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Bringing Substance Use Treatment into the 21st Century

By Lindsey Browning, Senior Policy Analyst

Last week the United States Senate Committee on Health, Education, Labor & Pensions held a hearing to examine options to address the poor outcomes our health system delivers for those with mental illnesses. I was struck by the general agreement among senators and witnesses on a particular point: we need integration of physical and behavioral health care to achieve better outcomes. One witness further explained that data sharing is vital to reach this goal.

Medicaid Directors could not agree more. Medicaid is at the vanguard of efforts to integrate physical and behavioral health care, and see data sharing as an essential tool to achieve this. However, this work is severely hampered by the restrictive and antiquated federal privacy regulations governing substance use disorder data. These regulations (known as 42 CFR Part 2) were last updated in 1987, and because of that, they don’t reflect the nearly three decades of advances in technology and other health information privacy safeguards. As a result, substance use disorder diagnosis and treatment information gets locked away from other providers and care managers, fueling bifurcation, limiting care coordination, and creating safety risks for beneficiaries.

Right now a proposed regulation that would update these privacy requirements is undergoing final review at the Office of Management and Budget. While we don’t know what the rule will change, Medicaid Directors are optimistic its timely release will serve as a step forward in tackling this impediment to coordinated care for the very individuals who need it the most.

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