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Draft Chapter: Substance Use Disorder Confidentiality Regulations and Care Integration in Medicaid

This presentation reviews a draft chapter and recommendations on 42 CFR Part 2 (usually referred to as Part 2), the federal regulations which govern substance use disorder (SUD) treatment records. The Commission has noted that the Part 2 regulations act as a barrier to integrated care by hindering exchange of information among providers and payers involved in the treatment of individuals with SUDs.

The chapter describes the need for confidentiality of SUD-related health information and discusses the challenges associated with sharing information subject to Part 2. The Commission approved two recommendations to clarify Part 2 that will be included in the June chapter:

  • The Secretary of Health and Human Services should direct relevant agencies to issue joint subregulatory guidance that addresses Medicaid and CHIP provider and plan needs for clarification of key 42 CFR Part 2 provisions.
  • The Secretary should direct a coordinated effort by relevant agencies to provide education and technical assistance on 42 CFR Part 2. Such efforts should target state Medicaid and CHIP programs, health plans, primary care and specialty providers, patients and their families, and other relevant stakeholders.