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Substance Use Disorder Confidentiality Regulations and Care Integration in Medicaid and CHIP

People with substance use disorders (SUDs) often have serious comorbidities, such as other behavioral health disorders, cardiovascular disease, cancer, hepatitis C, and HIV. Yet federal law and regulations on confidentiality of SUD-related patient records, usually referred to as Part 2, can act as a barrier to integrated care.

Chapter 2 draws on a review of publicly available information and the views of participants in an expert roundtable that MACPAC convened in November 2017. The Commission makes two recommendations to clarify Part 2 to help address this barrier to integrated care:

  • 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.
From: June 2018 Report to Congress on Medicaid and CHIP