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Provider Notice issued 05/23/12
Public Act 097-0515 Disclosure for Treatment and Coordination of Care
| To: | Physicians, Community Mental Health Providers, SASS Providers, DASA Treatment Providers, Advanced Practice Nurses, Federally Qualified Health Centers, Encounter Rate Clinics, Rural Health Clinics, Local Health Departments, School-based Clinics, Pharmacies, Hospitals and Home Health Agencies |
| Date: | May 23, 2012 |
| Re: | Public Act 097-0515 Disclosure for Treatment and Coordination of Care |
Healthcare and Family Services (HFS) is excited to inform providers that a new law in Illinois will greatly enhance the ability of providers to integrate mental, developmental disability and physical healthcare services for consumers covered by Medicaid, SCHIP and other programs. We encourage providers to make full use of this opportunity to improve the care of their patients.
Public Act 097-0515, signed into law on August 23, 2011, amends the Mental Health and Developmental Disabilities Confidentiality Act, (740 ILCS 110/) by adding Section 9.4, Disclosure for Treatment and Coordination of Care.
“(740 ILCS 110/9.4 new)
Sec. 9.4 Disclosure for treatment and coordination of care.
(a) For recipients in a program administered or operated by the Department of Healthcare and Family Services or the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities), records of a recipient may be disclosed without consent by county jails, insurance companies, integrated health systems, and State agencies, including the Department of Corrections, the Department of Children and Family Services, the Department of Healthcare and Family Services, and the Department of Human Services, to hospitals, physicians, therapists, emergency medical personnel and members of an interdisciplinary team treating a recipient for the purposes of treatment and coordination of care.
(b) An interdisciplinary care team treating a recipient may disclose the recipient's records without the recipient's consent to other members of the team.
(c) The records that may be disclosed under this Section are services rendered, providers rendering the services, pharmaceuticals prescribed or dispensed, and diagnoses. All disclosures under this Section must be made in a manner consistent with federal and State laws and regulations, including the federal Health Insurance Portability and Accountability Act (HIPAA).
(d) For the purpose of this Section only:
“Integrated health system” means an organization with a system of care which incorporates physical and behavioral healthcare and includes care delivered in an inpatient and outpatient setting.
“Interdisciplinary team” means a group of persons, representing different clinical disciplines (medicine, nursing, social work, psychology, etc.) providing and coordinating the care and treatment for a person with mental illness. The group may be composed of individuals employed by one provider or multiple providers.”
This new statute now allows treating healthcare providers to receive certain specified records on mental health or developmental disabilities services for recipients of HFS/Department of Human Services programs without the need for recipient consent. The intent of the new statute is to allow for greater integration of mental health or developmental disabilities services and physical health services, and to avoid potential dangerous drug interactions or other health risks that could arise when a treating provider does not have as complete a medical history of a recipient as is possible. If you have any questions, please contact the Bureau of Managed Care at 217-524-7478.
Theresa A. Eagleson, Administrator
Division of Medical Programs