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ACAP Joins Broad Coalition of Health Care Organizations to Ask HHS for Clarification on SUD Community Engagement Exemption Requirements
FOR IMMEDIATE RELEASE: February 10, 2026
FOR MORE INFORMATION: Marty Johnson, (202) 420-7424; mjohnson@communityplans.net
ACAP Joins Broad Coalition of Health Care Organizations to Ask HHS for Clarification on SUD Community Engagement Exemption Requirements
WASHINGTON — The Association for Community Affiliated Plans (ACAP) on Friday joined a diverse group of health care organizations in urging the Department of Health and Human Services (HHS) to provide written clarification concerning H.R. 1’s substance use disorder (SUD) community engagement exemption requirements.
The coalition believes that an existing, single consent for treatment, payment, and health care operations (TPO) under 42 CFR Part 2 should satisfy the exemption criteria. The exemption waives the 80 hours per month community engagement obligation adults covered under Medicaid expansion will need to meet starting in 2027.
“ACAP has been squarely focused on making sure our Safety Net Health Plans are able to meet all of the new policies outlined by H.R. 1, especially work requirements,” ACAP CEO Margaret A. Murray said. “Clear guidance from HHS regarding exemptions will allow for smooth implementation while also ensuring those living with SUD have no interruption in the care they need and deserve.”
Specifically, the group is calling for HHS to work alongside the Centers for Medicare & Medicaid Services to clarify, in writing, that:
- 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;
- A patient’s Part 2 consent for “payment” purposes satisfies the consent requirements for the Medicaid exemption eligibility determinations.
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
Hazelden Betty Ford Foundation
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
The group is committed to working with HHS to provide field examples and written clarification for providers and patients.
You can read the full letter at communityplans.net.
ABOUT ACAP
ACAP represents 90 health plans, which collectively provide health coverage to more than 30 million people. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other publicly-sponsored health programs. For more information, visit communityplans.net.
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