Perceptions and Concerns of SUD Treatment Organizations Regarding the CARES Act's Alterations to Patient Confidentiality Regulations.

Objectives: Learn how substance use disorder (SUD) treatment organizations view and respond to changes in confidentiality and disclosure law following adoption of CARES Act Sec. 3221 and prior to promulgation of revised implementing regulations. Methods: Online survey followed by informal interviews. Representatives of SUD organizations reported their degree of awareness of Sec. 3221 provisions and their organizations' views on amendments to disclosure practices; current and future changes of organizational policies; difficulties anticipated in implementing new rules; and preferences for resources. Results: Forty informant surveys on 30 organizations completed. Participants (62.5 percent) indicated being somewhat knowledgeable about Sec. 3221. Evenly divided positive and concerned views on Sec. 3221 reflect tension between preserving confidentiality of patient records and improving coordination of care. Most (76.7 percent) reported organizational discussions on Sec. 3221. Some (30 percent) identified changes to make in near future. Over a third expected few or no barriers to implementing changes to privacy and disclosure practices, while most (64.7 percent) expected hindrances including complexity and tensions in the law, staff education, cost, technological adjustments, and changes in the ways SUD organizations interact with external organizations and individuals. To overcome barriers noted, participants expressed desire (66.7 percent) for teaching tools such as webinars and templates to follow. Conclusions: SUD treatment organizations began thinking of and planning for proposed changes well before expected implementation of Sec. 3221. Their concerns reflected practicalities of implementation, determining content of law, and wondering about the extent to which it solves problems (improving coordination of care among various providers) or endangered other goals (protecting confidentiality of SUD patient records).

GRANULAR PATIENT CONTROL OF PERSONAL HEALTH INFORMATION: FEDERAL AND STATE LAW CONSIDERATIONS.

The advent of electronic medical records and health information exchanges has facilitated the possibility of patients exercising increasingly granular control over sensitive health information. In principle, patients should be able to control which of their health information is made accessible to which of their healthcare providers. To meet this goal, the architects of any system of granular control of patients' health information face a variety of challenges. In addition to technical, ethical, and prudential considerations, the architects of any effective system must also ensure compliance with applicable legal requirements. The extent of a patient's permissible control depends upon whether governing law prohibits providers from disclosing health information to other providers without a patient's authorization, permits providers to disclose to other providers at the provider's discretion, or requires such disclosure. To inform efforts to design a viable system, this article analyzes U.S. federal and state (Arizona) law in regard to the sharing of the following types of sensitive health information: substance abuse, mental health, genetic, communicable diseases, and sexual and reproductive health.

Reconsidering the legality of cigarette smoking advertisements on television public health and the law.

Television advertisements depicting the use of electronic cigarettes have recently exposed minors to images of smoking behaviors. While these advertisements are currently legal, existing laws should be interpreted or expanded to ban the commercial depiction of smoking behaviors with any product that resembles a cigarette to shield minors from potentially influential advertising.