HHS clarifies when state Medicaid agencies can use patient SUD records to verify exemption from community engagement requirements

The Department of Health and Human Services Office for Civil Rights released new guidance on statutory and regulatory requirements under 42 CFR Part 2, which protect the confidentiality of substance use disorder patient records. The notice clarifies that state Medicaid agencies can use Part 2 records to verify whether a Medicaid applicant or beneficiary meets the definition of a “specified excluded individual,” who would be exempt from Medicaid community engagement requirements outlined by the July 2025 budget reconciliation law. The notice includes examples of circumstances where the use of Part 2 records for verification would be permitted.