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HHS Proposes Easing Privacy Restrictions for Patients With History of Substance Use Disorder

Jaime Rosenberg
The proposed changes would implement revisions to the 4-decade-old 42 CFR Part 2, which requires confidentiality of patient records created by federally-assisted substance use disorder treatment programs.
HHS today announced proposed changes to federal regulations that would ease current privacy requirements for patients with substance use disorder (SUD). According to the agency, the changes would allow doctors to know if a patient has been treated for SUD, thus preventing them from unknowingly prescribing opioids to someone with a history of addiction. 

The proposed changes would implement revisions to 42 CFR Part 2, which predates the Health Insurance Portability and Accountability Act and requires confidentiality of patient records, created by federally-assisted SUD treatment programs.

Originally intended to protect the privacy of patients with SUD and encourage them to seek out treatment, the current regulations—implemented in 1975—have actually created barriers for these patients to seek treatment and for providers to safely treat these patients, explained HHS Secretary Alex Azar in a press call. Doctors looking to consider prescribing opioids or a drug that reacts poorly with opioids, such as benzodiazepine, do not have the ability to see if a patient has been treated for SUD, he said.

“The lack of critical substance use history in a patient’s medical record can lead to potentially damaging consequences for a person with a substance use disorder and can further stigmatize these conditions,” Elinore F. McCance-Katz, MD, PhD, assistant secretary for Mental Health and Substance Use at HHS, said in a statement. “This rule aims to ease the sharing of information, reduce burden for providers, and increase access to care for individuals while at the same time maintaining important privacy controls.”

Under the proposed changes, primary care and other providers would be permitted to record addiction treatment information into a medical record similar to how they would record any other piece of a patient's history. According to Azar, the changes would allow providers to better integrate a patient’s behavioral health into their overall health.

HHS would update the definition of what constitutes a Part 2 record and its applicability, which would offer providers clarity about what is or should be protected by Part 2 and ensure that providers are not dissuaded from offering treatment for patients with SUD or recording SUD information.

“President Trump has promised Americans a healthcare system that provides affordable, high-quality patient-centric healthcare—a system that treats you like a person, not a number. But outdated regulations have often stood in the way of delivering that kind of care, and our proposed reforms to 42 CFR Part 2 aim to change that,” Azar said in a statement. 

 
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