Proposal aims to modernize Part 2 at last

A proposal by the U.S. Department of Health and Human Services (HHS) would update Part 2 rules, paving the way for care coordination and better data sharing among substance use disorder (SUD) providers and other clinicians.

The proposed revisions to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations, 42 CFR Part 2, allow for several ways to modernize the SUD treatment provider system, creating new disclosure forms and allowing more health entities to have access to patient records to assist with care coordination. The changes will be published on February 9, 2016, and HHS will receive comments until April 11, 2016.

If enacted, the policy would modify the consent form to allow patients to agree to a general disclosure of medical records to any providers treating them, or patients could provide a more specific list of providers they would allow to access their clinical data. Additionally, the rule updates certain provider definitions and language to reflect electronic medical records as well as paper ones. Providers would also have more discretion to disclose data in medical emergencies.

Working in the complex system

Part 2 rules are more restrictive than HIPAA and have not been updated since 1987. Historically, SUD providers have struggled with obtaining the correct permission from patients to allow other clinicians to view data from their records in a fast and efficient way.

“The concept of protected records would be expanded from just SUD providers, to healthcare providers who include people and programs that include SUD,” says Ronald Manderscheid, PhD, executive director of the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD). “It also defines the disclosure procedure on the front end of patient care for different entities involved in the healthcare process.”

Though the proposed changes are sorely needed, the specifics of technology costs and a timetable of rule implementation are still in question. Manderscheid says that at this early stage, the rules are still “very hypothetical,” and that NACBHDD will comment to HHS that rule changes need to be practical, while also respectful for patients’ need for privacy.

 “What health organizations need to think about is whether this proposal works well for providers and protects patient records at the same time,” Manderscheid says. “All of this moves records from the paper world to the electronic world so that record sharing can improve. We want to make sure the system works in an electronic world, and is compatible with the Affordable Care Act’s mandates for medical homes and coordinated care. ”

HHS Secretary Sylvia M. Burwell, who announced the proposal, says that the policy will allow patients with SUD an opportunity to fully participate in the healthcare system.

“We are moving Medicare, and the healthcare system as a whole, toward new integrated care models that incentivize providers to coordinate and put the patient at the center of their care, and we are modernizing our rules to protect patients,” Burwell said in a press release.