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Waiver of Coverage Part 1: Employee Information Employees Last NameFirst NameInitialDistrict #Employee ID#Employee Groupware 2: Waiver of Coverage Before you sign this form, read the online benefit
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What is part 2 waiver of?
Part 2 waiver is a waiver of the requirement for certain entities to submit Part 2 information under the Substance Abuse and Mental Health Services Administration (SAMHSA) regulations.
Who is required to file part 2 waiver of?
Entities such as hospitals, clinics, and other healthcare providers who do not provide substance use disorder treatment directly and do not bill Medicare or Medicaid for those services.
How to fill out part 2 waiver of?
Part 2 waiver can be filled out online through the SAMHSA website or by submitting a paper form to the appropriate regulatory authority.
What is the purpose of part 2 waiver of?
The purpose of part 2 waiver is to protect the confidentiality of patients receiving substance use disorder treatment.
What information must be reported on part 2 waiver of?
Part 2 waiver requires reporting basic information about the entity applying, the services it provides, and the reasons for seeking the waiver.
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