Physicians Lawyers

Part 2 Records –  Specific Payment or Health Care Operations Purposes (§ 2.33)

Special restrictions apply to health information that is restricted under SAMHSA rules.  These rules protect patient information involving substance and alcohol treatment in Federal programs.  SAMHSA requirements are much more restrictive than HIPAA rules and must be considered, not only by substance abuse program, but also by providers and others who may receive these records and are subject to strict re-disclosure prohibitions.

The 2018 Rules finalizes the scope and requirements for permitted disclosures to contractors, subcontractors, and legal representatives for the purpose of payment and health care operations. SAMHSA lists 17 specific types of activities for which minimal information necessary may be disclosed for specific payment and health care operations activities. The 17 specific activites are listed in the preamble, rather than the regulatory text, as examples of potentially permissible disclosures.
SAMHSA states that its intent is for other appropriate payment and health care operations activities to be permitted beyond the 17 listed activities. In addition, consistent with SAMHSA’s prior statement in the SNPRM preamble, SAMHSA has added language to the regulatory text in § 2.33(b) to clarify that disclosures to contractors, subcontractors, and legal representatives are not permitted for activities related to a patient’s diagnosis, treatment, or referral for treatment. The rules require lawful holders of restricted information who engage contractors or subcontractors to carry out payment and health care operations activities to include specific contract provisions addressing compliance with part 2. Additionally, language was added to the regulation to clarify that disclosures to contractors, subcontractors, and legal representatives are not permitted for substance use disorder patient diagnosis, treatment, or referral for treatment.

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Source: Health Law Blog

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John Fisher is a seasoned health care lawyer with more than 30 years of experience advising physicians and health care providers. His practice spans a wide range of issues, including physician investments in ambulatory surgery centers, concierge and cash-based medical practices, and health care fraud prevention. John is dedicated to helping his clients navigate complex legal challenges while protecting their interests and ensuring compliance in a rapidly evolving industry.

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