Premier Comments on 42 CFR Part 2 Proposed Rule on Confidentiality of Substance Use Data

Premier submitted comments to the Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) on a proposed rule governing the confidentiality of substance use disorder patient records. The long-awaited 42 CFR Part 2 proposed rule implements provisions of the CARES Act to modernize a more than 40-year-old law that has impeded healthcare providers’ ability to diagnose, treat and prevent substance use disorders. For years, Premier co-led a coalition of more than 50 organizations to advance this policy change, and many of our members worked hard to garner support for its passage.

In its comments, Premier applauds the Administration for proposing to reform Part 2 regulations to align Part 2 requirements more closely with HIPAA, which would increase access to coordinated SUD services, promote greater integration of behavioral health into primary and acute care and reduce administrative burden. Specifically, Premier asks HHS to consider:

• Aligning Part 2 requirements with HIPAA requirements as closely as possible to reduce duplicative effort and administrative burden;
• Allowing maximum flexibility in Part 2 data sharing, including for purposes beyond treatment, payment and healthcare operations, within the current statutory requirements for patient consent;
• Maintaining flexibility around listing individual data recipients at the time of consent;
• Specifying that once Part 2 data are transmitted or retransmitted, there should not be a requirement to segregate a patient’s Part 2 data from the rest of the HIPAA database or record;
• Allowing 24 months for compliance as proposed, while investing in technical assistance to expedite implementation and improve SUD care; and
• Acting expeditiously to codify nondiscrimination protections for individuals with SUDs in order to combat the stigma that continues to limit access to treatment and recovery services.