American Society of Addiction Medicine Urges HHS to Expedite Revising Rule Pursuant to the CARES Act

CHEVY CHASE, Maryland, April 29 -- The American Society of Addiction Medicine issued the following news release:

On April 28, the Partnership to Amend 42 CFR Part 2, of which ASAM is a member, sent a letter to the Secretary of Health and Human Services Alex Azar thanking him and Deputy Secretary Hargan for their work on current 42 CFR Part 2 (Part 2) regulations while also urging the Department of Health and Human Services (HHS) to quickly issue a rule on the Part 2 provisions in the Coronavirus Aid, Relief, and Economic Safety Act (CARES Act).

The letter observes that the COVID-19 pandemic has the potential to contribute to an increase in SUDs, and therefore it is more important than ever that the roadblocks to providing care for patients with SUDs are removed.

It notes that the changes to Part 2 included in the CARES Act will significantly improve coordination of care for patients, but more specificity will be needed to implement the flexibilities provided in the act.

Thus, HHS must issue a rule on 42 CFR Part 2 as quickly as possible to supplement the provisions of the CARE Act.

The letter concludes by drawing attention to guidance issued by SAMHSA suspending the prohibitions on use and disclosure of patient information under Part 2 for medical emergencies. This guidance could be used as a stepping stone by HHS while it is revising the Part 2 rule.

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April 28, 2020

To: The Honorable Alex M. Azar, Secretary, U.S. Department of Health and Human Services, 330 C Street SW, Washington, DC 20416

Re: 42 CFR Part 2 - Request to Expedite Revising Rule Pursuant to the CARES Act

Dear Secretary Azar,

The undersigned organizations of the Partnership to Amend 42 CFR Part 2 (Partnership), write to make an urgent request that the Department of Health and Human Services (HHS) issue a rule as soon as possible on the 42 CFR Part 2 (Part 2) provisions in the Coronavirus Aid, Relief, and Economic Safety Act (CARES Act).

The Partnership is a coalition of nearly 50 organizations committed to aligning Part 2 with the disclosure requirements of the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO).

First and foremost, we want to take this opportunity to thank you and Deputy Secretary Hargan for your ongoing engagement with the Partnership to address the issues regarding the current Part 2 regulations. We appreciate your continued attention to patient care for those with substance use disorders (SUDs).

Given the longstanding nature of the issue, compounded with the potential for increase in SUDs during the current pandemic, it is more important than ever that the roadblocks to providing care for patients with SUDs are removed. We believe the recent changes to Part 2 in the CARES Act will greatly help in coordinating care for patients with SUDs. Specifically, Sec. 3221 changes the requirement to a one-time written consent and aligns Part 2 with HIPAA. More importantly, Sec. 3221 permits redisclosures made in accordance with HIPAA following that initial written consent. The CARES Act also directs the Secretary of HHS to revise any pertinent regulations.

While the Substance Abuse and Mental Health Services Administration (SAMHSA), prior to the passage of the CARES Act, issued guidance suspending the prohibitions on use and disclosure of patient information under Part 2 for medical emergencies, more specificity will be needed to implement the flexibilities provided by the CARES Act. Additionally, it has been reported that opioids may be used during the treatment of some patients with COVID-19/1, making it paramount that physicians have access to all patient records, especially SUD records, to formulate appropriate treatment plans. We believe HHS can use the SAMHSA guidance as a stepping stone when revising the Part 2 rule and we encourage HHS to act quickly to update the Part 2 rule to ensure patients with SUDs do not experience a disruption in their care.

Please feel free to contact Deepti Loharikar, Director of Regulatory Affairs, Association for Behavioral Health and Wellness, at loharikar@abhw.org or (202) 449-7659 with any questions.

Sincerely,

Academy of Managed Care Pharmacy

Alliance of Community Health Plans

American Association on Health and Disability

American Health Information Management Association

American Hospital Association

American Psychiatric Association

American Society of Addiction Medicine

America's Essential Hospitals

America's Health Insurance Plans

AMGA

Association for Behavioral Health and Wellness

Association for Community Affiliated Plans

Blue Cross Blue Shield Association

Catholic Health Association of the United States

Centerstone

College of Healthcare Information Management Executives

Confidentiality Coalition

Global Alliance for Behavioral Health and Social Justice

Hazelden Betty Ford Foundation

Healthcare Leadership Council

Health Innovation Alliance

The Joint Commission

The Kennedy Forum

National Alliance on Mental Illness

National Association of ACOs

National Association of Addiction Treatment Providers

National Association of County Behavioral Health and Developmental Disability Directors

National Association for Rural Mental Health

Netsmart

OCHIN

Opioid Safety Alliance

Otsuka America

Pharmaceutical Care Management Association

Population Health Alliance

Premier healthcare alliance

Strategic Health Information Exchange Collaborative

Cc: Deputy Secretary Eric D. Hargan

Footnote:

1/ Owermohle, S., America's new opioid crisis, https://www.politico.com/news/2020/04/10/america-new-opioidcrisis-179270. Last visited April 15, 2020.