For the Department of Health and Human Services,
Office of the Assistant Secretary for Planning and Evaluation,
Office of
Science Policy
by Mathematica Policy Research, Inc.
January 17, 2003
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II PERSONAL HEALTH INFORMATION COLLECTED BY MCOs: CURRENT PRACTICE
A. MCO REASONS FOR COLLECTING DATAB. INFORMATION COLLECTED BY MCOs FOR OUTPATIENT TREATMENT
C. DEGREE OF VARIATION IN TYPES OF INFORMATION COLLECTED
III STAKEHOLDER VIEWS ON WHAT CONSTITUTES "MINIMUM NECESSARY" INFORMATION FOR MCO OPERATIONS
A. PROVIDER ASSOCIATIONS, CLINICIANS, AND ADVOCATES
A. THREE PRIVACY-SENSITIVE APPROACHESB. USE OF ASAM CRITERIA AS A BASIS FOR DETERMINING NECESSARY INFORMATION FOR SUBSTANCE ABUSE TREATMENT
A. POSSIBLE CONSEQUENCES OF NO ACTIONB. DEVELOPING A NATIONAL STANDARD FOR WHAT CONSTITUTES "MINIMUM NECESSARY" INFORMATION
APPENDIX B: MARYLAND UNIFORM TREATMENT PLAN FORM
APPENDIX C: MAGELLAN TREATMENT REQUEST FORM
APPENDIX E: PERSONAL HEALTH INFORMATION REQUESTED BY MCOs AND MBHOs
APPENDIX F: PERSONAL HEALTH INFORMATION REQUESTED BY LOCAL AND NATIONAL MCOs
TABLES
I.1 INTERVIEW PARTICIPANTS, BY TYPE
IV.2 PRIVACY LAWS OF NEW JERSEY AND THE DISTRICT OF COLUMBIA: DISCLOSURE TO THIRD-PARTY PAYERS
This report would not have been possible without the many clinicians, advocates, managed care executives, association representatives, and other experts who provided us with relevant documents and took the time to discuss their perspectives on and experience with privacy issues in managed care for mental health and substance abuse treatment. In addition, the authors would like to thank Myles Maxfield for insightful comments on a draft of this report, Daryl Hall for editing the report, and Donna Dorsey for producing it. Finally, for their guidance throughout the project, we thank John Fanning and Kevin Hennessy of the Office of the Assistant Secretary for Planning and Evaluation (OASPE), and Sarah Wattenberg of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services.