Privacy is one of the most common concerns for public employees considering addiction treatment. The good news is that federal law gives substance use treatment records extra protection. This guide explains 42 CFR Part 2 in plain language and what it means for New York State and government employees using NYSHIP. This is general education, not legal advice; for questions about your specific situation, confirm details with your treatment provider, your union or a qualified attorney.
42 CFR Part 2 is a federal regulation that protects the confidentiality of records from federally assisted substance use disorder treatment programs. The U.S. Department of Health and Human Services describes Part 2 as providing privacy protections that, in some respects, are stronger than the general HIPAA Privacy Rule. The purpose is to encourage people to seek treatment without fear that their records could be used against them.
You can read the regulation itself on the Electronic Code of Federal Regulations, which sets out exactly how covered programs must handle patient records.
Part 2 generally restricts when a covered program can disclose information that would identify someone as having a substance use disorder. Under the rule, in most cases:
There are narrow exceptions — for example, in medical emergencies, certain reporting of crimes on program premises, or with a qualifying court order. SAMHSA's confidentiality guidance explains how these protections and exceptions work in practice.
In 2024, HHS finalized updates to better align Part 2 with HIPAA. According to the Federal Register, the changes include allowing a single patient consent for future uses in treatment, payment and health care operations, while adding new protections such as limits on using records in legal actions and giving patients the right to certain disclosure accounting. These updates aim to make care coordination easier while keeping strong privacy safeguards.
People sometimes assume one privacy law replaces the other, but Part 2 and HIPAA operate alongside each other. HIPAA is the broad federal privacy rule that covers most health information held by providers and insurers. Part 2 adds an extra layer specifically for records from federally assisted substance use treatment programs, with tighter limits on disclosure. Where both apply, a covered program generally has to follow the more protective requirement. The 2024 updates were designed to make these two frameworks fit together more smoothly so that care can be coordinated without sacrificing the stronger protections Part 2 provides.
If you are a public employee worried about your employer learning about treatment, Part 2 is an important safeguard. Your treatment program generally cannot share your records with your employer without your written consent. Your insurer may receive information needed to pay claims, but that information is itself protected by privacy laws. If you have specific concerns, ask your provider how they handle Part 2 and consider speaking with your union or an attorney.
You have every right to understand how your information is handled. Before treatment begins, it can help to ask a few straightforward questions so you know what to expect.
To understand how coverage and privacy fit together, see our NYSHIP coverage verification page, where we can walk you through the process confidentially.
Knowing your records are protected can make reaching out easier. For free, confidential, 24/7 support, contact the SAMHSA National Helpline at 1-800-662-4357. If you are in crisis or thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline. To talk privately about treatment and NYSHIP coverage, call us at 213-321-6518.
We confirm your exact NYSHIP / Empire Plan coverage and report back, usually within a few hours. HIPAA & 42 CFR Part 2 protected.
Call 213-321-6518