SUD confidentiality protections for members

The U.S. Department of Health & Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office for Civil Rights, announced a final rule modifying the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations at 42 CFR part 2 (Part 2). Enforcement of 42 CFR Part 2 begins in February 2026.

What are Part 2 programs?

Part 2 programs are federally assisted programs that offer SUD diagnosis, treatment, or referral for treatment, and are subject to specific confidentiality regulations outlined in 42 CFR Part 2.

What this means for care providers:

• The regulation mandates that Part 2 regulated care providers and facilities secure compliant consent from their patients and include specific language about Part 2 protections in their submitted claim materials. This must be completed prior to submitting claims or any other Part 2‑related information to any third party, including us.
• This consent must allow for the use and disclosure of records for treatment, payment, and healthcare operations. Without it, care providers or Facilities are prohibited by Part 2 from submitting Claims for payment or disclosing information protected under Part 2.
• Any claim submitted without the required language is not identifiable as information subject to Part 2.

For more information, access the Fact Sheet 42 CFR Part 2 Final Rule provided by HHS.