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Substance Use Disorder Confidentiality Regulation

The U.S. Department of Health & Human Services (HHS) has announced a final rule, effective February 8, 2024, modifying the confidentiality regulations for Substance Use Disorder (SUD) patient records under 42 CFR Part 2. This aligns Part 2 with HIPAA and HITECH as mandated by the CARES Act of March 27, 2020. Key Changes:

The U.S. Department of Health & Human Services (HHS) has announced a final rule, effective February 8, 2024, modifying the confidentiality regulations for Substance Use Disorder (SUD) patient records under 42 CFR Part 2. This aligns Part 2 with HIPAA and HITECH as mandated by the CARES Act of March 27, 2020.

Key Changes:

  • Patient Consent
    • Single consent for all future uses and disclosures related to treatment, payment, and health care operations.
    • HIPAA-covered entities can redisclose records per HIPAA regulations.
  • Uses and Disclosures:
    • Allows de-identified record disclosure to public health authorities without patient consent.
    • Limits use of records in legal proceedings without consent or a court order.
    • Aligns penalties with HIPAA, using civil and criminal enforcement.
    • Applies HIPAA Breach Notification requirements to Part 2 records.
    • Aligns Patient Notice requirements with HIPAA.
  • Safe Harbor:
    • Provides safe harbor for investigative agencies acting with due diligence before requesting records.
    • Clarifies required steps for agencies to qualify for safe harbor.
  • Other Updates:
    • No need to segregate Part 2 records.
    • Right to file complaints directly with the Secretary for Part 2 violations.
    • Defines and protects SUD counseling notes, requiring specific consent.
    • Prohibits combining legal consent with other consents and mandates detailed consent documentation.
    • Allows patients to opt out of fundraising communications.
  • Unchanged:
    • SUD treatment records cannot be used for prosecution without written consent or a court order.
    • Audit/evaluation records cannot be used against patients without consent or a court order.
  • Next Steps:
    • The final rule can be accessed here.
    • Compliance required two years post-publication.
    • HHS will provide guidance and support for implementation.
    • OCR will finalize changes to HIPAA Notice of Privacy Practices and implement CARES Act antidiscrimination provisions separately.

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