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CONFIDENTIALITY (42 CFR PART-2)

Confidentiality is a fundamental aspect of the physician-patient relationship, and it is especially important for patients with addiction. Unfortunately, because of the legal and social ramifications associated with addiction, patients are often reluctant to tell their doctor that they may have an addiction or consent to the disclosure of information about their addiction treatment for fear of prosecution. This is an unfortunate aspect of the stigma that surrounds this disease, and it exacerbates the addiction treatment gap that exists in this country.

To address this issue, the federal government has implemented 42 CFR Part 2, regulations that protect the confidentiality of addiction treatment records of any person who has sought treatment for or been diagnosed with addiction at a federally assisted program.  42 CFR Part 2 aims to encourage people to seek treatment without fear of legal or social consequences. Improper sharing of a patient's addiction treatment information can lead to: negative perceptions and discrimination; criminal legal consequences, such as probation or jail time; and civil legal consequences, such as loss of child custody, employment or housing.

ASAM appreciates the heightened need for confidentiality protections of a patient's addiction treatment records as well as the need for complete and accurate medical information to be shared among a patient's treating clinicians. ASAM strives to strike this critical balance in its advocacy activities and will continue to call for needed privacy protections as 42 CFR Part 2 regulations and the underlying statute are updated.

Resources

  • The Legal Action Center (LAC) has created several sample consent forms for the release of confidential substance use disorder patient records. The new forms comply with changes made to the federal regulations governing 42 CFR Part 2 by a Final Rule issued in January 2017. The Final Rule took effect on March 21, 2017.
  • Privacy and Confidentiality Free Webinar: This CME webinar was developed in response to Final Rule changes made by the Substance Abuse and Mental Health Services Administration (SAMHSA) to the 42 CFR Part 2 confidentiality rule. To access the recording and informational materials from the webinar, visit the ASAM eLearning Center or click here.

  • ASAM has a sample Appendix D Consent to Release of Information under 42 CFR Part 2 form for physicians for educational and informational purposes only.

Appendix D Consent to Release of Information Under Title 42

  • SAMHSA has two fact sheets regarding 42 CFR Part 2 regulations:
  1. Does Part 2 Apply to me?
    • This fact sheet explains a 42 CFR Part 2 Program and how healthcare providers can determine how Part 2 applies to them.
  2. How do I exchange Part 2 data?
    • This fact sheet describes how 42 CFR Part 2 applies to the electronic health records with a Part 2 Program.
  • It is permissible for state laws, for the disclosure of confidential information on substance use disorder care, to be more restrictive than these federal regulations. However, state laws may not override them. If a state law is not stricter and conflicts with federal regulations, then the state law must yield to the federal regulations. The below resources from the George Washington University’s Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation's website, Health Information and the Law, can help treatment clinicians know if their state laws are more restrictive than the federal regulations.

Partnership to Amend 42 CFR Part 2

A coalition of over 20 health care stakeholders committed to aligning 42 CFR Part 2 with HIPAA to allow appropriate access to patient information that is essential for providing whole-person care.

Related News

  • November 6, 2017

    ASAM Joins Letter Expressing Support for Legislation to Align Part 2 with HIPPA for TPO

    The Partnership to Amend 42 CFR Part 2 (Part 2) strongly supports the Overdose Prevention and Patient Safety (OPPS) Act, which would align Part 2 with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of health care treatment, payment, and operations (TPO).
  • August 11, 2017

    Setting the Record Straight: ASAM’s Position on 42 CFR Part 2

    In the wake of the introduction of the Overdose Prevention and Patient Safety (OPPS) Act, a bill that would amend the federal statute underlying the addiction treatment privacy regulations known as 42 CFR Part 2 (“Part 2”), ASAM has received many questions about our support for the bill and our position on changing Part 2.
  • July 28, 2017

    ASAM Supports Bill to Modernize the Privacy Laws to Combat Opioid Epidemic

    ASAM and the Partnership to Amend 42 CFR Part 2 (Partnership) sent a letter strongly supporting the Overdose Prevention and Patient Safety (OPPS) Act, H.R. 3545, which would align 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of health care treatment, payment, and operations (TPO).