Moving Substance Abuse Treatment into the 21st Century


Health-care today is all about integration, with patients and providers increasingly linked through electronic health records. Yet tension still exists between patient privacy concerns and improved access to records, especially when it comes to substance abuse records.

A recent final rule from the Substance Abuse and Mental Health Services Administration attempts to thread the needle by giving providers more leeway to disclose substance abuse records while retaining privacy protections.

The guidance underlines when substance abuse records can be disclosed for payment, operations, and audit purposes, and also authorizes providers to use a shorter notice prohibiting the re-disclosure of patient records.

SAMHSA also issued a January 2017 final rule that also eased substance abuse disclosures by letting patients give a general consent to the disclosure of their records instead of requiring individual consent every time a record was shared.

Until last year’s final rule, Part 2 substance abuse regulations hadn’t been updated since before the creation of the Health Insurance Portability and Accountability Act, Eric Fader, a health-care attorney with Day Pitney LLP in New York, told me.

Part 2 refers to the section of the U.S. Code of Federal Regulations (42 CFR Part 2) covering the confidentiality of patients’ alcohol and drug abuse records.

“Industry awareness and compliance with HIPAA and the HITECH Act, and the available regulatory guidance concerning HIPAA, were far ahead of those for Part 2, so the new rule will certainly improve compliance with Part 2,” Fader said.

The new rule highlights SAMHSA’s efforts give providers more flexibility in disclosing alcohol and drug abuse records, W. Reece Hirsch, a health-care attorney with Morgan, Lewis & Bockius LLP in San Francisco, told me recently.

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