Lawmakers are hoping Congress can pass a proposed overhaul of addiction-related privacy laws now that the American Medical Association is no longer opposed.
Hospitals badly want Congress to waive the statute known as 42 CFR Part 2 and its dictates that only substance-use disorder, or SUD, patients themselves can decide who sees their medical history. They argue that given the stakes with widespread opioid addiction, it's risky to ban doctors from sharing medical histories when appropriate.
The Trump administration is also expected to release its regulatory changes to the so-called "Part 2" protections any day now, but it's unclear how far officials can go in reshaping the law.
In the House, Rep. Earl Blumenauer (D-Ore.) is now leading the legislative push to match substance abuse disorder privacy laws with HIPAA rules. His lead co-sponsor is Rep. Markwayne Mullin (R-Okla.), who fought last year, when Republicans had the majority in the House, to get the bill into Congress' bicameral opioid legislation.
"If providers are unable to get the full picture of a patient's condition, it can often have tragic consequences," Blumenauer said in a statement to Modern Healthcare. "The AMA's recognition of this has provided momentum in Congress to make meaningful reforms that will ensure physicians have all of the necessary information to provide care to all patients regardless of the possibility that they are suffering from a substance-use disorder."
The bill was close to making it into opioid package, but the AMA expressly opposed it and the effort died.
Then in June of this year, the AMA's House of Delegates changed its policy stance and voted to support alignment of 42 CFR Part 2 with HIPAA "for the purposes of treatment, payment and health care operations," as long as appropriate safeguards are maintained.
The AMA delegates also voted to support sharing of substance-use disorder patient records "to improve patient safety and enhance the quality and coordination of care."
The legislation has both ardent supporters and detractors. Supporters say that given the ravages of the opioid epidemic, clinicians need to know whether they are prescribing opioids to people who have struggled with addiction. "There is no argument that the restrictions of 42 CFR Part 2 has cost lives," Blumenauer said.
There's a strong contingent of support for reforms in the upper chamber as well. West Virginia's two senators—Democrat Joe Manchin and Republican Shelley Moore Capito—reintroduced their version of the bill, titled Protecting Jessica Grubb's Legacy Act. Their fellow co-sponsors include Sens. Dianne Feinstein (D-Calif.), Kamala Harris (D-Calif.), Thom Tillis (R-N.C.) and Susan Collins (R-Maine).
But it's unclear whether the legislation's critics in Congress would agree to move forward.
Vocal critics in last year's debate included Rep. Frank Pallone (D-N.J.), then the ranking member and now chair of the Energy and Commerce Committee. A Pallone spokesperson did not comment on his position this year.
Sen. Patty Murray (D-Wash.) also expressed concerns in 2018; a spokesperson did not immediately respond as to whether anything had changed.
One hospital representative said some of the legislative debate may depend on what the Trump administration is able to do through its forthcoming regulatory tweaks to 42 CFR Part 2.
Hospitals haven't let up on their pressure for changes, as was clear from comment letters submitted to the CMS to aid the agency's information-gathering for its Medicare red-tape initiative.
"Lack of access to a patient's substance use records can result in a physician inadvertently prescribing opioids to a patient with a prior history of addiction," Michael Griffin, vice president of political advocacy for AdventHealth, wrote. "Physicians need access to a patient's complete medical history, including information related to any substance-use disorder, to ensure their patients' safety."