substance use disorder

We continue to see an increase in fiduciary litigation involving employer-sponsored group health plans, particularly litigation involving mental health.  A recent New York Federal District Court case, Collins et al. v. Anthem, Inc. & Anthem UM Services, Inc., Case No. 1:20-cv-001969, is one example that may have wide-ranging impact. This case caught our attention because of its potential impact on plan design and plan administration of its mental health and substance use disorder (collectively “behavioral health”) benefits.
Continue Reading New York District Court: The Choice of Medical Necessity Criteria is a Fiduciary Act

On March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security Act (the CARES Act) into law. Section 3221 of the CARES Act ratified fundamental changes to the Public Health Service Act, codified at 42 U.S.C. § 290dd-2 and associated regulations, which govern the confidentiality requirements of substance use disorder records, commonly known as 42 C.F.R. Part 2, or simply, “Part 2.” Substance use disorder (SUD) records are defined broadly as “[r]ecords of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance abuse education, prevention, training, treatment, rehabilitation, or research.” The changes are significant and align with the increasing movement to align the Part 2 rules with the Health Insurance Portability and Accountability Act (HIPAA). The CARES Act requires the Department of Health and Human Services (HHS) to revise the Part 2 regulations within 12 months to comply with the CARES Act.
Continue Reading CARES Act Changes to Federal Substance Use Privacy Law