On July 13, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it had revised 42 C.F.R. Part 2, the Confidentiality of Substance Use Disorder Patient Records regulations to facilitate better care coordination in response to the opioid epidemic. The revisions to Part 2 were made as part of a joint effort among federal agencies analyzing how their regulations can be revised to incentivize care coordination and improve patient care. 

Under 42 C.F.R. Part 2, records created by a federally assisted substance use disorder program that contain patient identifying information may only be disclosed with written consent from the patient, or in a few other limited circumstances. Although SAMHSA did not change the basic structure of the confidentiality protections under Part 2, the agency did seek to make care coordination, claims management, training, patient safety, quality improvement and program integrity activities easier for providers.  

Under the revised rules, non-opioid treatment program providers and non-central registry treating providers may query a central registry to determine whether their patients are already receiving opioid treatment through other providers.  The revised rules also clarified and expanded disclosures for “purposes of payment and heath care operations.” The expanded list includes case management and care coordination activities. This revision better aligns the Part 2 rules with the HIPAA Privacy Rule that permits disclosure of a person’s protected health information for purposes of care coordination and case management, as these activities are considered health care operations under HIPAA.