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Substance Use Disorder Records (42 CFR Part 2)

42 CFR Part 2 provides federal confidentiality protections for substance use disorder (SUD) patient records that are stricter than HIPAA in many respects. Originally enacted to encourage people to seek treatment without fear of disclosure, Part 2 restricts how SUD treatment programs, and those who receive records from them, can use and disclose patient information.

Citation: 42 C.F.R. Part 2
Sections: 38
Words indexed: 21,280
Applies to: Federally assisted SUD treatment programs (which includes most programs that accept Medicaid, Medicare, or any federal funding), and anyone who receives records from such programs

Key Points

Part 2 protections are stricter than HIPAA and apply ON TOP of HIPAA

Patient consent is generally required for ANY disclosure, including for treatment and payment (unlike HIPAA)

Records that identify a patient as having or being treated for a SUD are protected

Re-disclosure is prohibited: anyone who receives Part 2 records cannot share them further without patient consent

Recent amendments (2024) have aligned some Part 2 provisions with HIPAA, allowing disclosure for treatment, payment, and operations with patient consent

Key Areas

Consent Requirements

Patient consent for disclosure, revocation

Permitted Disclosures

Medical emergencies, audits, research, court orders

Key Provisions

2.31

Consent Requirements

Specifies what a valid consent must include: who can disclose, who will receive, purpose, what information, right to revoke, expiration date.

2.12

Applicability

Defines which programs and records are covered by Part 2. Understanding scope is the first compliance question.

All Regulation Sections

Part 2Substance Use Disorder Records Confidentiality(38)