HHS Clarifies Use of SUD Records for Medicaid Work Exemptions
The HHS Office for Civil Rights issued guidance clarifying how 42 CFR Part 2 confidentiality rules for substance use disorder patient records interact with Medicaid community engagement requirements. The notice explains when state Medicaid agencies may use Part 2 records to verify whether an applicant or beneficiary qualifies as a "specified excluded individual" exempt from the work requirements established by the July 2025 reconciliation law. It includes examples illustrating permitted circumstances for this verification use. The guidance helps states implement exemption determinations without running afoul of federal SUD confidentiality protections.
State Medicaid agencies must use this guidance to design compliant eligibility verification processes for work requirement exemptions without violating federal substance use disorder privacy protections.
Behavioral Health · Managed Care · Finance
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