TY - JOUR
KW - addiction treatment
KW - alcohol use disorders
KW - Confidentiality
KW - Drug use disorders
KW - Public policy issues
AU - D. McCarty
AU - T. Rieckmann
AU - R. L. Baker
AU - K. J. McConnell
A1 - 
AB - OBJECTIVE: Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. METHODS: Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. RESULTS: Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. CONCLUSIONS: The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.
BT - Psychiatric services (Washington, D.C.)
C5 - Financing & Sustainability; Healthcare Policy; Opioids & Substance Use
CP - 3
CY - United States
DO - 10.1176/appi.ps.201600138
IS - 3
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. METHODS: Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. RESULTS: Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. CONCLUSIONS: The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.
PP - United States
PY - 2017
SN - 1557-9700; 1075-2730
SP - 245
EP - 249
EP - 
T1 - The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis
T2 - Psychiatric services (Washington, D.C.)
TI - The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis
U1 - Financing & Sustainability; Healthcare Policy; Opioids & Substance Use
U2 - 27799017
U3 - 10.1176/appi.ps.201600138
VL - 68
VO - 1557-9700; 1075-2730
Y1 - 2017
ER -