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SAMHSA Proposes Revisions to 42 CFR Part 2

The Substance Abuse and Mental Health Services Administration (SAMHSA) released two proposed rules revising regulations pertaining to confidentiality of substance use disorder patient records, 42 CFR Part 2 (Part 2).

The proposed changes aim to remove barriers to care coordination and allow additional information sharing for providers treating patients with substance use disorders (SUD). Part 2, a longstanding rule that dictates how to share patient data related to SUD, intends to protect patient privacy by requiring additional consent from patients before disclosing a history of SUD.

The first rule proposes to modify several provisions of Part 2, including:

  • applicability and redisclosure;
  • consent requirements;
  • disclosures;
  • medical emergencies;
  • research; and
  • audits and evaluation.

The second rule proposes to clarify the conditions in which a court may authorize disclosure of patient information in connection to an investigation or prosecution of an “extremely serious crime,” even if that crime was not committed by the patient.

America’s Essential Hospitals supports Part 2 alignment with Health Insurance Portability and Accountability Act (HIPAA) regulations to improve care coordination. HIPAA permits sharing of patients’ health records for treatment, payment, and health care operations. While the proposed changes loosen Part 2 regulations, full alignment with HIPAA would require congressional action.

The rules will take effect 60 days after publication in the Federal Register.

The association issued a statement on the proposed rules and will send members a detailed Action Update.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Gontscharow is a senior policy analyst for America's Essential Hospitals.

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