Magazine article Clinical Psychiatry News

HIPAA to Allow More Reporting of Dangerous Patients

Magazine article Clinical Psychiatry News

HIPAA to Allow More Reporting of Dangerous Patients

Article excerpt

As part of the Obama administration's efforts to reduce gun violence, certain physicians and health care providers will be permitted to disclose to the National Instant Criminal Background Check System (NICS) the identities of patients with mental illness who could be a danger to themselves or others.

NICS is the federal system by which firearms sellers determine whether a potential buyer has a criminal record or is otherwise ineligible to buy firearms.

The change--a modification to the HIPAA Privacy Rule--was published in the Federal Register on Jan. 5, the same day President Obama announced new executive actions that aim to expand background checks for firearm purchases and increase federal enforcement of gun laws. Opponents accuse the president of overreaching his authority.

The HIPAA modification, which takes effect in February, makes clear that certain covered entities are permitted to disclose information to the NICS, including the minimum identifying information necessary about patients who have been involuntarily committed to a mental institution or who have otherwise been determined by a lawful authority to be a danger to themselves or others.

The modification is tailored to preserve the patient-provider relationship and ensure that patients are not discouraged from seeking voluntary treatment, according to officials at the Department of Health & Human Services.

The rule applies only to a small subset of HIPAA-covered entities that either make mental health determinations that disqualify patients from having firearms or are designated by states to report the information to NICS.

The modification does not apply to most treating health providers and does not permit reporting of diagnostic, clinical, or other mental health treatment information.

The scope of disclosed information under the final rule is quite limited, according to Gerald "Jud" E. DeLoss, a Chicago health law attorney and cybersecurity expert. Disclosure is restricted to limited demographic data and other information.

In addition, state statutes or regulations regarding mental health information disclosure that are more stringent than HIPAA will still apply regardless of the final rule, he added.

"Further, while the final rule would apply to mental health information, substance abuse treatment information held by a federally assisted program covered under the confidentiality regulations set forth under 42 CFR Part 2 would still be protected," Mr. DeLoss said in an interview.

The HIPAA change finalizes a 2014 proposed rule that was recommended as part of President Obama's plan to strengthen the national background check system and remove unnecessary legal barriers that prevent states from making data available to the background check system.

"Due to a history of underreporting, the NICS has lacked complete information about all individuals who are prohibited by federal law from possessing or receiving a firearm," Jocelyn Samuels, director of the HHS Office for Civil Rights, wrote in a blogpost.

"The modification announced today better enables the reporting of the identities of prohibited individuals to the background check system and is an important step toward improving the public's safety while continuing to strongly protect individuals' privacy interests."

Psychiatrist Daniel J. Carlat of Tufts University, Boston, said that he does not see the new rule posing a major threat to patient confidentiality. …

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