State AGs ask Congress to replace law on substance use disorder records

By | August 7, 2019

The National Association of Attorneys General wants the U.S. Senate and House of Representatives to get rid of decades-old regulations preventing doctors from knowing patient addiction treatment histories.

In a letter to congressional leaders, 39 state AGs called on Congress to “replace the cumbersome, out-of-date, privacy rules contained in 42 CFR Part 2 with the effective and more familiar privacy rules contained in the Health Insurance Portability and Accountability Act.”

Congress passed 42 CFR Part 2 more than 40 years ago out of concern about the potentially negative consequences—including discrimination—that could come from disclosing the patient records of individuals with substance use disorders.

However, the AGs contend that the antiquated law prevents lifesaving medical care for patients in trying to recover from addiction.

“42 CFR Part 2 sets forth strict requirements for the use and disclosure of patients’ substance use disorder treatment records,” according to the AGs. “The complexities of complying with 42 CFR Part 2 often prevent general practice providers from even attempting to treat patients with substance use disorders through the use of medication-assisted treatment (MAT), because–while providers are familiar with how to comply with the privacy requirements of HIPAA–they may be intimidated by the requirements of 42 CFR Part 2.”

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The east front of the Capitol building stands in Washington, D.C., U.S., on Monday, Jan. 3, 2011. President Barack Obama and Democrats are preparing to confront a strengthened Republican opposition to tax, spending and immigration priorities when the 112th session of Congress convenes this week after Democrats lost control of the House during midterm elections. Photographer: Andrew Harrer/Bloomberg

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In addition, their letter makes the case that “while maintaining confidentiality is imperative to encouraging individuals to seek and obtain treatment, the inability to share records among providers can burden coordination of care, potentially resulting in harm to the patient.”

As a result, the AGs urged Congress to align the rules regarding disclosure of substance use disorder treatment records with the protections against unwanted disclosure of patient records already contained in HIPAA.

The letter points out that last year, the Protecting Jessica Grubb’s Legacy Act was introduced by Sens. Joe Manchin (D-W.Va.) and Shelley Moore Capito (R-W.Va.), and the Overdose Prevention, and Patient Safety Act was introduced by Reps. Markwayne Mullin (R-Okla.) and Earl Blumenauer (D-Ore.).

“Both bills will align Part 2 with HIPAA for the purposes of healthcare treatment, and both are supported by the Partnership to Amend 42 CFR Part 2, a growing coalition of more than 40 national healthcare organizations that includes the American Hospital Association, the American Psychiatric Association, and the American Society of Addiction Medicine,” the letter concludes.

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