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The National Association of Attorneys General yesterday urged congressional leaders to remove federal barriers to opioid use disorder treatment. Specifically, the letter from 39 state AGs urges Congress to: “replace the cumbersome, out-of-date, privacy rules contained in 42 CFR Part 2 with the effective and more familiar privacy rules contained in the Health Insurance Portability and Accountability Act”; “fully repeal” the Medicaid Institutions for Mental Diseases exclusion, which generally prohibits state Medicaid programs from receiving federal reimbursement for adults between 21 and 65 receiving mental health or substance use disorder treatment in a residential treatment facility with more than 16 beds; and “eliminate unnecessary burdens” on buprenorphine prescribing imposed by the Drug Addiction Treatment Act of 2000.

The complexities of complying with 42 CFR Part 2 often prevent general practice providers from attempting to treat patients with substance use disorders through medication-assisted treatment, the  states. “This regulatory scheme also sets up a strange situation in which office-based MAT providers do not have to follow the specialized requirements of 42 CFR Part 2 unless they advertise to the public that they provide MAT. So, in an era when we are trying to promote access to MAT, we are encouraging office-based MAT providers to keep secret the fact that they provide this lifesaving service so they can avoid the cumbersome 42 CFR Part 2 rules.” 

AHA supports legislation (H.R. 2062/S. 1012) that would align 42 CFR Part 2 with HIPAA regulations and strengthen patient protections while allowing clinicians access to the information they need to ensure patient safety and provide quality care. The SUPPORT for Patients and Communities Act of 2018 included an AHA-supported provision that partially repealed the IMD exclusion, providing state Medicaid programs the option to cover care for Medicaid beneficiaries with SUD for up to 30 days in a 12-month period.