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Proposed 42 CFR Part 2 Changes Aimed at Facilitating Better Care Coordination

August 26, 2019

The Substance Abuse and Mental Health Services Administration on Thursday proposed a series of revisions to 42 CFR Part 2 regulations in an effort “to facilitate better coordination of care for substance use disorders which will also enhance care for opioid use disorder.”

Among the proposed changes:

  • The definition of what constitutes a Part 2 record will be updated to clarify for providers what is (or should be) protected by Part 2, and “to ensure non-Part 2 providers are not discouraged from caring for SUD patients or recording SUD information due to onerous legal requirements,” per a U.S. Department of Health and Human Services news release.
  • Non-Part 2 providers will be granted access to central registries to determine if patients are enrolled in an opioid treatment program and receiving medications for treatment so that patients are not accidentally overprescribed or given prescriptions for which they are seeking treatment.
  • Part 2 program employees who receive “incidental” messages from SUD patients on their personal devices will be able to satisfy Part 2 “device sanitizing” requirements by simply deleting the messages.

Per a proposal fact sheet released by HHS, the changes will not affect the basic framework for confidentiality protection of SUD patient records created by federally funded treatment programs, and it will continue to prohibit law enforcement use of such patients’ record in criminal prosecution against said patient. Restrictions will also remain in place around the disclosure of SUD treatment records without patient consent.

In regards to the proposed changes, Mark Dunn, director of public policy for the National Association of Addiction Treatment providers told BHE in an email: “NAATP supports moving addiction treatment into mainstream health care. We insist on patient confidentiality, but believe that can be achieved while providing a comprehensive medical record to health care professionals.”

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