On October 26, 2017, U.S. President Donald Trump declared that the opioid crisis in the United States was a national public health emergency. 12 months later, a new opioid bill has been enacted and on October 24, 2018, Donald Trump signed the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act – “SUPPORT for Patients and Communities Act” into law. It is hoped that the Act will help the government respond to the opioid crisis and improve access to addiction treatment services.
The 42 CFR Part 2 regulations differ from the HIPAA Privacy Rule in that information about substance abuse disorder and cannot be shared in the same way as other health disorders without consent being obtained from patients. many organizations believe that 42 CFR Part 2 regulations should be aligned with the HIPAA Privacy Rule to allow that information to be shared, without consent, to ensure doctors have access to information about opioid addiction to inform decisions.
The SUPPORT for Patients and Communities Act does not go that far, although it is now possible for information about opioid use disorder and treatment to be included in a patients medical record if consent has been obtained from the patient.
The SUPPORT for Patients and Communities Act requires the Department of Health and Human Services to engage with stakeholders and establish best practices for prominently displaying that information in medical records, the most effective way of obtaining consent, and the strategies and procedures that should be adopted for displaying that information.
The stakeholders that must be consulted include a patient with a history of opioid use disorder, a specialist in patient health information privacy, an electronic health record authority, and a healthcare provider. The HHS is required to published those best practices within a year.
After the passing of the SUPPORT for Patients and Communities Act, the HHS’ Office for Civil Rights embarked upon a public education campaign to explain what the HHS is doing to combat the opioid crisis.
The campaign has two key objectives. First, OCR is trying to enhance access to evidence-based opioid use disorder treatment and recovery services, which includes medication assisted treatment and that all individuals should have equal access to those services regardless of their proficiency in English or disability. The second objective is to increase understanding of civil rights protections for patients undergoing opioid use disorder treatment.
OCR Director Roger Severino said that civil rights laws protect people while receiving help for opioid use disorder throughout their recovery. “Discrimination, bias, and stereotypical beliefs about persons recovering from an opioid addiction can lead to unnecessary and unlawful barriers to health and social services that are key to addressing the opioid crisis.”
More information about the campaign is available on the HHS web page. There are also fact sheets about nondiscrimination related to opioid use disorder as well as drug addiction and federal disability rights laws.
OCR has produced guidance for healthcare organizations that makes clear how HIPAA allows the disclosure of opioid use disorder without consent under certain circumstances. The guidance document, called “How HIPAA Allows Doctors to Respond to the Opioid Crisis,” can be downloaded – in PDF form – on this link.