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New Legislation Intends to Align Substance Abuse Treatment Records with HIPAA

September 27, 2017
by Rajiv Leventhal
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Two U.S. senators are introducing a bill to bring the regulations governing substance use treatment disorder records in better alignment with the privacy rules and protections for other medical records.

U.S. Senators Joe Manchin (D-WV) and Shelley Moore Capito (R-WV) introduced the Protecting Jessie Grubb’s Legacy Act (Legacy Act) this week, with the broad goal to ensure that healthcare providers have access to the full scope of their patient’s medical history and are able to provide appropriate care.

This bill will specifically aim to improve healthcare coordination and reduce the risk of overdose death for people with substance use disorders by allowing their treatment records to be safely and privately shared between healthcare providers, according to a release from the senators.

The legislation is named after Jessie Grubb, a young woman who sadly lost her life from an opioid overdose last year. The 30-year-old from West Virginia was at a rehab center in Michigan recovering from a seven-year heroin addiction, and then after that, a hospital in Michigan for an unrelated hip surgery. However, reports at the time said that the doctor who discharged her post-surgery never knew the information about her addiction. As such, Grubb was given a prescription for 50 oxycodone pills on her way out, leading to a fatal overdose. This then sparked debate on if her life could have been saved if medical professionals had full knowledge of the patient’s previous opioid addiction, assuming consent was given.

As reported previously by Healthcare Informatics, 42 CFR Part 2 regulations restricting how data of patients with substance use disorders (SUDs) is shared were written in 1975 out of concern that the information could be used against individuals, causing them to avoid seeking needed treatment.  But the way the regulation was written, it required the patient to consent every time their data was shared or accessed, which HIEs and healthcare organizations have found very difficult to implement. Many HIEs have just avoided the issue during their startup phases.

In a rule that updated 42 CFR Part 2 rules in January, the Substance Abuse and Mental Health Service Administration (SAMHSA) aimed to facilitate the sharing of information within the healthcare system to support new models of integrated healthcare. But some associations attested at the time that the rule makes sharing clinical information for treatment purposes more difficult.

As noted in the text of this bill, “Whether or not  the  patient with respect to whom any substance use  disorder patient record referred is maintained gives written consent, the content of such record may be used or disclosed as follows: a) In  connection with the provision of medical  services or healthcare  to  substance  use  disorder  patients consistent with the allowable uses and disclosures to carry out  treatment, payment, or healthcare operations; and b) to qualified personnel for the purpose of conducting  scientific  research,  management  audits, financial  audits, or program evaluation” (though the patient cannot be identified in this situation).

In a statement, Senator Manchin said, “Last month the Senate passed Jessie’s Law, the first step to making sure physicians and other medical professionals have access to information at every step of a patient’s care, enabling them to consider the patient’s substance use disease when determining appropriate medical care. Jessie’s Law creates voluntary standards for hospitals to report information about a patient’s addiction history if the patient provides that information. This legislation actually changes the underlying regulations to ensure that information about substance use disorder treatment is being shared…”

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