I'm unclear how you came to that conclusion with the information above in other posts. You might be referring to CFR 42 Part 2 facilities? I hope you're not because if you work at one, you should be familiar with their rules. Indeed, they do require written consent to disclose, which is stricter than HIPAA and quite honestly inappropriate. HOWEVER, under 2020 updates to that law, Part 2 facilities can (and should) have ALL patients under their care sign written paper global authorizations for "treatment, payment and operations" when first admitted. This would authorize disclosure to other treating providers (without being individually named) outside the Part 2 facility. If the Part 2 facility doesn't do this, they aren't really meeting the standard of care, much like any other provider who avoids disclosure of substance abuse to other treating providers of a shared patient. If the patient for some reason declines to do this for a Part 2 facility, you cannot safely (or honestly financially) treat them and should refer them elsewhere. The literal point of the CFR 42 Part 2, as described in much commentary by Congress, is to avoid disclosure to law enforcement, civil courts and educational institutions. The other treating providers part got caught up in this goal initially, but was at least mostly mitigated by the global authorization change in 2020.
