Presentation Resources:
Federal Policy:
42 CFR Part 2
A federal law governing confidentiality for people seeking treatment for substance use disorders from federally assisted programs
21 U.S. Code § 812
Schedules of controlled substances
The Controlled Substances Act (CSA)
A law that regulates how legal and illegal substances are manufactured, imported, used, possessed, and distributed in the United States
State Policy
ACTIVE OPIOID LEGISLATION IN MICHIGAN
COVID 19 Regulatory Resources:
Governor Whitmer Signs Executive Order Temporarily Suspending Scope of Practice Laws, Allowing Qualified Physician Assistants, Nurses to Treat COVID-19 Patients
https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-523481--,00.html
Michigan Controlled Substance Regulations
Michigan Controlled Substances Regulation in Response to the Opioid Epidemic?
Recreational Marihuana Michigan Law and Resources
Reimbursement Updates
Medicaid and Behavioral Health CPT codes
https://www.ama-assn.org/press-center/press-releases/ama-releases-2020-cpt-code-set
Proposed
Medicare Coverage for Opioid Use Disorder Treatment Service: CMS proposes policies to implement requirements of the SUPPORT Act to establish a new Medicare Part B benefit for opioid use disorder (OUD) treatment services, including medications for medication-assisted treatment (MAT), furnished by opioid treatment programs (OTPs).
Bundled Payments for Substance Use Disorder Services: CMS proposes to create new coding and payment for a bundled episode of care for management and counseling for OUD. The proposed codes describe a monthly bundle of services for the treatment of OUD that includes overall management, care coordination, individual and group psychotherapy, and substance use counseling. CMS also seeks comment on bundles describing services for other SUDs and on the use of MAT in the emergency department setting to inform future rulemaking.
https://www.calhospital.org/cy2020-pfs-proposed
Legislation to Watch
https://www.federalregister.gov/documents/2020/07/15/2020-14675/confidentiality-of-substance-use-disorder-patient-records
The law went into effect Aug 15, 2020
Among the changes under the 2020 Final Rule are the following:
For Part 2 Programs:
With a patient’s consent, a Part 2 Program may disclose patient information orally to a non-Part 2 provider for treatment purposes and when the recipient records the information in its records, the patient’s substance use disorder information is no longer protected by Part 2.
With a patient’s consent, a Part 2 Program may disclose patient information to entity(-ies) named by the patient without requiring the patient to name a specific individual who will receive their information on behalf of a given entity.
With a patient’s consent, a Part 2 Program may report the substance use disorder medications prescribed or dispensed to a patient to a prescription drug monitoring program (PDMP), if required by applicable state law.
The longer notice to accompany disclosures of Part 2 records (found at 42 CFR § 2.32(a)(1)) has been revised.
During a temporary state of emergency (declared by a state or federal authority as the result of a natural or major disaster) in which a Part 2 Program is closed and unable to provide services or obtain the prior written consent of the patient, a Part 2 Program may disclose patient identifying information to medical personnel in compliance with 42 CFR § 2.51.
For Non-Part 2 Programs that Receive Part 2 Records:
Information received orally from a Part 2 Program may be recorded by a non-Part 2 Program without its record becoming subject to Part 2.
Information from paper or electronic Part 2 records that are segregated or segmented may be recorded by a non-Part 2 Program without its record becoming subject to Part 2. The segregated or segmented records remain subject to Part 2.
With a patient’s consent to disclose for payment or health care operations, a lawful holder of Part 2 records may further disclose the records to its contractors, subcontractors, or legal representatives for purposes of care coordination and/or case management services.
These changes provide some flexibility; however, the compliance challenges related to Part 2 remain. Until the CARES Act changes go into effect (sometime after March 27, 2021), Part 2 Programs must update their consent forms, patient notices and disclosure notices to comply with the 2020 Final Rule. Health centers, which often have teams, sites, or individual providers who meet the definition of a Part 2 Program, should also determine whether information from the Part 2 records can now be recorded in the health center’s other medical records without those records being subject to Part 2.
Other Resources
Key Questions about Medicaid Payment for Services in “Institutions for Mental Disease"
Comparison in current Policy and those proposed in the CONNECT for Health Act of 2019
Site Authors
Dr. Marilyn Skrocki
Legal and Regulatory Liaison
mskrocki@svsu.edu
James Woodrow
Administrative and IT Coordinator