42 CFR Part 2 Explained: What Home Health and Hospice Agencies Need to Know

 

HCA has received several questions regarding 42 CFR Part 2, the federal confidentiality rule that applies to certain substance use disorder (SUD) treatment records. These questions have been prompted by recent regulatory discussions within the provider community.

 

Home health and hospice agencies are not considered substance use disorder treatment providers. As a result, 42 CFR Part 2 generally does not apply to routine home health or hospice services, and agencies do not need to update their Notices of Privacy Practices or patient consent forms beyond existing HIPAA requirements.

 

Part 2 applies specifically to programs whose purpose is to provide substance use disorder diagnosis, treatment, or referral for treatment. Home health and hospice agencies do not operate in this capacity and remain subject to HIPAA for standard patient care.

 

Some home health agencies provide services to patients with substance use or behavioral health diagnoses, including daily or twice-daily medication administration and other skilled services provided under a physician’s order. In these situations, agencies are delivering medical care, not substance use disorder treatment.

 

For agencies providing medication administration, monitoring, or other skilled home health services to patients with SUD diagnoses—often alongside care for other medical conditions—42 CFR Part 2 does not generally apply. HIPAA confidentiality requirements continue to govern these services.

 

Part 2 considerations may arise only in limited circumstances, such as when an agency receives records directly from a federally assisted substance use treatment program. In those cases, the additional confidentiality requirements apply to the specific records received, and the agency itself does not become a Part 2-covered program.