Possible Legal Barriers for PCP Access to Mental Health Treatment Records

Published in:The Journal of Behavioral Health Services & Research, Volume 43, Issue 2 (April 2016), pages 319-329. doi:10.1007/s11414-015-9458-7

Posted on RAND.org on July 19, 2017

by Leslie S. Rothenberg, David A. Ganz, Neil S. Wenger

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Provider and payer groups have endorsed the goal of improving the integration of primary care and behavioral health across a variety of programs and settings. There is an interest in sharing patients' medical information, a goal that is permissible within HIPAA, but there are concerns about more restrictive state medical privacy laws. This article assesses whether a substantial number of state medical privacy laws are, or could be interpreted to be, more restrictive than HIPAA. Preliminary investigation found that in almost one third of the states (including large-population states such as Florida, Georgia, Massachusetts, New York, and Texas), primary care physicians (PCPs) may have difficulty accessing mental health treatment records without the patient's (or his/her guardian/conservator's) written consent. If a comprehensive legal analysis supports this conclusion, then those advocating integration of behavioral and primary care may need to consider seeking appropriate state legislative solutions.

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