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Patients Need Privacy Protections in All Medical Matters, Not Just Substance Abuse

Citizens’ Council for Health Freedom: Congress’ Plan to Permit Sharing of Substance Abuse Data Without Patient Consent Would Be Detrimental and Strips These Patients of the Privacy Protections All Patients Need


ST. PAUL, Minn.—Two bills in Congress seek to roll back the restrictions on a 46-year-old law that currently keeps information about drug and alcohol treatment private. The new measures would allow broad sharing of this sensitve information.

Not only should the law not move forward, but the stringent restricitions about releasing drug and alcohol treatment details should be expanded and extended to all patients regarding everything in their medical records, says Citizens’ Council for Health Freedom (CCHF,

CCHF co-founder and president Twila Brase recently talked to Inside Health Policy about the potential downsides in weakening confidentiality protections for addiction information. Information about drug or alcohol abuse treatment is extremely sensitive and should not be haphazardly shared with third parties.

“People with substance abuse—if you really want to help them, you’re going to give them the confidence they need to be able to walk through the door,” Brase told the news outlet. “The last thing we want to do is get rid of this protection. If nothing else, we should start with the folks who have substance abuse and the law that they have, and expand it to everyone else.”

The new proposed bills, H.R. 3545 and S. 1850, would make substance-abuse records subject to the more relaxed Health Insurance Portability and Accountability Act (HIPAA) standards. Under HIPAA, providers, health plans and others may share a patient’s health information without the patient’s consent for purposes such as treatment, billing, research, public health purposes, law enforcement and a very long list of “health care operations.” CCHF has long educated misinformed patients who think HIPAA protects their privacy that it does exactly the opposite.

According to Inside Health Policy, loosening privacy protections for medical records so that providers can more easily find out if their patients have a history of substance abuse would also allow CMS to hand over more data about claims involving substance abuse to accountable care organizations, prescription drug monitoring programs and state governments. The original law, 42 C.F.R. Part 2, which was designed to guarantee confidentiality to people with addiction issues and encourage them to seek treatment, “bars providers and insurers in most circumstances from sharing medical records pertaining to substance abuse unless the patient consents to the disclosure,” Inside Health Policy reports.

Brase says talk about loosening restrictions on sharing drug and alcohol treatment information parallels another privacy assault currently being waged by Congress.

“Republicans have recently introduced legislation, H.R. 4613, to let health care clearinghouses join the data-sharing free-for-all,” Brase said. “Clearinghouses, which are part of the administrative infrastructure of health care, handle about 90 percent of all health care claims transactions in the U.S. If enacted, the ‘Ensuring Patient Access to Healthcare Records Act of 2017’—which has very little to do with patient access—would allow clearinghouses to use and share patient data without express patient consent for the purpose of ‘enhancing treatment, quality improvement, research, public health efforts and other functions.’”

This troubling bill could also be used to establish a national patient ID system, Brase added, which Congress has long prohibited. Clearinghouses already help create unique patient IDs for each individual health system, and there are other efforts to standardize patient IDs across pharmacy systems nationwide.

“Comprehensive health care records including ‘every healthcare event going back decades’ is the goal, and no doubt, money is at stake,” Brase said. “However, a survey regarding health information exchange found only 57.3 percent of respondents are willing to share identified information for health care.

“This legislation appears to be moving forward,” she continued. “Senator Bill Cassidy (R-La.) introduced S. 3530 on December 8, 2016, and Congresswoman Cathy McMorris Rodgers (R-Wash.) introduced H.R. 4613 on December 11, 2017. The House bill has one Democrat and seven Republican cosponsors. If it passes, patients will need to prevail upon state legislators to protect them from HIPAA. State laws that provide greater privacy protections and privacy rights supercede the federal HIPAA ‘no-privacy’ law and rule.”

For more information about CCHF, visit, 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, The Wedge Facebook page or follow The Wedge on Twitter @wedgeoffreedom.