WPF files comments on US government proposal on confidentiality of drug/alcohol patient records, urges revisions

The World Privacy Forum commented on an important proposal to make changes to the existing rules regarding the confidentiality of alcohol and drug abuse patient records. The proposal is from the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the US Department of Health and Human Services.

These proposed rule changes are important, as the current rules are among the strongest confidentiality rules in HIPAA. The new rule, when it is final, will change the Confidentiality of Alcohol and Drug Abuse Patient Records regulations, 42 C.F.R. Part 2.

Here is a brief summary of the most important aspects of our comments regarding the SAMSHA proposal:

  • We have major objections to the proposal to add to consent forms a “statement that the patient … confirms their understanding of the terms of their consent.” This part of the proposal may be the single most anti-patient provision in the entire proposed rule. We strongly recommended deleting this proposed requirement from the consent form. It serves those requesting consent, not the patients.
  • We found several definitional problems in the proposal. Problematic definitions included the definition of a program, the proposed definition of a record, and the proposed definition of patient identifying information. These definitions are deficient for various reasons which we discussed at length in our comments, and we suggested solutions and changes.
  • We supported the proposed changes to the scope of activities permitted by a Qualified Service Organization (QSO).

We discuss additional issues, including disclosures, research, internal confidentiality agreements, and data use agreements in the comments. Please see our detailed comments here.

Related Documents:

Read WPF’s comments (PDF, pages)

Read the SAMSHA proposal