On July 13, the Substance Abuse and Mental Health Services Administration (SAMHSA), under the U.S. Department of Health and Human Services (HHS), finalized new rules aimed at making it easier for providers to share substance use records.

Under 42 CFR Part 2, the federal regulations that govern health information sharing, when a person is identified as having a substance abuse disorder, no information, or even confirmation that the person is being treated, may be released without a written authorization by the client or guardian. The Health Insurance Portability and Accountability Act (HIPAA) privacy rule, on the other hand, permits the disclosure of health information needed for patient care and other important purposes (i.e., coordination of care, consultation between providers and referrals). 

The final rule intends to facilitate better coordination of care for substance use disorder (SUD) patients between health care providers and specialists and are an essential component of the federal response to the opioid epidemic. The revised rules would make it easier for patients to consent to the disclosure of their information to a wide range of entities and allows providers to note a patient’s treatment history directly on their electronic health record (EHR). Additionally, the rule aides in improving data sharing in the case of declared emergencies and makes allowances for states to share and access data on individuals being treated for opioid use disorder (OUD). However, the rule maintains its restrictions on the use of patient SUD records in criminal prosecutions against patients, and still requires patient consent for the disclosure of SUD treatment records outside of the outlined exceptions.

Last October, NACo submitted comments to the administration on the proposed rule change, calling for more congruence between 42 CFR Part 2 and HIPAA to enhance care coordination within the county health care safety net. While we applaud the administration’s efforts to advance the behavioral health of the nation while protecting the privacy of citizens, without additional changes to the proposed rule that fully align 42 CFR Part 2 with HIPAA, counties will not be able to fully provide coordinated, quality systems of care for people with substance abuse disorders while still protecting the patients right to treatment.  

Additional Resources:

• SAMHSA Press Announcement
• Fact Sheet: SAMHSA 42 CFR Part 2 Revised Rule
• NACo Blog: NACo Submits Comments on Proposed Changes to 42 CFR Part 2 Regulations