Delivering the health system and the health outcomes Americans deserve requires thinking not just about healthcare financing, which debates in Washington have focused on for a while. It requires looking at actual delivery of care, including coordination of care, and looking at how to tackle particular impactable health challenges. That kind of thinking led us to what we’re announcing today: a historic proposal to revise the four-decade old regulation called 42 CFR Part 2."
As Prepared for Delivery
Thank you all for participating in this call. I want to begin by laying out how today’s announcement fits into a much broader vision for healthcare, one that President Trump has been working toward and we have been articulating at HHS.
The President has a particular vision for healthcare: a system with affordable, personalized care, a system that puts patients in control, provides peace of mind, and treats them like a human being, not a number. Such a system will provide patients with the affordability they need, the options and control they want, and the quality they deserve.
Delivering the health system and the health outcomes Americans deserve requires thinking not just about healthcare financing, which debates in Washington have focused on for a while. It requires looking at actual delivery of care, including coordination of care, and looking at how to tackle particular impactable health challenges.
That kind of thinking led us to what we’re announcing today: a historic proposal to revise the four-decade old regulation called 42 CFR Part 2.
One of the reasons we’re proposing these changes now is President Trump’s focus on our country’s opioid crisis. In fact, the idea of reforming Part 2 came out of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
But changing Part 2 is also an element of a larger regulatory reform project we’ve launched at HHS, the Deputy Secretary’s Regulatory Sprint to Coordinated Care.
Coordinated care is essential to delivering high quality care, at a lower cost, and producing better health outcomes. Americans want a system where their doctors can work with each other and pay attention to them as a whole person, with a full spectrum of health and social needs.
Rules like Part 2 can impose significant barriers to that kind of coordination. Part 2, which predates HIPAA, was intended to protect patients’ privacy and encourage Americans to seek out treatment for substance use disorders. But today, we know Part 2 can pose significant barriers to care for Americans struggling with substance use disorders like opioid addiction.
Assistant Secretary McCance-Katz will explain more of the details of our changes, but I will highlight a few of the issues now. Today, doctors considering prescribing an opioid, or a drug that may interact dangerously with an opioid, like a benzodiazepine for anxiety, cannot query a central database about whether the patient might be in treatment for opioid addiction. We’re proposing to change that. Not having that information can literally be deadly: It has led to patients relapsing into addiction and dying of overdoses.
Further, under the proposed rule, when a patient gives their primary care provider access to Part 2-protected records about substance abuse treatment, their primary care doctor can make note of this history in their own records, protected by HIPAA, rather than having to follow the onerous and sometimes unfamiliar Part 2 requirements. These onerous requirements may actually cause primary care providers today to choose not to serve patients with substance use disorders. This will make it easier for providers to integrate a patient’s behavioral health into treating their overall health, and give them the freedom and time they need to care for patients.
We’re also eliminating other headaches for providers. Today, if a patient texts or emails their substance abuse treatment provider’s cellphone, and then that program is discontinued, the provider has to sanitize their phone, a process that can render it unusable. We’re proposing they just be legally required to delete the messages.
Those are just a few of the changes in our proposed rule, which we believe will make it easier for people struggling with substance use disorders to discuss these issues with their doctors, seek treatment, and find the road to recovery, while always protecting their privacy.
These changes are one piece of a series of steps we’ll be taking toward a system where providers can coordinate to deliver Americans the better healthcare, and better health, that they deserve.
I now want to hand things over to Deputy Secretary Hargan, who will discuss more of how this fits into our regulatory reform work.
