Bills seek to update law on substance use disorder records

Proposed legislation has been reintroduced in Congress to remove decades-old regulations preventing physicians from knowing their patients’ addiction treatment histories.

Reps. Earl Blumenauer (D-Ore.) and Markwayne Mullin (R-Okla.) reintroduced the Overdose Prevention and Patient Safety Act, which would align Title 42 of the Code of Federal Regulations Part 2—governing the confidentiality of substance use disorder treatment and prevention records—with HIPAA, while the companion Protecting Jessica Grubb’s Legacy Act was reintroduced by Sens. Joe Manchin (D-W.Va.) and Shelley Moore Capito (R-W.Va.).

The House and Senate bills seek to align 42 CFR Part 2 with HIPAA for the purposes of treatment, payment and healthcare operations, enabling access to patient information while protecting the data with penalties for unlawful disclosure and use.

More than 40 years ago, Congress passed 42 CFR Part 2 because of concerns about the potentially negative consequences—including discrimination—that could come from disclosing the patient records of individuals with substance use disorders. However, healthcare organizations contend that the law in antiquated and prevents lifesaving medical care for patients in recovery for substance use disorders.

“Too many patients with substance use disorder have been prescribed an opioid or another drug that may endanger their life or sobriety because of an outdated law that prevents clinicians from reviewing their complete treatment history,” the American Hospital Association noted in a written statement. “The Overdose Prevention and Patient Safety Act and the Protecting Jessica Grubb’s Legacy Act would allow clinicians access to the information they need to ensure patient safety and the highest quality of care.”

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“It is essential that healthcare providers have a complete medical history with all relevant information that will help them treat patients,” said Russell Branzell, president and CEO of the College of Healthcare Information Management Executives. “To ensure the highest quality of care, information pertaining to substance use disorder history must be shared. Unfortunately, under current law, 42 CFR Part 2, SUD treatment and diagnoses are kept confidential from other providers, which can be extremely problematic when a clinician is attempting to treat someone but is unaware of their prior addiction history.”

Likewise, the Opioid Safety Alliance—a group of prescribers, health systems, technology vendors, pharmacies and pharmacists, as well as patients—praised the reintroduction of the Overdose Prevention and Patient Safety Act and the Protecting Jessica Grubb’s Legacy Act.

“For too long, the flawed 42 CFR Part 2 law has put a wall between patients’ addiction treatment records and the rest of their health history,” said Joel White, executive director of the Opioid Safety Alliance. “This policy creates needless stigma that impedes care coordination and threatens patient safety.

“By aligning laws governing addiction treatment records with HIPAA, these bills represent a smart step in the right direction that will protect the well-being of those recovering from substance misuse and ensure prescribers do not become unwitting aides to a patient’s relapse,” White added. “Better information for a patient’s provider will help ensure better treatment and less addiction.”