State Attorneys General Call For the Alignment of Part 2 Regulations with HIPAA

The National Association of Attorneys General (NAAG) told the House and Senate leaders to make improvements to Confidentiality of Substance Use Disorder Patient Records regulations referred to as 42 CFR Part 2.

NAAG tagged the regulations under consideration as cumbersome [and] out-of-date and they limit the substance abuse treatment records uses and disclosures.

The HIPAA allows the sharing of protected health information (PHI) between providers and caregivers when used in relation to treatment, healthcare operations, and payment even without patient consent. 42 CFR Part 2 forbids federally assisted treatment programs to share addiction treatment data except if the patient has given the consent to do so.

CFR Part 2 was put together over 40 years ago to protect the privacy of patients and to make sure that patients who sought substance abuse disorder treatment won’t face any legal or civil consequences.

NAAG explained that the rules were made when there was an “intense stigma” related to substance abuse disorder. The principle behind these rules is the belief that substance use disorder treatment is embarrassing and such treatment records should be kept a secret from other treatment providers but not the treatment records of other chronic illnesses.

NAAG would like the recognition of substance abuse disorder as the chronic illness that it is. This suggests that rules on substance abuse treatment records should be aligned with the HIPAA. Substance abuse treatment data and other health data can be shared as long as there are protections that keep the privacy and confidentiality of that data.

It seems that Part 2 regulations serve as an obstruction to the treatment of opioid use disorder. Healthcare providers are familiar with HIPAA compliance, but the conditions of Part 2 could be intimidating. Therefore, a lot of providers do not provide medicated-assisted treatment (MAT) to substance abuse disorder patients.

MAT providers do not need to follow the Part 2 requirements if they’re not advertising their MAT services. However, that means fewer people will avail those services. To successfully deal with the opioid epidemic in America, MAT services must be advertised and made conveniently accessible. At present, a lot of providers are not promoting their MAT programs because of the constraints of Part 2 regulations.

There was only a minor update of 42 CFR Part 2 privacy regulations in 2018. NAAG and a coalition of over 40 national healthcare organizations are asking for more significant changes to the regulations that closely align with HIPAA regulations.

There are some Congressmen and Senators who are supporting this call. Reps. Earl Blumenauer (D-OR) and Markwayne Mullin (R-OK) submitted the Overdose Prevention and Patient Safety Act (OPPS Act) (H.R. 2062) while Sens. Shelley Moore Capito (RWV) and Joe Manchin (D-WV) submitted the Protecting Jessica Grubb’s Legacy Act (Legacy Act) (S. 1012). The two proposed laws align Part 2 with the HIPAA. However, there is a big challenge in having more people to support the changes.