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Why 42 CFR Part 2 is outdated

December 23, 2015
by Julie Miller, Editor in Chief
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The Association for Behavioral Health and Wellness (ABHW), which represents managed care behavioral health companies, released a policy recommendation this week calling for a reassessment of 42 CFR Part 2, which separates patient health information related to substance abuse treatment.

A proposed rule revising Part 2 is currently under review by the federal Office of Management and Budget, and ABHW leaders expect that the findings will be released shortly for inspection.

“Revising 42 CFR Part 2 would give providers access to all relevant patient information and would allow them to more easily coordinate their patient’s care with other providers treating that patient,” says Pamela Greenberg, president and CEO of ABHW, and Behavioral Healthcare editorial advisor.

She says separation of substance use from the rest of medicine creates several problems. For example, primary care and addiction treatment providers lack the ability to coordinate a patient’s medical and substance use treatment, and patients are put at risk. It goes against the grain of today's efforts to delivery whole-person care.

ABHW’s paper indicates that there is no legal basis for the penalties attached to violations of Part 2 and outlines details of the law’s iterations. Recommendations propose changes that can be made to the 45-year-old Part 2 policy that balance the need to facilitate communications with privacy protection.

“Changes to Part 2 would also decrease the burden put on providers to obtain multiple authorizations to integrate a patient’s care,” Greenberg says. “Privacy protections would still be in place via HIPAA and the HITECH Act.”





The fundamental issue has been and remains what is best for the patient and who makes that decision. 42CFR2 does not constrain the patient from disclosing anything,