The AAMC May 12 joined the Premier Healthcare Alliance, American College of Physicians, Medical Group Management Association, National Association of Accountable Care Organizations, and the American Academy of Family Physicians in a letter strongly urging the House leadership to include language in the final House opioids legislative package to allow certain stakeholders access to a patient’s entire medical record, including substance use disorder-related information, to promote effective valued-based care.
Current regulations (42.C.F.R. Part 2 (Part 2)) preclude the Centers for Medicare and Medicaid Services (CMS) from disclosing drug and alcohol treatment and prevention records to providers, including accountable care organizations (ACOs) and bundled payment organizations. The groups state the regulations “require complex and multiple patient consents for the use and disclosure of patients’ substance use records that go beyond the sufficiently strong patient confidentiality protections that were subsequently put in place by the Health Insurance Portability and Accountability Act (HIPAA).”
The letter further highlights the transition to new delivery system models such as ACOs and bundled payments focused on a more holistic, patient-centered approach to health care. It states, “Critical to making these new models truly work for patients is having access to the individuals’ health records, including those related to substance use,” and “ensuring that the health care providers who are on the front-lines treating those with opioid or other substance use disorders have an unobstructed view of their patients’ medical records.”
“Accordingly, we call on Congress to ensure that the Medicare, Medicaid and SCHIP data feeds sent to providers that are participating in alternative payment models such as Medicare ACOs and bundled payment arrangements include all claims, including those where a substance use disorder is listed as a primary or secondary diagnosis.”