"This proposal will help patients with substance use disorders fully participate and benefit from a health care delivery system that's better, smarter and healthier, while protecting their privacy," said Secretary Burwell. "We are moving Medicare, and the health care system as a whole, toward new integrated care models that incentivize providers to coordinate and put the patient at the center of their care, and we are modernizing our rules to protect patients."

The current rules governing the confidentiality of substance use disorder records, often referred to as "Part 2," were promulgated in 1975, during a time of great concern that the potential use of substance use disorder treatment information in criminal prosecutions would deter individuals from seeking needed treatment. These rules were last substantively updated in 1987.

HHS is proposing to modernize the existing rules because new models are built on a foundation of information sharing to support coordination of patient care; the development of an electronic infrastructure for managing and exchanging patient data; and an increased focus on performance measurement and quality improvement within the health care system.  HHS wants to ensure that patients with substance use disorders have the ability to participate in new integrated health care models without adverse consequences that could result from inappropriate disclosure of patient records.   

Due to its targeted population, the Part 2 rules provide more stringent federal protections for patients with substance use disorders records than most other health privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA).

In a previous Federal Register Notice published on May 12, 2014, HHS' Substance Abuse and Mental Health Services Administration (SAMHSA) announced a listening session, held June 11, 2014, to solicit feedback on the current regulations -- Confidentiality of Alcohol and Drug Abuse Patient Records regulations, 42 CFR Part 2.  SAMHSA also accepted written comments until June 25, 2014. All the feedback received from the Listening Session was considered and helped to inform the development of this NPRM. 

HHS welcomes public comment on this proposed rule.  Comments on the proposed changes may be submitted by using one of the methods outlined in the Notice of Proposed Rulemaking. To be assured consideration, comments must be received no later than 5 p.m. on April 11, 2016.  All comments received by that deadline will be considered by SAMHSA.