Introduction
In the early 1970’s, Congress recognized that the stigma associated with substance
abuse and fear of prosecution deterred people from entering treatment.

Federal confidentiality regulations (42 CFR Part 2) have been in place for almost three decades.

Substance abuse treatment programs subject to HIPAA do not have to comply with the Privacy Rule.

I. Applicability
The Privacy Rule applies to:

Part 2 of 42 CFR protects any person who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program.

Submission of claims to health plans is one example of a HIPAA transaction that a substance abuse treatment program might engage in.

Part II How the Privacy Rule affects disclosures of information
The “general rules” established by Part 2 and the Privacy Rule regarding uses and disclosures of patient health information are very much the same.

The core required elements for the Privacy Rule written authorization are similar to those of Part 2.

The Privacy Rule imposes three additional steps programs must take when disclosing information pursuant to a patient’s written consent.

Part 2 requires a patient to revoke consent only in writing while the Privacy Rule permits oral revocation of an authorization.

Some States require programs to obtain parental permission before providing treatment to a minor. In these States only, programs must get the signatures of both the _____ and a parent, guardian, or other person legally responsible for the minor (42 CFR §2.14(c)(2)).

The Part 2 regulations and the Privacy Rule have the same requirements for disclosures
of health information to researchers.

Part III Other Changes Required by the Privacy Rule
Programs that are subject to both Part 2 and the Privacy Rule can combine Patient Notice and Notice of Privacy Practices into a single notice.

When should the above notice be provided to the patient?

Both Part 2 and the Privacy Rule require programs to obtain a written consent from individuals before permitting them to see their own records.

The Privacy Rule establishes a process for individuals to file a complaint with the Secretary of HHS if they believe a program violated the Privacy Rule.

Programs that are subject to the Privacy Rule are required to designate a privacy official who is responsible for the development and implementation of its policies and procedures.

For substance abuse treatment programs, which of the following disclosures are typically made without patient consent and must therefore be included in an accounting of disclosures?

Part 2 does not require any kind of special security regarding patient written records such as a secure, locked room.

Substance abuse treatment programs should contact their respective state substance abuse agencies and/or provider organizations, as well as legal counsel for assistance in implementing practices that will comply with both Part 2 and the Privacy Rule.

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