Beginning January 1, 2025, BCBSRI requires that participating providers, who treat or diagnose patients for substance use disorders or refer patients for treatment of substance use disorders and are subject to the Confidentiality of Substance Use Disorder Patient Records Rule (42 CFR. Part 2) as a Part 2 Program, to obtain “Treatment, Payment, and Health Care Operations” consent (or “TPO Consent”) compliant with § 2.31. BCBSRI will NOT pay claims if a Part 2 program does not obtain TPO consent.  

Compliant TPO consent will includes: 

• The patient information including name, health plan ID number, date of birth and address
• The name of the person (s) permitted to make disclosures (the Part 2 Provider furnishing treatment to the patient)
• Statements regarding:
  • The recipient of and purpose for disclosure, such as:
    • Provider may use and disclose information about me to my treating health care providers, my health plans (health insurers), other third-party payers, and their business associates (vendors) for the provider’s treatment, payment, and health care operations. The information may then be redisclosed as permitted by the HIPAA Privacy Rule, including (but not limited to) for treatment, payment, and health care operations, except that: the information cannot be used or disclosed for civil, criminal, administrative, or legislative proceedings against me. 
  • Information that may be disclosed, such as:
    • All information necessary to process my claims and coordinate my care. This may include (among other information) diagnoses (names of illnesses or conditions), procedures (type of treatments), my prescriptions, dates of treatment, and names of health care practitioners or other providers who treat me.
  • Expiration or revocation of consent, for example:
    • [This consent will not expire] [or] [This consent will expire] [insert expiration date (i.e., “after one-year”) or expiration event]]. You may revoke this consent at any time by contacting Provider at the address provided below. Your revocation will not be effective, however, to the extent that Provider or others have already acted in reliance on the consent.

Provider must retain a record of which claims are subject to Part 2 as well as a copy of the consent for the applicable claims and make them available to BCBSRI upon request.