SAMSHA Broadens Disclosure Rules for Substance Use Disorder Records

SAMSHA Broadens Disclosure Rules for Substance Use Disorder Records

Patient Privacy/Medical Records

SAMSHA Broadens Disclosure Rules for Substance Use Disorder Records

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​The Substance Abuse and Mental Health Services Administration (SAMHSA) issued January 2 a final rule (83 Fed. Reg. 239) permitting additional disclosures of patient identifying information under the Confidentiality of Alcohol and Drug Abuse Patient Records regulations, 42 C.F.R. Part 2, with the aim of promoting integrated and coordinated care for those with substance use disorders.

“This rule will permit healthcare providers, with patients’ consent, to more easily conduct such activities as quality improvement, claims management, patient safety, training, and program integrity efforts,” said the nation’s first Assistant Secretary for Mental Health and Substance Use Dr. Elinore F. McCance-Katz.

Another aim of the final rule is better aligning Part 2 requirements with the Health Insurance Portability and Accountability Act, the agency said.

The final rule follows a major update last year to the Part 2 regulations, which before then hadn’t been revised since 1975 when they were promulgated. The final rule (82 Fed. Reg. 6052) issued in January 2017 allowed patients to agree to a general disclosure instead of requiring a separate consent for each provider. Many stakeholders, however, said the overhaul of the Part 2 regulations didn’t go far enough.

SAMHSA at that time also issued a proposed rule (82 Fed. Reg. 5485) seeking public input on additional clarifications for the Part 2 regulations.

The rule, published January 3, finalizes that proposed rule, permitting additional disclosures of patient identifying information, with patient consent, for payment and health care operations.

The final rule also allows disclosures to certain contractors, subcontractors, and legal representatives for Medicare, Medicaid, or Children’s Health Insurance Program audits or evaluations.

In addition, the final rule permits the use of an abbreviated notice on prohibiting re-disclosures, which the agency said is intended to accommodate electronic health record text fields.

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