[ Friday, August 23, 2019 ]
Part 2 Rule Changes Are Coming. HHS issued a
press release yesterday, along with a
fact sheet, outlining some textual changes to 42 CFR Part 2. The proposed rule was issued yesterday, but has not yet been published in the Federal Register; the rule will be open for comment for 60 days. I was not able to locate a copy of the actual text of the rule; guess I'll have to wait for the Federal Register publication.
The Part 2 rules serve as a sort of "super-HIPAA" for federally-assisted substance abuse treatment centers. Unlike HIPAA, which allows a HIPAA covered entity to disclose patient information for treatment, payment, or healthcare operations without the consent of the patient, Part 2 required the patient to specifically consent to the specific disclosure. The rules currently indicate that the consent must indicate the exact recipient; stating that the recipients will be "healthcare providers involved in the patient's care" is insufficient, the Part 2 provider must say "Dr. Jones" or Dr. Smith." The new rules will loosen up this requirements somewhat.
Part 2 also require that any disclosure contain an instruction to the recipient that the information remains subject to Part 2 and cannot be further disclosed. HIPAA, on the other hand, operates under a "horse is out of the barn" structure, where once a disclosure is made to a non-HIPAA-covered entity, it may be further disclosed. This concept in Part 2 isn't really changing, except that it's now clear that if a non-Part 2 provider develops medical records relating to a Part 2 patient that includes information from the Part 2 provider,
as long as the non-Part 2 provider keeps the records separate, the Part 2 records don't subject all of the non-Part 2 provider's records to Part 2 restrictions.
The new rules also expand the "emergency" exception to disclosure of Part 2 medical records. As originally drafted, it was a medical emergency involving the patient that triggered the exception; now, if there's a declared emergency (like a hurricane), disclosure restrictions are loosened. Other changes involve the ability of providers to disclose information to state prescription drug monitoring plans and looser rules for disclosures for research.
The
AP article has a pretty good explanation of the impetus for the revisions, including an explanation of why Part 2 exists in the first place. These changes are really nibbling at the edges and fixing specific issues.
Jeff [12:01 PM]
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