Jennifer Wessel, JD, MPH
Senior Policy Analyst and Data Privacy Officer
On August 22, the Substance Abuse and Mental Health Services Administration, or SAMHSA, released a proposed rule that would change regulations to facilitate better care coordination while protecting the confidentiality of patients in substance use disorder (SUD) treatment programs.
The rule would make changes to 42 CFR (Code of Federal Regulations) Part 2, commonly referred to as “Part 2.” Part 2 protects the confidentiality of SUD patient records by restricting the circumstances under which treatment programs can disclose information.
Part 2 regulations were established in the 1970s to address concerns about the use of SUD information in non-treatment-based settings, such as criminal proceedings, and encourage individuals to seek treatment. Since then, there have been significant changes in the healthcare system and technology. The added protections have created silos of care and, as a consequence, ineffective care coordination among different providers.
The emergence of the opioid crisis has highlighted the need to update Part 2 requirements. The proposed rule is the first of four regulations that have been identified in the U.S. Department of Health and Human Services initiative known as the Regulatory Sprint to Coordinated Care, which seeks to reduce regulatory burdens and incentivize coordinated care.
The proposed rule would not alter the basic framework of Part 2 and would continue to prohibit law enforcement use of SUD patient records in criminal proceedings. Patient consent would still be required to disclose SUD treatment records, with exceptions. Changes in the proposal include: