Trump Administration Relaxes Medical Privacy Rule for Overdoses

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Health-care providers permitted to share information with family and friends if patient is in crisis or incapacitated

Source: Wall Street Journal
By Michelle Hackman
Oct.27, 2017 7:19 p.m. ET

WASHINGTON—The Trump administration announced Friday it is relaxing a federal privacy rule that prevents health providers from notifying family members about a drug overdose, one of the administration’s most significant policy shifts to combat the nation’s opioid crisis.

The new rule will explicitly permit health-care providers to share information with family members, friends and legal representatives about a patient’s medical condition if the patient is in crisis or incapacitated, such as during an opioid overdose.

“We know that support from family members and friends is key to helping people struggling with opioid addiction, but their loved ones can’t help if they aren’t informed of the problem,” said Roger Severino, Director of the Office for Civil Rights at the department of Health and Human Services, which announced the change.

The new guidance comes a day after President Donald Trump declared opioid use disorders a public health emergency and promised to accelerate the federal government’s response to the crisis. The change in privacy rules was also one of the top recommendations made by Mr. Trump’s White House Commission on opioids in an August report.

The question of whether to alter patient privacy laws has long been the focus of an emotional debate in the addiction community. Supporters of loosening existing restrictions say they limit doctors’ ability to share critical information with family members, who could potentially intervene to prevent future overdoses.

But opponents say they provide vital protection for people with substance use disorders, whose addictions could be considered a crime, particularly if they are misusing an illegal drug like heroin. Allowing physicians to share information about drug treatment, advocates fear, could inadvertently allow the information to reach employers or law-enforcement officials, when the patient needs care rather than punishment.

Karla Lopez, senior staff attorney at the Legal Action Center, an organization that fights discrimination against people with histories of addiction, said she welcomed Friday’s rule because it does not touch core privacy rules governing treatment facilities. But further action to loosen privacy standards by the administration or Congress would put patients at risk, she said.

“All of the protections are still critical, because people who seek treatment for substance use disorders are still reporting discrimination from health-care providers and others,” she said.

The federal rule in question says drug treatment centers cannot share information about an individual’s treatment with outside medical professionals, family members or others without the patient’s explicit permission. The rule was first created in the 1970s, when soldiers returning from Vietnam with substance use disorders were avoiding treatment centers out of fear they could be arrested for drug use.

Legal analysts have long believed the rule does not apply to emergency rooms, which handle most overdose cases, but most medical professionals have tended to comply with the privacy standard to avoid any potential legal action. Friday’s rule will likely provide them more leeway.

Jessica Hulsey Nickel, president and chief executive of the Addiction Policy forum, said the administration’s rule will allow families to help loved ones in the case of a drug overdose, while leaving in place core privacy protections that allow people to receive treatment in confidence.

“This is a really thoughtful way to approach this without dissuading our patients from seeking care,” Ms. Nickel said.

In a separate action, HHS officials Friday released a proposed rule that could give states more flexibility in how insurers cover benefits that are mandated under the Affordable Care Act.

Under the rule, states could get more latitude in defining the scope of required ACA coverage—for example, the number of doctor visits that are allowed for certain conditions—but plans would still have to comply with state insurance regulations, health analysts said.

The proposal was one of an array of changes outlined in the rule, which acts as a road map for the ACA’s open enrollment rules in 2019.

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