For treatment centers

Compliance guide for treatment centers: Regulations you must follow

Published May 15, 2026 · 8 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Treatment center compliance is complex, involving federal, state, and sometimes local regulations. Non-compliance risks licensure, fines, and criminal penalties.

State licensing

Every state has specific licensing requirements for substance abuse treatment facilities. These include physical plant standards, staffing requirements, programming standards, and documentation requirements. Contact your state substance abuse agency for specific requirements.

HIPAA

Standard healthcare privacy requirements apply. Includes physical safeguards, technical safeguards, and administrative safeguards. Breach notification requirements. Business associate agreements with all vendors accessing PHI.

42 CFR Part 2

Additional privacy protections specifically for substance use treatment records. Written patient consent required for almost all disclosures. More restrictive than standard HIPAA. Recent CARES Act modifications partially aligned with HIPAA.

EKRA

Prohibits per-lead, per-call, and per-admission referral fees. Flat-rate marketing is compliant. All marketing relationships should be documented with fair market value basis. See our EKRA compliance guide.

Staff requirements

State-specific credentialing requirements for all clinical staff. Supervision requirements for trainees and pre-licensed clinicians. Background check requirements. Ongoing continuing education.

Authoritative sources

This article references guidelines from: SAMHSA · NIDA · ASAM

Frequently asked questions

What regulations do treatment centers have to follow?

State licensing, HIPAA, 42 CFR Part 2, EKRA, state-specific advertising regulations, and staff credentialing requirements.

What is the penalty for EKRA violations?

Up to $200,000 per violation and up to 10 years imprisonment.

Do I need an attorney for compliance?

Healthcare compliance counsel is strongly recommended, especially for marketing relationships and multi-state operations.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.