Administrative service providers do not obtain unrestricted access to substance-use treatment records merely because information exchange could become easier. SAMHSA's supplemental proposal published January 18, 2017 addressed disclosures by lawful holders to contractors, subcontractors and legal representatives for payment and health-care operations. The contemplated route depended on consent and permitted purposes. It was not finalized authority for a new data market. [2017-00719][2017-00742]

That distinction is especially important because a final rule appeared the same day. The final, announcing February 17 effectiveness, revised consent and security requirements. It permitted general recipient designations in specified circumstances, but the relevant participants had to have a treating-provider relationship with the patient. Consent still had to specify how much and what kind of information could be disclosed. [2017-00719][2017-00742]

The general-designation mechanism also required a statement recognizing the patient's right to request a list of entities receiving the information. Meanwhile, formal security procedures for Part 2 programs and other lawful holders covered both paper and electronic records. These are concrete conditions on handling information, not evidence that service providers gained unlimited permission or that their compliance costs necessarily fell. [2017-00719][2017-00742]

The economic distinction is between making an exchange administratively possible and defining the authority to carry it out. The proposal supplied unfinished contractor conditions; the final supplied adopted consent and custody safeguards. They form one agency evidence chain. Actual changes in outsourcing prices, competition or service quality cannot be inferred from their publication, even where the agency's stated aims included reducing unnecessary burden. [2017-00719][2017-00742]

Source documents

  1. Confidentiality of Substance Use Disorder Patient Recordshttps://www.govinfo.gov/content/pkg/FR-2017-01-18/html/2017-00719.htm
  2. Confidentiality of Substance Use Disorder Patient Recordshttps://www.govinfo.gov/content/pkg/FR-2017-01-18/html/2017-00742.htm