😢 Issue with LabCorp sending reports from drug or alcohol treatment agency

This is not a new change.  Labcorp has not reported any patient from a known alcohol or drug treatment facility for 20+ years.  
I fully acknowledge that SAMHSA, 42 Part 2 may not have been intended to prevent public health reporting, but as the only exception is by patient written consent, child abuse issues, and medical emergencies, Labcorp could not report patients from these facilities because the reports contain the information that the patients are in fact, in these facilities.


Per SAMHSA, 42 CFR Part 2, Labcorp is unable to release a patient report to public health when the patient is being treated at a known alcohol or drug treatment facility.    

We cannot report any reportable disease on a patient in one of these facilities.  The exception being COVID PCR tests because the CARES Act “overruled” this federal rule.

 

Here is the link to the federal regulation:  https://www.ecfr.gov/current/title-42/chapter-I/subchapter-A/part-2

 

Please specifically note section §2.13 (c) (1)   and   §2.20

 
Acknowledging the presence of patients: Responding to requests.

(1) The presence of an identified patient in a health care facility or component of a health care facility which is publicly identified as a place where only substance use disorder diagnosis, treatment, or referral for treatment is provided may be acknowledged only if the patient's written consent is obtained in accordance with subpart C of this part or if an authorizing court order is entered in accordance with subpart E of this part. The regulations permit acknowledgement of the presence of an identified patient in a health care facility or part of a health care facility if the health care facility is not publicly identified as only a substance use disorder diagnosis, treatment, or referral for treatment facility, and if the acknowledgement does not reveal that the patient has a substance use disorder.

§ 2.20 Relationship to state laws.

The statute authorizing the regulations in this part (42 U.S.C. 290dd–2) does not preempt the field of law which they cover to the exclusion of all state laws in that field. If a disclosure permitted under the regulations in this part is prohibited under state law, neither the regulations in this part nor the authorizing statute may be construed to authorize any violation of that state law. However, no state law may either authorize or compel any disclosure prohibited by the regulations in this part.



Additionally- There are SAMHSA FAQs, please see Question #35
https://www.samhsa.gov/sites/default/files/faqs-applying-confidentiality-regulations-to-hie.pdf
Q35. Can an HIO disclose data for Disease Management purposes under Part 2 without patient consent? A35. No. The HIO may not disclose protected Part 2 information for Disease Management purposes unless the patient specifically authorizes such a redisclosure for that purpose in a consent form that meets Part 2’s requirements. It would be helpful for the consent form to explain the term “Disease Management” and even, perhaps, provide examples of how the information might be used. If a Part 2 program discloses information to the HIO via a QSOA, the HIO would still need to obtain the patient’s consent before redisclosing the protected information to any third parties for Disease Management purposes. A disclosure would be permitted in those rare situations where information disclosed by the HIO for Disease Management purposes does not implicitly or explicitly disclose the information protected by Part 2. An example would be when information is aggregated data that does not reveal that the patient has a drug or alcohol problem or the patient’s status as a participant in alcohol or drug treatment. 

 

 This is not necessarily a matter that can be resolved amongst state and CSTE.  This is a federal law and any conversation around its applicability to public health reporting should be done at the federal level.
Thanks,
Carmen Pugh
Labcorp State Reporting