Coronavirus CARES Act

On March 27, the Coronavirus Aid, Relief and Economic Security (CARES) Act was signed into law. Section 3221 allows for additional care coordination by aligning the 42 CFR Part 2 regulations, which govern the confidentiality and sharing of substance use disorder treatment records, with the Health Insurance Portability and Accountability Act (HIPAA). This change has been part of AHIMA's Advocacy Agenda. Here is a summary of the Part 2 provisions in the CARES Act.

If you were part of Virtual Hill Day on Tuesday, March 24, you will recognize this legislation as the Protecting Jessica Grubb’s Legacy Act, “Legacy Act”. The Legacy Act makes it easier to share substance abuse records for the purposes of treatment, payment and healthcare operations, while allowing patients to remain in control, as well as providing new protections not afforded under 42 CFR Part 2. 42 CFR Part 2 was passed into law in the 1970s, well before HIPAA and electronic medical records.

Thank you to all members who participated in AHIMA’s Virtual Hill Day!  Thank you for advocating on behalf of the HIM profession through the Advocacy Action Center.    Advocacy in Action!

AHIMA's Advocacy Initiative This Year:  

AHIMA's Request to Congress to modernize health information laws to help stem the tide of opioid misuse:

Cosponsor and pass HR 2062, the Overdose Prevention and Patient Safety Act and S 3374, the Protecting Jessica Grubb's Legacy Act which more closely aligns Part 2 with HIPAA for purposes of healthcare treatment, payment and operations and strengthens protections around the use of substance use disorder records in criminal, civil and administrative proceedings.

A little history:

  • 42 CFR Part 2 (Part 2) set requirements limiting the use and disclosure of patients' substance abuse records from certain substance use treatment programs.
  • Under current law, disclosure of information that identifies an individual as having received or receiving substance use disorder treatment from a designated Part 2 program is generally prohibited unless an individual gives his or her written consent.

Key points:

  • Substance abuse disorders have a cascading effect on an individual's health that should be carefully managed and coordinated.
  • HIM professionals working in Part 2 programs often work with paper records or with electronic health records systems that do not support data segmentation. Lacking such functionality, HIM professionals must often keep a patient's addiction records separate from the rest of the patient's medical record. Because such information is kept separate, the outdated rule poses a serious safety threat to persons with substance use disorders because clinicians may be unaware of the risks to their patient from multiple drug interactions and co-existing medical program.
  • Part 2 compromises the purpose of integrated care delivery models and puts individuals with substance use disorders at a disadvantage over other patients because clinicians cannot deliver the informed, coordinated care that is the foundation of such care models.
  • AHIMA requested that the Substance Abuse and Mental Health Services Administration (SAMSHA) exercise its authority to align Part 2 to HIPAA, however, HHS Secretary Alex Azar has stated that such a change requires congressional action.

Full CARES Act Text

As the outbreak of the Coronavirus (COVID-19) affects every sector of the US economy, the US Congress and the White House came together to provide funding, supplies and regulatory relief to address the crisis. The US Senate passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act on March 25, 2020. The US House of Representatives passed the CARE Act on March 27, and President Trump signed it into law later in the day on March 27, 2020. The CARES Act represents the third stimulus bill passed by Congress in response to the COVID-19 pandemic. With $2 trillion in allocations, it is the largest stimulus bill in US history.