The below list is an ongoing collection of definitions of terms and services relevant to this months theme. These are colloquial definitions created with and by medical professionals. 

MEDICARE

Federal program that provides coverage of health care services for individuals aged 65 years and older, certain individuals with disabilities, and individuals with end-stage renal disease.

Centers for Medicare and Medicaid Services (CMS)

The CMS administers Medicaid, Medicare, the Children’s Health Insurance Program, and insurance regulations for federally qualified health insurance policies offered through state and federal insurance marketplaces established under the ACA.

HIPAA & patient privacy

Health Insurance Portability and Accountability Act (HIPAA) allows patient information to be shared in order to provide care coordination. HIPAA allows disclosure without the consent of the patient for purposes of payment, treatment, and health care operations.

Health & Human Services (HHS)

Coordinates three tiers of health departments, the federal health department, state health department and local health department.

*In relation with state and local government, the federal government provides states with funding to ensure that states are able to retain current programs and are able to implement new programs.

**The health department at state level needs to safeguard good relations with legislators as well as governors in order to acquire legal and financial aid to guarantee the development and enhancements of the programs.

***The state sets up the regulations and health policies whereas the local health departments are the ones implementing the health policies and services.

42 CFR and Patient Privacy

Specifically, a federal statute written in the 1970s called the Confidentiality of Alcohol and Drug Abuse Patient Records, 42 Code of Federal Regulations (CFR) 2 (known as 42 CFR Part 2) was intended to protect patient privacy by keeping SUD records separate from other medical records.89 To be sure, disclosure of information related to the diagnosis and treatment of SUD could harm patients and cause them to avoid treatment. The disclosure of treatment records has the potential to lead to adverse outcomes such as loss of employment, loss of housing, loss of child custody, discrimination by medical professionals and insurers, arrest, prosecution, and incarceration.

*While intended to protect individuals from these outcomes related to the stigma surrounding treatment, 42 CFR Part 2 has had the unintended consequence of limiting treatment providers from sharing information that would provide better and more integrated care for a patient who is also seeking care for other health conditions. Primary care practitioners, for example, have no way of knowing about a patient’s SUD and accompanying treatment unless the patient discloses that information during a visit.

February 2020 | Continuity of Care