Policy Watch

May 3—Legislation to allow more patient data sharing—long sought by hospitals—is expected to continue advancing in Congress next week.

The House Energy and Commerce Committee’s Health Subcommittee will hold a hearing May 8 on the Overdose Prevention and Patient Safety Act, which tweaks the federal rule 42 CFR Part 2 to allow more sharing of behavioral health data. The House panel’s effort follows the approval in April of the Opioid Crisis Response Act of 2018 by the Senate Health, Education, Labor and Pensions Committee. However, the Senate bill would not align 42 CFR Part 2 regulations with privacy provisions in HIPAA—unlike the House bill—according to published reports.

Hospital advocates have argued that the rule’s partitioning of patients’ medical records to keep substance use disorder diagnoses and treatments hidden from the clinicians who treat them creates dangers for the patient and treatment challenges for providers while also contributing to the stigmatization of mental and behavioral health conditions.

“Applying the same requirements to all patient information, whether behavioral or medical, would support the appropriate information sharing essential for clinical care coordination and population health improvement, while safeguarding patient information from unwarranted disclosure,” Tom Nickels, executive vice president for the American Hospital Association (AHA), wrote in a letter to the House committee’s leaders.

To comply with current regulations, hospitals have said they must maintain two separate computer servers and two separate medical records to keep patients’ behavioral health conditions distinct from other health records.

“This adds burden and expense, but without benefit,” Nickels wrote.

Some patient and privacy advocates have raised objections to the bill over concerns that it would allow sensitive data to be inappropriately accessed.

The committee had been expected to consider the bill in April when it approved several other opioid-related measures, but did not take it up.

Daniel Duhigg, DO, medical director for addiction services for Presbyterian Healthcare Services, said the rule was intended to eliminate the fear of those seeking drug treatment that their condition would be discovered and affect their employment or other parts of their life.

However, the privacy rule has so constricted access to patient data that no other clinician can see documentation for patients whom Duhigg is treating for opioid abuse.

“And the whole point of documentation, really, is to communicate to my coworkers what I have been doing in the care of this patient,” Duhigg said. “Privacy is important, but when it impedes and gets in the way of patient care, then it is a barrier and not helpful.”

During this week’s World Health Care Congress in Washington, D.C., Duhigg urged that the rule’s restrictions be addressed.

Pamela Greenberg, president and CEO of the Association for Behavioral Health and Wellness, is a member of the Partnership to Amend 42 CFR Part 2, which includes many hospital advocates. They are pushing for the prospective legislation to be included with a large package of opioid bills that are moving through Congress, she said.

On May 2, the Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology and the Substance Abuse and Mental Health Services Administration issued two fact sheets to help healthcare providers and others apply the 42 CFR Part 2 rule to healthcare programs and settings and to the electronic exchange of health information.

“We want to familiarize stakeholders with scenarios pertaining to Part 2 to help eradicate any barrier someone might encounter to either choosing or providing appropriate treatment,” Elinore McCance-Katz, MD, PhD, assistant secretary for mental health and substance use at HHS, said in a release.

Sunday, May 6

AHA Annual Membership Meeting in Washington, D.C. (through May 9). Learn more.

Tuesday, May 8

Hearing by the House Education and Workforce Committee’s Subcommittee on Workforce Protections titled “The Opioid Epidemic: Implications for the Federal Employees’ Compensation Act.” Learn more.

Hearing by the House Energy and Commerce Committee’s Oversight and Investigation Subcommittee titled “Combating the Opioid Epidemic: Examining Concerns About Distribution and Diversion.” Learn more.

Hearing by the House Ways and Means Committee’s Health Subcommittee titled “The Current Status of and Quality in the Medicare Advantage Program.” Learn more.

Advisory Board web conference titled “Navigating the Patient Financial Journey: Part I.” Learn more.

Health Affairs briefing and webcast on precision medicine. Learn more.

Wednesday, May 9

Centers for Medicare & Medicaid Services (CMS) webinar titled “Quality Payment Program: Participation Criteria for Year 2.” Learn more.

Thursday, May 10

CMS webinar titled “eCQI Resource Center Demonstration and Annual Update.” Learn more.

CMS webinar for participants in the Inpatient Quality Reporting program. Learn more.

AHA webinar titled “Improving Patient Experience with Enhanced Mobile Communications.” Learn more.

Kaiser Family Foundation and the Peterson Center on Healthcare forum focused on healthcare prices. Learn more.


Rich Daly is a senior writer/editor in HFMA’s Washington, D.C., office. Follow Rich on Twitter: @rdalyhealthcare

Publication Date: Thursday, May 03, 2018