HHS Clarifies When States Can Use SUD Records For Medicaid Work Requirements Documentation

State Medicaid agencies can use certain substance use disorder (SUD) treatment records they already have to determine whether Medicaid applicants and beneficiaries are excluded from new federal community engagement requirements, according to guidance from the U.S. Department of Health and Human Services (HHS). The guidance explains when states can use these confidential records, including when an individual's existing written consent allows it.

Under the new guidance, state Medicaid agencies can use SUD treatment records protected by federal confidentiality rules known as 42 CFR Part 2 to verify whether an individual qualifies for an exemption from the work requirements . . .