Citizens’ Council for Health Freedom Highlights Privacy Concerns Within Opioid Bill
Congressional Opioid Bill Erodes Current Federal Privacy Protections for People with Behavioral Health Issues
PAUL, Minn.—Congress is poised to pass an extensive opioid bill that thus far has had bipartisan cooperation, but Citizens’ Council for Health Freedom (CCHF) has concerns about some of the patient privacy issues within the bill.
After the House and Senate separately passed their own versions of the bill, the current compromise—the 660-page H.R. 6, which the House passed Friday—aims to, according to USA Today, “stop illegal drugs at the border, speed up research for new nonaddictive prescription painkillers and make treatment more readily available for those who are addicted. … Other measures contained in the package boost state prescription drug monitoring programs to prevent ‘doctor shopping,’ provide for comprehensive opioid recovery centers, authorize Medicaid to cover 30 days of substance abuse treatment and allow for special safety packaging to limit opioid doses to a three- to seven-day supply.”
The trouble, says CCHF president and co-founder Twila Brase, lies in how patient information is shared, and therefore, how privacy is compromised for those struggling with addiction, especially because the bill would require the Department of Health and Human Services (HHS) to develop “best practices” for “prominently” displaying this information in EHRs, when requested by the patient.
“This opioid bill erodes current federal privacy protections for people with behavioral health issues,” Brase said. “While it allows ‘history of opioid use disorder’ to be displayed in the electronic health record (EHR) ‘only at the patient’s request,’ the HHS Secretary will define what constitutes a ‘patient’s request.’ Thus, this power to define a patient’s request could lead to insufficiently informed patients. It could lead to a simple oral statement by the patient being defined as a ‘request.’ It could take place at a time and place where patients are under duress. Or it could mean not telling patients that if that statement is in the record it may be impossible to remove, and a doctor could decide to not treat patients that refuse to divulge more information about that statement.”
Also concerning in the bill are the financial incentives for therapists and other behavioral health providers to digitize this sensitive information, Brase said.
“Behavioral health providers will receive incentive payments to put information about a patient’s history with behavioral health or addiction services in a government-certified EHR (CEHRT),” she added. “Once sensitive mental and behavioral health data enters an EHR, it is often placed on corporate EHR vendor servers far from the bedside or exam room, where it can be readily shared and is vulnerable to hackers.”
Fortunately, the bill does not align the protective 42 CFR Part 2 privacy regulation with the permissive federal HIPAA data-sharing rule, says Brase. It maintains the integrity of 42 CFR Part 2, “which is intended to protect the confidentiality of people who seek treatment for drug or alcohol abuse.” 42 CFR Part 2 restricts the disclosure of patient records concerning addiction treatment by federally assisted alcohol and drug abuse programs without the express written consent of the patient. It gives those with experiences in drug or alcohol treatment the privacy that all patients should have, but do not, thanks to the sweeping disclosures permitted under HIPAA, Brase said.
However, Brase notes, “The push to digitize sensitive information, the HHS secretary’s power to define ‘patient’s request’ and the ramifications of displaying a history of opioid use disorder in the patient’s record could fundamentally erode these regulatory protections and reduce patient access to care.”
For more information about CCHF, visit www.cchfreedom.org, its Facebook page or its Twitter feed @CCHFreedom. Also view the media page for CCHF here. For more about CCHF’s initiative The Wedge of Health Freedom, visit www.JointheWedge.com, The Wedge Facebook page or follow The Wedge on Twitter @wedgeoffreedom.