Redaction of Substance Abuse Claims

Redaction of Substance Abuse Claims

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On January 17, 2017, the Substance Abuse and Mental Health Services Administration (SAMHSA) finalized changes to the Confidentiality of Alcohol and Drug Abuse Patient Records Regulations, 42 CFR Part 2. Under these changes to the Part 2 regulations, CMS is now permitted to include substance use disorder claims data in the Research Identifiable Files (RIFs).  Research Identifiable Files shipped or extracted in the VRDC after 05/22/2017 are no longer subject to the redaction.

Researchers who previously received redacted claim files will be able to request the missing records, in the form of “gap” files. Please be aware that “gap” files will be in the new version K specified in the recent announcement titled “Update to Research Identifiable File (RIF) Claims Layout.”

In order to request the “gap” files, submit an amendment request through ResDAC with the following materials: a Request Letter for an Amendment, a DUA Update form, and a Specifications Worksheet (request materials can be found on the Data Request Materials Index). The amendment request to add the “gap” files can be combined with any other file request or submitted separately. 


Historical Status

Under the previous regulations, CMS was required to redact all substance use disorder claims from the RIF files. Please see the tables under Additional Resources to understand the impact of the historical claims redaction on Medicare and Medicaid data.

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This work was performed under CMS Contract Number HHSM-500-2013-00166C


The process and materials mentioned as part of this KnowledgeBase article are current, as of the publication date on the article, to the best of our knowledge. The examples provided are correct in the aggregate but may not apply to every subgroup or circumstance that a researcher may wish to study. It is up to the researcher to conduct analysis and confirm that the patterns described in this KnowledgeBase article apply to his/her particular study. If your research findings appear to contradict the advice provided, please contact ResDAC at