Substance Use Knowledge Center

Updates to Patient Medical Record Confidentiality


Updates to Patient Medical Record Confidentiality

Announcement from AdCare President, Jeffrey W. Hillis:


It has been more than twenty nine years since the federal regulation protecting the confidentiality of substance use disorder patient records, 42 CFR Part 2, has been substantively amended. As of February 17, assuming that no delays occur, the Substance Abuse and Mental Health Services Administration's (SAMHSA) final rule is intended to  modernize 42 CFR Part 2 regulations on the sharing of substance use disorder (SUD) patient data.  Changes are intended to allow patients receiving treatment for SUDs in programs covered by the rule to benefit from integrated healthcare systems, while addressing the legitimate privacy concerns of patients.


Among the substantive changes is allowing SUD patients to use a general designation in the “To Whom” section of a consent form. This change will permit disclosure from programs covered by the rule to healthcare intermediaries, such as Health Information Exchanges (HIEs), and in turn, their participants. In short, the patient will no longer be required to consent every time data is shared or accessed by a treating provider of the HIE.  An added privacy safeguard will require that, upon request, patients who have used a general designation on the consent form must be provided with a list of disclosures. The responsibility of providing this list to patients will lie with the intermediary/HIE.

Additionally, a revision to the research provision of 42 CFR Part 2 will permit more extensive scientific research to be conducted.  This update is intended to facilitate the continual quality improvement of programs covered by the rule and the specialized services that they provide.


AdCare will fully comply with the updated 42 CFR Part 2 regulations that are designed to better align patient confidentiality practices with advances in the healthcare delivery system.   The shared goal is to maintain privacy protections, while ultimately improving the care coordination, safety, and quality of healthcare services received by patients seeking treatment for substance use disorders.

Topics: patient medical records, confidentiality, policy changes