Disclosure of Substance Use Disorder Patient Records: How Do I Exchange Part 2 Data? 1
Disclosure of Substance Use Disorder Patient Records:
How Do I Exchange Part 2 Data?
Title 42 of the Code of Federal Regulations (CFR) Part 2: Confidentiality of Substance Use
Disorder Patient Records (Part 2) was first promulgated in 1975 to address concerns about the
potential use of Substance Use Disorder (SUD) information in non-treatment based settings such as
administrative or criminal hearings related to the patient. Part 2 is intended to ensure that a patient
receiving treatment for a SUD in a Part 2 Program does not face adverse consequences in relation to
issues such as criminal proceedings and domestic proceedings such as those related to child custody,
divorce or employment. Part 2 protects the confidentiality of SUD patient records by restricting the
circumstances under which Part 2 Programs or other lawful holders
1
can disclose such records.
Part 2 Programs are federally assisted
2
programs.
3
In general, Part 2 Programs are prohibited from
disclosing any information that would identify a person as having or having had a SUD unless that
person provides written consent. Part 2 specifies a set of requirements
for consent forms, including
but not
lim
ite
d to
the name of the patient, the names of individuals/entities that are permitted to disclose or receive patient identifying information, the amount and kind of the information being disclosed, and
4
In addition to Part 2, other privacy laws such as the Health
Insurance Portability and Accountability Act of 1996 (HIPAA)
5
have been enacted. HIPAA generally
permits the disclosure of protected health information for certain purposes without patient
authorization, including treatment, payment,
or health care operations
. To help stakeholders understand their rights and obligations under Part 2, the Office of the National
Coordinator for Health Information Technology (ONC) and the Substance Abuse and Mental Health
Services Administration (SAMHSA) have released two fact sheets illustrating how Part 2 might apply
in various settings. This fact sheet demonstrates how Part 2 applies to the electronic exchange of
health
1
A “lawful holder” is an individual or entity who has received patient identifying information as the result of a part
2-compliant consent or as otherwise permitted under the part 2 statute, regulations, or guidance.
2
“Federally assisted” (defined at § 2.12 (b)) encompasses a broad set of activities, including management by a
federal office or agency, receipt of any federal funding, or registration to dispense controlled substances related to
the treatment of SUDs. Many SUD treatment programs are federally assisted.
3
A “program” (defined at § 2.11) is an individual, entity (other than a general medical facility), or an identified unit
in a general medical facility, that “holds itself out” as providing and provides diagnosis, treatment, or referral for
treatment for a SUD. Medical personnel or other staff in a general medical facility who are identified as providers
whose
primary function is to provide diagnosis, treatment, or referral for treatment for a SUD are also Programs. “Holds itself out” means any activity that would lead one to reasonably conclude that the individual or entity
provides substance use disorder diagnosis, treatment, or referral for treatment.
4
A full description of the requirements of a Part 2 consent form is available at:
https://www.gpo.gov/fdsys/pkg/FR-2017-01-18/pdf/2017-00719.pdf.
5
State laws and regulations may also further restrict the disclosure of substance use disorder patient records.
The information in this fact sheet is not intended to serve as legal advice nor should it substitute for legal counsel. The fact sheet
is not exhaustive, and readers are encouraged to seek additional technical guidance to supplement the illustrative information
contained herein.