Confidentiality of Substance Use Disorder Patient Records Rule (42 CFR Part 2)

Provider agrees to comply with the Confidentiality of Substance Use Disorder Patient Records Rule (42 CFR Part 2) to the extent that provider is subject to 42 CFR Part 2. 

Provider agrees to obtain appropriate patient consent prior to disclosing patient information that is subject to 42 CFR Part 2 to Blue Cross and Blue Shield of Nebraska (BCBSNE). The patient consent must: identify the appropriate third-party as the permitted recipient, allow the third party to use the information for payment and health care operations activities, specify that the third-party payer may disclose information back to the provider for the provider’s payment and health care operations activities, and otherwise comply with the requirements of 42 CFR Part 2. Each disclosure made with patient consent must include a copy of the consent or a clear explanation of the scope of the consent. A separate patient consent is required for the use and disclosure of SUD counseling notes. For BCBSNE members, the consent should name the patient’s self-funded health plan (if applicable) and should always name BCBSNE. For other Blue Plan members, the consent should name the self-funded health plan (if applicable) and should always name BCBSNE and the Blue Plan through which the patient receives health coverage. For information on if the patient is covered under a fully insured or self-funded plan and the name of the employer group, please contact Customer Service using the number on the back of the patient’s identification card or call the BlueCard Eligibility Locator line at 800-676-2583. 

In addition, provider must include a Part 2 Disclaimer with any claim (or other record) that contains Patient Identifying Information (subject to 42 CFR Part 2) when submitting the claim (or other records) to BCBSNE. The Part 2 Disclaimer is: “42 CFR part 2 prohibits unauthorized disclosure of these records.” BCBSNE reserves the right to deny payment of any claim, and/or to refuse to process other information, if the provider fails to obtain the required consent and/or fails to include the required notification. It is prohibited to combine patient consent for the use and disclosure of records for civil, criminal, administrative, or legislative proceedings with patient consent for any other use or disclosure.