Mental Health America and Netsmart urge Congressional action to streamline consent process for new models
Washington, D.C, Oct. 6, 2015 – Mental Health America
(MHA) and Netsmart today announced their support for
legislation in Congress that would update decades-old 42 CFR Part 2 regulations to streamline the patient consent
process for sharing addiction treatment information with their healthcare providers.
“You can’t treat the ‘whole person’ with half the data,” said Paul Gionfriddo, president and CEO of MHA. “It’s
critical that these regulations be updated to permit the sharing of addiction treatment medical records, with patient
consent, in new integrated care settings like Health Information Exchanges (HIEs), Accountable Care Organizations
(ACOs), and Medicaid Health Homes.”
Current complex patient consent requirements make it difficult or impossible for patients and providers in these care
settings to share patient data related to substance use disorders (SUD) and co-occurring physical and behavioral
In April 2015, the New England Journal of Medicine noted that 42 CFR Part 2 makes it “difficult or impossible” to
share addiction medical records [and associated mental health records] among doctors and other health care
professionals in Health Information Exchanges (HIEs), some of which are funded under the HITECH Act. NEJM stated that
similar problems occur among Medicare ACOs where – in sharing claims data with ACOs – the Centers for Medicare and
Medicaid Services (CMS) must redact all records containing substance use treatment information, and in the
implementation of the 19 state Medicaid Health Homes.
“Misinformation is rampant about these proposed changes,” said Kevin Scalia, executive vice president, Netsmart.
“Patient privacy will still be protected, while consent procedures will be streamlined, enabling people to experience
the full benefits of coordinated, integrated care. Patients will still be required to provide consent for their
records to be shared with providers, and they could still opt out at any time.”
Besides continued safeguards under 42 CFR Part 2, additional protections for alcohol and SUD treatment information is
provided under the Health Insurance Portability and Accountability Act (HIPAA), HIPAA Privacy and Security
Regulations, applicable state laws and ethical codes, and federal and state employment laws.
Netsmart and MHA released a memorandum outlining HIPAA
protections for SUD information.
Outdated 42 CFR Part 2 regulations are also a concern for patient safety. In a
href="http://www.ntst.com/PSM_42CFR_letter_8_19_2015.pdf">letter to the leadership of the Health Energy and
Commerce Committee, the Patient Safety Movement expressed the need
for 42 CFR Part 2 changes in the context of a “technology-enabled healthcare system that treats all patients equally,
particularly those with substance abuse or mental health problems.” The letter points out that individuals with mental
health or SUD often suffer from co-morbidities, and may be prescribed different medications by several different
The letter states that without a way to effectively manage these individuals’ care, they are at a significantly
higher risk for adverse events, particularly when mental health and substance abuse patients are unable to benefit
from the modern tools that coordinate other patients’ care, such as HIEs.
Several bills that include 42 CFR Part 2 reform provisions have been introduced in the House and Senate.
Last week, the Senate Health, Education, Labor and Pensions Committee held a markup of the Mental Health Awareness
and Improvement Act, S. 1893, a mental health reform bill from Chairman Lamar Alexander (R-TN) and Ranking Member
Patty Murray (D-WA). The bill requests a GAO report on 42 CFR Part 2, as well as the federal requirements impacting
access to mental health and substance use disorder treatment related to integration with primary care, administrative
and regulatory issues, quality measurement and accountability, and data sharing.
Also pending hearings in the Senate is the Mental Health Reform Act of 2015, S. 1945, introduced by Sen. Chris
Murphy (D-CT) and Sen. Bill Cassidy (R-AL), which also includes provisions for 42 CFR Part 2 consent reform.
In the House, the Helping Families in Mental Health Crisis Act of 2015,
href="http://www.gpo.gov/fdsys/pkg/BILLS-114hr2646ih/pdf/BILLS-114hr2646ih.pdf">H.R. 2646, introduced by Rep. Tim
Murphy (R-PA) and Rep. Eddie Bernice Johnson (D-TX), includes provisions for 42 CFR Part 2 consent reform.
MHA has not endorsed S. 1945 or H.R. 2646, but sees both pieces of legislation as a solid start in addressing mental
health reform. MHA provided the following feedback on the bills: href="http://www.mentalhealthamerica.net/hr-2646-helping-families-mental-health-crisis-act-2015">on H.R. 2646,
and on S. 1945.
Netsmart supports 42 CFR Part 2 legislative reform provisions in H.R. 2646 and S. 1945, and the GAO report called for
in S. 1893.
About Mental Health America
Mental Health America (MHA) – founded in 1909 – is the nation’s leading community-based nonprofit dedicated to
helping all Americans achieve wellness by living mentally healthier lives. Our work is driven by our commitment to
promote mental health as a critical part of overall wellness, including prevention services for all, early
identification and intervention for those at risk, integrated care and treatment for those who need it--with recovery
as the goal.
Netsmart is healthcare’s largest post-acute EHR provider, and is committed to helping health and human services
providers deliver coordinated, integrated, outcomes-based services and care. Netsmart serves more than 20,000 clients
across all 50 states, resulting in approximately 450,000 users of its software and technology solutions. Netsmart
clients include mental health and addiction services agencies, health homes, psychiatric hospitals, private and group
mental health practices, public health departments, social services and child and family services agencies, managed
care organizations, and vital records offices.
Netsmart’s CareFabric™, a framework of innovative clinical and
business solutions and services, supports integrated, coordinated delivery of health services across the spectrum of
Netsmart’s HIT Value Model™, a vendor-agnostic planning and measurement
system, provides a path for health and human services organizations to evaluate where on the healthcare IT spectrum
they should focus their efforts, the value associated with that strategic decision and a comparison with peer
Netsmart is pleased to support the EveryDay Matters Foundation, which was established for behavioral and public
health organizations to learn from each other and share their causes and stories. For more information, visit href="http://www.everydaymatters.com">www.everydaymatters.com
Learn more about how Netsmart is changing the face of healthcare today. Visit www.ntst.com,
call 1-800-472-5509, follow us on LinkedIn
and Twitter, like us on href="https://www.facebook.com/#!/netsmart">Facebook or visit us on href="http://www.youtube.com/user/netsmarttech">YouTube
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