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Substance abuse patients suffer from privacy rules, agency says


By Virgil Dickson
Posted: May 9, 2014 - 7:30 pm ET
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Existing federal privacy regulations are keeping healthcare organizations, including health-information exchange organizations, accountable care organizations and coordinated care organizations from relaying information about patients' substance-abuse disorders, according to HHS' Substance Abuse and Mental Health Services Administration (SAMHSA).

This inability to share information is preventing some patients from fully benefiting from appropriate treatment models, the agency said. As a result, SAMSHA is now attempting to tweak regulations so those individuals can have full access to coordinated care, while still ensuring their personal information isn't at risk for exposure to unauthorized personnel, the agency said in a federal notice.

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Under federal statutes, a federally assisted substance-abuse program may only release patient-identifiable information related to substance-abuse treatment services with the individual’s express consent. The need for consent can be waived in the case of a medical emergency.

These regulations were last updated in 1987 and since then “significant changes have occurred within the U.S. health care system that were not envisioned by these regulations, including new models of integrated care that are built on a foundation of information sharing to support coordination of patient care,” SAMHSA said in a federal notice.

“A number of organizations across the country are excluding substance-abuse treatment data because of the difficulty and expense of implementing the functionality and workflow changes necessary to comply with current regulations,” the agency said. “In these instances, patients are prevented from fully participating in integrated-care efforts even if they are willing to provide consent.”

The agency plans to conduct a public meeting June 11 to provide interested parties with the opportunity to share their views prior to the initiation of rulemaking.

One issue it hopes to address is an existing requirement that those suffering from substance abuse must provide written consent that includes the name or titles of individuals or organizations that can be made aware of their addictions.

Some stakeholders have reported that this requirement makes it difficult for HIEs, ACOs and coordinated-care organizations to work with their growing number of member providers.

SAMHSA is considering several fixes including allowing the consent to include a more general description of the individual, organization, or healthcare entity to which disclosure is made. Another option is to require that the patient be provided with a list of providers or organizations that may access their information, and be notified regularly of changes to the list.

Follow Virgil Dickson on Twitter: @MHvdickson


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