By NICOLETTE TABOR
Dickinson Wright

 On Jan. 29, 2026, President Trump signed an executive order with the potential to significantly impact behavioral health and substance use disorder providers.

Executive Order 14379, titled “The Great American Recovery Initiative,” outlines the Trump Administration’s efforts to coordinate the federal government’s response to substance use disorders and the addiction crisis in the United States. Importantly, the executive order acknowledges that addiction “is a chronic, treatable disease” and that the framework for addiction treatment should parallel that of other chronic diseases – signaling a continued historical shift in the US healthcare framework. While this executive order does not immediately affect substance use disorder (SUD) providers, it does provide an important glimpse into how the Trump Administration plans to work with Congress to allocate funds to expand access to SUD treatment.

This executive order affects SUD providers in at least three ways:

  1. Potential for increased federal and state funding opportunities. The executive order specifically directs the appropriation of grants to support addiction recovery, with a focus on prevention, treatment, and long-term resilience. Therefore, this means the Trump Administration expects increased funding to flow through federal and state programs addressing SUD treatment. Providers may be able to position themselves for federal and state funding opportunities – including Medicaid waivers and new grants – pursuant to this new initiative.

 

  1. Integration and Care Coordination. The executive order directs the implementation of programs that integrate prevention, early intervention, treatment, recovery support, and re-entry into all relevant public health, healthcare, criminal justice, workforce, education, housing, and social services systems. This also hints at the potential for additional funding and a realignment towards value-based arrangements in the behavioral health and SUD space.

 

  1. Increased Access to Care. The general theme of the executive order is to acknowledge the need to help many Americans overcome the barriers of access to SUD treatment. The executive order does not provide specific details or plans as to how the Trump Administration expects this to be carried out. However, the executive order does coincide with Congress’ recent extension of Medicare telehealth flexibilities that continued the requirement of an in-person visit within six months of an initial Medicare behavioral health telemedicine visit through the end of 2026 or 2027 (depending on the type of visit). It will be important for providers to continue to monitor the telehealth flexibilities and how they will affect increased access to SUD treatment.

 

Notably, this executive order coincides with the recent deadline for compliance with the 42 CFR Part 2 Confidentiality of SUD Patient Records (“Part 2”) Final Rule. By February 16, 2026, all entities subject to Part 2 must comply with the new requirements under the Final Rule. This includes:

 

  • Patient Consent: Part 2 now allows a single consent for all future uses and disclosures for treatment, payment, and health care operations. HIPAA covered entities and business associates that receive records under this consent may now redisclose the records in accordance with HIPAA. A Part 2 program, covered entity, or business associate that receives these records based on a single consent is no longer required to segregate or segment the records. Notably, separate patient consent is still required for the use and disclosure of SUD counseling notes. Part 2 records are still unable to be used or disclosed in civil, criminal, administrative, or legislative proceedings against the patient, absent the patient’s written consent or court order.

 

  • Notice of Privacy Practices: Part 2 programs and HIPAA covered entities that receive or maintain Part 2 records must revise their Notice of Privacy Practices (NPPs) to address Part 2-specific protections and requirements for use and disclosure of those records. The Department of Health and Human Services (HHS) has noted that Part 2 NPPs may be combined with a provider’s standard NPP so long as it contains all the information required by 42 CFR § 2.22, including:

 

  • Revised headers: Specific language is required for Part 2 NPPs which contrasts with HIPAA NPPs

 

  • Permitted Uses and Disclosures: There must be a description of uses and disclosures which includes scenarios wherein uses and disclosures may be done with and without patient consent

 

  • Patient Rights: The notice must include a statement summarizing the patient’s rights with respect to their records and how the patient may exercise their rights including the right to obtain an accounting of disclosures of electronic records

 

  • Patient Complaints: The notice must state that patients may complain to the Part 2 program and to the Secretary of HHS if they believe their privacy rights have been violated

The penalties for noncompliance with Part 2 align with the penalties available under HIPAA. See 42 U.S.C. 1320d-5 and 1320d-6.

For the first time, HHS’ Office for Civil Rights (OCR) recently announced on February 13, 2026 that it has established a civil enforcement program to protect SUD patient records. As of February 16, 2026, OCR will now accept complaints alleging violations of Part 2 that protect the confidentiality of SUD patient records and notification of breaches of SUD patient records.

In sum, Executive Order 143 and OCR’s recent announcements signal the Trump Administration is prioritizing access to SUD treatment and the enforcement of regulations pertinent to the provision of SUD care. Behavioral health and SUD providers alike must take ensure their compliance with the Part 2 Final Rule to avoid OCR scrutiny.