionals.

HHS has prepared a fact sheet about the proposed rule. For related information, see the Psychiatric News articles “APA Pushes to Reform Outdated Regulation Jeopardizing Care for SUD Patients” and AMA Backs Alignment of Regs Governing SUD Treatment Records With HIPAA.

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