Robin Frazier Kandel, JD, Attorney and Assistant Director for Legal Affairs, Social and Health Services, Ltd., a Division of ORC Macro, 11426 Rockville Pike, Rockville, MD 20852, 301-770-5800 (5257), rkandel@shs.net and Brian J. Balicki, MHS, Social and Health Services, Ltd., a division of ORC Macro, 11426 Rockville Pike, Rockville, MD 20852.

Programs regulated by the strict confidentiality protections within 42 C.F.R. Part 2 are now faced with new challenges since the recent enforcement of the Health Insurance Portability and Accountability Act’s (HIPAA’s) privacy regulations within 45 C.F.R. Parts 160 & 164. Much confusion currently exists with regard when either or both of these regulations apply, how they integrate and compare with one another, and what the new HIPAA privacy provisions truly mean for the vast majority of substance abuse programs that are now also within HIPAA covered entities. Generally, both sets of regulations are structured in terms of setting forth a general prohibition against the use and disclosure of individually identifiable health information, with various exceptions in which use/disclosure is otherwise permitted (and/or, in the case of HIPAA, required in limited instances). The exceptions within the two separate federal regulations differ greatly, primarily due to the very different goals for which each set of regulations was designed. In addition, the HIPAA privacy rule places an obligation on covered entities to provide minimal rights to individuals, where no such rights were otherwise created within 42 C.F.R. Part 2. Confidentiality protections within 42 C.F.R. Part 2 were designed to encourage substance abusers to seek treatment, who might otherwise be deterred for fear that their substance abuse would become public information. Thus, understanding the confidentiality and privacy requirements for substance abuse patients is at the very core and establishes the foundation for the Section’s other detailed sessions regarding treatment, prevention, and/or policy.

Learning Objectives:

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• Understand generally the HIPAA privacy regulations, their purpose and to whom they apply. (
• Discuss what it means for a substance abuse program regulated by 42 C.F.R. Part 2 to now also be a HIPAA covered entity. (
• Explore the integration and comparisons between privacy/confidentiality protections provided within these two different federal regulations. (
• List and learn the new HIPAA created minimal rights.

Keywords: Privacy, Health Law

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am an employee of SHS/OCR Macro, and a contractor for CSAT/SAMHSA in its Confidentiality and Ethics Training Project (Contract # 270-03-7112). Charts I developed and which were approved for use in our SAMHSA training project on alcohol and drug confide