HIPAA and the Opioid Crisis

January 24th, 2018 - Wyn Staheli, Director of Research
Categories:   HIPAA|PHI   Drugs|Pharmaceuticals|FDA   Anesthesia|Pain Management  

In response to the opioid crisis, the Trump administration and the Department of Health and Human Services (HHS) have issued additional information relevant to both providers and patients. A December 18, 2017 press release included the following highlights of these actions:

  • Two new HIPAA webpages focused on information related to mental and behavioral health, one for professionals and another for consumers. These webpages reorganize existing guidance to make it more user-friendly and provide a one-stop resource for our new guidance and materials. This guidance is an important step forward in clarifying the circumstances under which HIPAA permits a covered entity to disclose information to family members and caregivers.
  • These webpages contain new HIPAA guidance on sharing information related to mental health and substance use disorder treatment with a patient's family, friends, and others involved in the patient's care or payment for care. The new information includes: a package of fact sheets; an infographic; decision charts, including materials specifically tailored to the parents of children who have a mental health condition; and scenarios that address sharing information when an individual experiences an opioid overdose.

  • New collaboration with partner agencies within HHS to identify and develop model programs and materials for training healthcare providers, patients, and their families regarding permitted uses and disclosures of the protected health information of patients seeking or undergoing mental health or substance use disorder treatment, and to develop a plan to share the programs and materials with professionals and consumers.
  • Launch of a working group to study and report on the uses and disclosures under HIPAA of protected health information for research purposes. The working group will include representatives from relevant federal agencies as well as researchers, patients, healthcare providers, and experts in healthcare privacy, security, and technology. The working group will release a report addressing whether uses and disclosures of PHI for research purposes should be modified to facilitate research while protecting individuals’ privacy rights.

There are some misconceptions about HIPAA and the disclosure of information in certain emergency type situations such as:

  • When the patient is incapacitated or unconscious
  • To prevent or lessen a serious and imminent threat to a patient’s health or safety

See the Reference "How HIPAA Allows Doctors to Respond to the Opioid Crisis" for additional information.

The key here is the status of the patient and the amount of information released. It is also important to recognize that there can be state requirements which differ from HIPAA. It is up to the provider to know and understand the state privacy rules when it comes to these situations. Another important factor to consider is that the patient's capacity to make decisions can change during the course of treatment. For example, the patient may be unconscious or delirious upon arrival at the facility, but then later on, they are capable of making decisions. Healthcare providers need to use their best judgment as to when that changes and be sure the patient's best interest is served.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

Artificial Intelligence in Healthcare - A Medical Coder's Perspective
December 26th, 2023 - Aimee Wilcox
We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities? 
Specialization: Your Advantage as a Medical Coding Contractor
December 22nd, 2023 - Find-A-Code
Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.
Changes to COVID-19 Vaccines Strike Again
December 12th, 2023 - Aimee Wilcox
According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.
Updated ICD-10-CM Codes for Appendicitis
November 14th, 2023 - Aimee Wilcox
With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.
COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....
Can We Score Interpretation of an EKG Towards E/M Medical Decision Making?
October 10th, 2023 - Aimee Wilcox
When EKGs are performed in the facility setting or even in the physician's office, what are the requirements for reporting the service and who gets credit for scoring data points for Evaluation and Management (E/M) medical decision making (MDM)? Let's take a look at a few coding scenarios related to EKG services to get a better understanding of why this can be problematic.



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association