HIPAA and 42 CFR Part 2: Managing Health Care and Substance Use Disorder Information



For much of healthcare, HIPAA sets the standards for how to manage uses and disclosures of patient information, known as Protected Health Information (PHI).  But when it comes to information related to the treatment of substance use disorders, regulations of the Substance Abuse and Mental Health Services Administration (SAMHSA) under 42 CFR Part 2 prevail.  These rules apply to information collected under SAMHSA, which may be difficult to separate from “regular” PHI in your records, and there are special rules for disclosure and re-disclosure of substance abuse treatment information.  

This session focuses on the issues of managing health information when it may involve substance use disorder treatment information.  HIPAA allows a number of disclosures without consent that SAMHSA prohibits without consent.  We will explain how HIPAA and 42 CFR Part 2 are similar and how they’re different, and what are the additional considerations when substance use disorder information is involved. We will discuss the latest guidance from HHS and SAMHSA about harmonization of HIPAA and 42 CFR Part 2, as well as recent changes to Part 2 and new legislation affecting the sharing of information for treatment when substance use disorder information is involved.

With the current epidemic of opioid abuse, there has been a great deal of publicity around the release of information and the necessity to share information with family and friends to facilitate recovery.  The rules remain in place as-is but are expected to change under a new law.  HIPAA allows such releases under some circumstances, while a consent is required under 42 CFR Part 2.  HHS has issued guidance on how to deal with the regulations in the face of the crisis, but the inconsistencies and difficulties remain.  In this session, we will review the guidance and learn how it helps explain some of the rules.

 Attendees will learn how the rules on Substance Use Disorder information can affect records storage and release processes, and how the HIPAA and SAMHSA rules are different and similar.  There are some significant differences between the HIPAA and 42 CFR Part 2 rules that need to be understood, especially when it comes to involving family and friends in an individual’s treatment, which HIPAA allows, but Part 2 does not.  Meanwhile, there have been some significant changes to the Part 2 rules that make some sharing of information for treatment purposes easier, and new legislation to deal with substance use disorders is being adopted.  Recent significant changes to the rules and expected changes under the new law will be presented and explained.

Learning Objectives: 

We will discuss these key issues, and the future of Part 2 information handling, in this important session. At the conclusion of the session, participants will be able to:

  • Understand what organizations or programs may be subject to 42 CFR Part 2.
  • Know how to treat Substance Use Disorder information as opposed to “regular” health information.
  • Understand the requirements for consent to release under 42 CFR Part 2 and how they have been changing.
  • Discuss issues in separating Part 2 data from other data in a medical record.

 Areas Covered In The Session:

  • What HIPAA allows, what SAMHSA requires, and the differences will be explained.
  • We will examine how to determine if the services you provide the place you under 42 CFR Part 2.
  • We will explore the means for making sure substance abuse treatment information receives the appropriate protections.
  • The consent and release requirements under 42 CFR Part 2 will be explained.
  • Re-release of information released under 42 CFR Part 2 will be discussed.
  • Sharing of information with family and friends in an overdose incident will be explored.
  • The latest guidance from the US Department of Health and Human Services as well as recent and new laws on harmonization of SAMHSA and HIPAA will be explained.

Who will benefit:

  • Compliance Director
  • CEO
  • CFO
  • Privacy Officer
  • Security Officer
  • Information Systems Manager
  • HIPAA Officer
  • Chief Information Officer
  • Health Information Manager
  • Healthcare Counsel/lawyer
  • Office Manager

About The Presenter:

Jim Sheldon-Dean is the founder and director of compliance services at Lewis Creek Systems, LLC, a Vermont-based consulting firm founded in 1982, providing information privacy and security regulatory compliance services to a wide variety of healthcare entities.  He is a frequent speaker regarding HIPAA, including speaking engagements at numerous regional and national healthcare association conferences and conventions and the annual NIST/OCR HIPAA Security Conference.  Sheldon-Dean has more than 36 years of experience in policy analysis and implementation, business process analysis, information systems and software development, and eight years of experience doing hands-on medical work as a Vermont certified volunteer emergency medical technician.  Sheldon-Dean received his B.S. degree, summa cum laude, from the University of Vermont and his master’s degree from the Massachusetts Institute of Technology.

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