In March 2019, the Office of the National Coordinator for Health Information Technology (ONC) issued a Proposed Rule, 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. ONC released a final rule in March 2020, published in the Federal Register on May 1, 2020. The Final Rule on Information Blocking prohibits actors from blocking the exchange of electronic health information and seeks to increase the ease and choices available for patients to access their data. 

New guidelines from SAMHSA released in July 2020 are designed to improve coordination of care for patients in treatment for substance disorder, while protecting confidentiality against unauthorized disclosure and use of patient information. View this HITEQ webinar on changes to SAMHSA’s 42 CFR Part 2 rule (Part 2) which protects individuals receiving substance use disorder treatment by defining privacy and security requirements for written, electronic and verbal information. This webinar features expert presenters from the University of New Hampshire Institute for Health Policy and Practice and the Center of Excellence for Protected Health Information who present on the new final Part 2 rule and future changes in the CARES Act, including what has changed, what has not changed, what this means for health centers in regard to consents and disclosures, and the implications for care coordination. This presentation also addresses privacy considerations for tele-behavioral health and exceptions during the state of emergency waiver.

We are adding additional telehealth policy information relevant to coronavirus/ COVID-19 pandemic as it impacts health centers as it becomes available.

HHS Office of Civil Rights (OCR), the entity responsible for enforcing regulations under HIPAA, stated, effective immediately, it will exercise enforcement discretion and will not impose penalties for HIPAA violations against covered healthcare providers if patients are served on a good faith basis during the COVID-19 nationwide public health emergency. Find out what this means in implementation by accessing this issue brief.

This decision tree, developed through funding from the  Substance Abuse and Mental Health Services Administration (SAMHSA) helps organizations determine if Part 2 of CFR 42 applies to them. It should be noted that FQHCs will always be designated as “federally assisted” due to certified status as Medicaid providers and/or federal funding.

The timely exchange of health information between behavioral health providers and physical health providers to support care coordination is a critical element of the National Quality Strategy and health reform efforts. However, privacy and confidentiality concerns are currently limiting the inclusion of behavioral health data in electronic health information exchange efforts.

General cybersecurity guidance would suggest that Health IT breach should not be considered a matter of “if”, but rather a matter of “when”. How Health Centers prepare and respond to an episode of a breach is just as important as defending itself from the breach.

It is of critical importance to motivate and educate healthcare professionals on current critical privacy and security concepts and methods for defense of health data. Aspects of security awareness training, breach protection, incident response, and related topics all play a role toward organization-wide information protection. Healthcare cybersecurity is the ultimate team sport. The responsibility goes beyond the IT staff and includes front and back office staff, doctors and nurses, patients, executives, and the board of directors. The attached presentation is directed to all levels of the healthcare organization so that they may be proactive and aware.

The HIPAA Security Rule establishes the requirements for protection of electronic patient health information. The safeguards identified are made up of three domains that include administrative, physical, and technical safeguards that need to be addressed. The technical safeguards as defined within 45 CFR §164.312 of the HIPAA Security Rule can be some of the most difficult to comprehend and implement for smaller Health Centers with lower levels of IT and security staffing. Resources and tools that help Health Centers better process and implement these security requirements are much needed and require well-documented methods for planning and maintaining critical security controls.

Frequently Asked Questions (FAQs) and Fact Sheets regarding the Substance Abuse Confidentiality Regulations. 

Two fact sheets include: 

• Disclosure of Substance Use Disorder Patient Records: Does Part 2 Apply to Me?
  • This fact sheet explains a 42 CFR Part 2 Program and how healthcare providers can determine how Part 2 applies to them.
• Disclosure of Substance Use Disorder Patient Records: How Do I Exchange Part 2 Data?
  • This fact sheet describes how 42 CFR Part 2 applies to the electronic exchange of healthcare records with a Part 2 Program.

FAQs about Applying the Substance Abuse Confidentiality Regulations, answers provided by Substance Abuse and Mental Health Services Administration (SAMHSA)

Is it acceptable/recommended for health centers to adopt the new password policy guidelines under NIST Special Publication 800-63B and will that still uphold the HIPAA security rule? This question had been posed to the HITEQ Center asking whether we had any guidance or recommendations on implementing the new NIST Guidelines regarding password security.  New Digital Identity Guidelines under NIST Special Publication 800-63-B presents new guidelines regarding password security that are much more user-friendly and consequently more likely to be observed by health center staff since constantly changing, complex password on multiple systems can be a source of frustration for the end user. 

This slide deck provides health centers with information and a presentation template overview of the HIPAA and electronic PHI risks related to texting and messaging that are important for health center leadership and IT managers to understand in making organizational decisions for these types of tools.

A Health Center’s online reputation plays an ever-growing role in client satisfaction, as 6 out of 10 patients use online patient reviews before selecting a physician. This webinar and related handouts recommend three specific steps to managing your reputation online to improve patient engagement.

From the OCR: The Privacy Rule protects individually identifiable health information from unauthorized or impermissible uses and disclosures. The Rule is carefully designed to protect the privacy of health information, while allowing important health care communications to occur. These pages address the release of protected health information for planning or response activities in emergency situations.  In addition, please view the Civil Rights Emergency Preparedness page to learn how nondiscrimination laws apply during an emergency.

From the OCR: Severe disasters – such as Hurricanes Harvey, Irma, and Maria – impose additional challenges on health care providers. Often questions arise about the ability of entities covered by the HIPAA regulations to share information, including with friends and family, public health officials, and emergency personnel. As summarized in more detail below, the HIPAA Privacy Rule allows patient information to be shared to assist in disaster relief efforts, and to assist patients in receiving the care they need. In addition, while the HIPAA Privacy Rule is not suspended during a public health or other emergency, the Secretary of HHS may waive certain provisions of the Privacy Rule under the Project Bioshield Act of 2004 (PL 108-276) and section 1135(b)(7) of the Social Security Act.

The conference will explore the history and recent changes of 42 CFR Part 2, review common definitions, and how the changes may affect integrated medication-assisted treatment (MAT) and Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs, and discussion on LifeLong Medical Care’s experience.

Fact Sheet outlining a three-step process to make sure you’re in compliance with HIPAA and if not, the steps that can be taken to make sure you are. This fact sheet also includes questions to ask potential business associates and things to keep in mind in case there is a breach.

This is a recent presentation by the Substance Abuse and Mental Health Services Administration's Health IT effort that provides an overview of their Consent2Share project. Consent2Share is a tool for consent management and data segmentation that is designed to integrate within existing electronic health record (EHR) and Health Information Exchange (HIE) systems.

This overview is provided to health center leadership and staff to help them better understand new practices and technologies in the field that can assist in compliance with HIPAA 42 CFR Part 2 regulations when trying to participate in health information exchange activities.

This guide provides examples and overviews of patient portal considerations for minors as it relates to Meaningful Use, HIPAA. state consent laws and associated policies. The articles and presentations included for download and linked to from related websites include use cases and examples from multiple states and national level guidelines.

This article from Optum provides a breakdown on Bring Your Own Device (BYOD) policy considerations based on the mix of devices your organization is trying to support, the size of your healthcare organization and implementation factors that may have an impact on success.