A Broad Group of Organizations Urge HHS to Clarify That an Existing Single TPO Consent Under Part 2 Satisfies OBBBA SUD Community Engagement Exemption Requirements

Washington, D.C. – February 6, 2026 – A group of diverse health care organizations urge the U.S. Department of Health and Human Services (HHS) to provide written clarification that an existing, single consent for treatment, payment, and health care operations (TPO) under 42 CFR Part 2 (Part 2) satisfies the One Big Beautiful Bill Act (OBBBA) substance use disorder (SUD) community engagement exemption requirements. 

The group calls on HHS, including the Office for Civil Rights (OCR) and the Substance Abuse and Mental Health Services Administration (SAMHSA), to work with the Centers for Medicare & Medicaid Services (CMS) in providing written clarification that 1) eligibility determinations for Medicaid community engagement exemptions based on an individual’s SUD diagnosis or treatment in Part 2 records are subject to Part 2 protections and require patient consent and 2) a patient’s Part 2 consent for “payment” purposes satisfies the consent requirements for the Medicaid exemption eligibility determinations. 

“Clarifying that a single TPO consent under Part 2 meets SUD community engagement exemption requirements is key to providing guidance, safeguarding patient privacy, and making these exemptions work smoothly without unnecessary hurdles,” said ABHW President and CEO Debbie Witchey. “Clear written guidance will promote consistent interpretation, cut down on administrative burden, and free up more resources to go directly toward patient care.”

The group remains committed to working with HHS to provide field examples and written clarification for providers and patients.

View the group’s letter here. 

Organizations in this group include:
Alliance of Community Health Plans 
American Association on Health and Disability 
American Academy of Addiction Psychiatry 
American Association of Psychiatric Pharmacists
American Health Information Management Association 
American Psychiatric Association
American Society of Addiction Medicine
Association for Behavioral Health and Wellness 
Association for Community Affiliated Plans
Blue Cross Blue Shield Association
Centerstone
College of Healthcare Information Management Executives (CHIME)
Hazelden Betty Ford Foundation
Healthcare Trust Institute
Illinois Association for Behavioral Health 
Inseparable
Lakeshore Foundation
Meadows Mental Health Policy Institute
Medicaid Health Plans of America
Mental Health America
National Association for Behavioral Healthcare 
National Association for Rural Mental Health
National Association of County Behavioral Health and Developmental Disability Directors
Netsmart
The Catholic Health Association of the United States