Lawmakers To Address Behavioral Health Data Sharing via EHRs

May 20, 2015 in News

On Tuesday, Reps. Tim Murphy (R-Pa.) and Paul Tonko (D-N.Y) urged fellow House Energy and Commerce Committee members to support a proposal that would address legal issues with electronically sharing patients’ behavioral health data, Health Data Management reports (Slabodkin, Health Data Management, 5/20).

A draft of the 21st Century Cures initiative was approved by the committee’s health subcommittee on Thursday by voice vote (iHealthBeat, 5/14). The full committee is expected to continue its markup of HR 6 on Thursday.

Background

Current federal law (42 CFR Part 2) restricts, with limited exceptions, federally-assisted substance misuse programs from disclosing all personally identifiable information — including for treatment –  to any other entity if programs do not receive patient consent to disclose the information. In addition, if an entity receives such data, it must again obtain patient consent before re-disclosing the data to other groups (Health Data Management, 5/20).

According to Modern Healthcare, some see the current regulations as barriers to interoperability, which could make it more difficult for providers to manage population health and transition from fee-for-service payment systems to alternative payment systems (Conn, Modern Healthcare, 5/15).

During the committee’s hearing on the 21st Century Cures Act (HR 6), Tonko said that the current federal rules “provide critical and needed privacy protections for those receiving treatment for substance [misuse].” However, he said the “regulations were also written in an era before electronic health records and some of the requirements of 42 CFR Part 2 are now creating barriers to coordinated care for individuals struggling with a substance [misuse] problem.”

Murphy said the lawmakers’ proposal would “allow the sharing of substance [misuse] records on a patient with a single consent form throughout a medical system or hospital,” rather than a patient having to give written consent to every provider, as is required under current federal law.

Tonko said their proposal would “moderniz[e]” the current federal regulations “without compromising needed privacy protections that ensure a patient has the opportunity to meaningfully consent to whom has access to their substance [misuse] records” (Health Data Management, 5/20).

SAMHSA Mulls Rule Change

Meanwhile, an official from the Substance Abuse and Mental Health Services Administration said that the agency intends to issue a rule or guidance on 42 CFR Part 2 prior to President Obama leaving office in 2017, Modern Healthcare reports (Modern Healthcare, 5/15).

In June 2014, federal officials held a meeting to discuss easing the regulations — which were last updated in 1987 — to better accommodate the use of EHRs (iHealthBeat, 6/12/14).

SAMHSA public health adviser Kate Tipping said that agency officials had reviewed the more than 700 comments it received from the meeting and that officials are “talking with the departments on what our next steps will be.”

She said, “For the most part, folks were supportive of looking at the regulations and updating them” and that there were “a handful [of commenters] that did say that the laws and the regulations should be repealed and we should just use HIPAA.”

Under a 2002 rule revision, HIPAA stopped requiring patient consent prior to sharing EHRs for treatment, payment or other care-related matters.

Tipping added that “[t]here was agreement” among commenters that 42 CFR Part 2 “is a barrier to [data] sharing” and to providers successfully participating in accountable care organizations (Modern Healthcare, 5/15).

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