The U.S. Department of Health and Human Services released its final rule on the confidentiality for patients with substance use disorders, opting to leave the privacy framework relatively untouched for providers using alternative payment models.

The HHS’ Substance Abuse and Mental Health Services Administration regulation outlines when it’s acceptable for contractors to receive these types of patient records for billing and payments. Pieces of 42 CFR Part Two restrict sharing addiction records with providers, even if patients have given access.

[Also: Why HIPAA shouldn't be an impediment to public health data sharing]

Providers and hospitals who commented on the rule proposed by SAMHSA in January 2016 said HHS should make it easier for providers using alternative payment models to share records within the group, as the lack of access to abuse records can impede care. 

HHS, however, did not agree. The agency stressed the rule wasn’t intended to cover care coordination or case management. And the new language in the final rule clearly states that these types of disclosures aren’t permitted for diagnosis, treatment or referrals.

[Also: OCR revamps HIPAA guidance in wake of opioid crisis, 21st Century Cures rules]

Further, the list of acceptable payment and healthcare operators is “substantively unchanged,” as “SAMHSA maintains its position that payment and healthcare operations … are not intended to encompass substance use disorder patient diagnosis, treatment or referral for treatment.”

The final rule differs from HIPAA, which does allow healthcare operators to share this information for case management and care coordination. HHS officials said it attempted to align the final rule as best it could with HIPAA, per commenters’ requests.

“Part 2 provides more stringent federal protections than other health privacy laws…and seeks to protect individuals with substance use disorders who could be subject to discrimination and legal consequences in the event that their information is improperly used or disclosed.”

SAMHSA will continue to review the issues addressed by commenters and will explore better alignment with HIPAA in the future.

As part of the 21st Century Cures Act, HHS will hold a public meeting on 42 CFR Part Two and the effects on patient privacy, care outcomes and patient care, tentatively scheduled for Jan. 31.

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com