HHS Office for Civil Rights Clarifies Privacy Rules for State Medicaid Programs - Scorecard - MDSpire
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HHS Office for Civil Rights Provides Clarification on Privacy Regulations for State Medicaid Programs

  • By

  • Office for Civil Rights (OCR)

  • September 29, 2026

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Clinical Scorecard: HHS Office for Civil Rights Provides Clarification on Privacy Regulations for State Medicaid Programs

At a Glance

CategoryDetail
ConditionSubstance Use Disorder (SUD)
Key Mechanisms42 CFR Part 2 governs the confidentiality of SUD patient records and allows for their use in Medicaid eligibility verification.
Target PopulationMedicaid applicants or beneficiaries aged 19–64 with SUD.
Care SettingState Medicaid agencies

Key Highlights

  • Guidance clarifies use of Part 2-protected records for Medicaid eligibility verification.
  • Supports compliance with confidentiality while verifying community engagement requirement exclusions.
  • Excludes certain groups from community engagement requirements, including individuals with SUD.

Guideline-Based Recommendations

Diagnosis

    Management

      Monitoring & Follow-up

        Risks

          Patient & Prescribing Data

          Individuals receiving substance use disorder treatment.

          Guidance aids in identifying individuals excluded from community engagement requirements.

          Clinical Best Practices

          • Utilize existing records to verify Medicaid eligibility without additional documentation demands.

          Related Resources & Content

          Original Source(s)

          HHS Office for Civil Rights Clarifies Privacy Rules for State Medicaid Programs

          • by Office for Civil Rights (OCR)

          • September 29, 2026

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