Addiction Medicine / MAT Clinic Launch Roadmap
State-specific compliance overview for opening a facility in California.
Nurse Practitioner Practice Authority & Collaboration Agreement
NP practice authority varies by state: FULL (independent practice), REDUCED (collaborative agreement required), or RESTRICTED (physician supervision required). Whether an NP can own and run the clinic without a physician depends on this tier.
Confirm your state's NP practice tier, and where required, execute and file a written collaboration/supervision agreement with a physician before the NP evaluates patients or prescribes.
Buprenorphine (MAT) Prescribing — DEA Registration & Training
The federal X-waiver was eliminated in January 2023 — any DEA-registered prescriber with Schedule III authority may now prescribe buprenorphine for opioid use disorder. The MATE Act requires 8 hours of substance-use-disorder training at DEA registration or renewal.
Ensure each prescriber holds a current DEA registration with Schedule III authority and has completed the one-time 8-hour MATE Act training; check state-level MAT prescribing rules, which may add requirements.
42 CFR Part 2 — Substance Use Disorder Record Confidentiality
Substance-use-disorder treatment records are protected by 42 CFR Part 2, which is stricter than HIPAA: patient consent is generally required before disclosing SUD records, including to other treating providers.
Implement Part 2-compliant consent forms, staff training, and record segmentation; update Notice of Privacy Practices to address SUD records and redisclosure prohibitions.
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