Your state · The federal floor
The federal addiction marketing layer
The rules that apply in every state, and the survey that says which states add nothing on top. Derived from the live library.
Every addiction and rehab marketing scan runs a federal layer, whatever the state. It is four things: EKRA (18 U.S.C. 220) on how you pay for referrals, 42 CFR Part 2 on what you can reveal about a patient, the FTC Act on what you can claim, and, for email, CAN-SPAM. In the 31 states with no distinctive statute of their own, this federal layer plus general consumer-protection law is the whole picture.
These federal rulesets run on every applicable scan. Each carries its citation and a review clock, and counts toward a clean pass only while its clock is fresh.
42 C.F.R. Part 2 (2024 Final Rule, effective Apr. 16, 2024, compliance required Feb. 16, 2026; OCR enforcement under the Aug. 25, 2025 delegation; civil and criminal penalties now apply; stricter than
Google Ads Healthcare and medicines policy (LegitScript certification required for addiction treatment advertisers since 2018).
CAN-SPAM Act, 15 U.S.C. 7704(a)(1) (false or misleading transmission information) and 7704(a)(2) (deceptive subject headings); enforced by the FTC.
Eliminating Kickbacks in Recovery Act, 18 U.
FTC Act Section 5 (15 U.
FTC Act Section 5 (15 U.
45 CFR 164.501 and 164.508(a)(3)-(4); HHS Office for Civil Rights. 2013 Omnibus (HITECH) final rule.
The per-admission pay rule is the one that reaches marketing intermediaries directly. Here is what the scanner does with it.
We pay our marketing partners 500 dollars for every admission they send us.
Volume-based pay for referrals to a treatment facility is the exact conduct EKRA prosecutes; calling it a marketing fee does not cure it.
EKRA, 18 U.S.C. 220 · 18 U.S.C. 220
Our marketing partners earn a fixed monthly fee that does not change with volume.
Fixed pay untied to the number or value of patients is the safe structure under EKRA.
A 50-state survey on 2026-07-23 found no distinctive substance-use-disorder marketing or patient-brokering statute in this state beyond general consumer-protection law. This scan therefore covers the federal layer only: the FTC Act, the Opioid Addiction Recovery Fraud Prevention Act, and any applicable HIPAA and platform rules. General state consumer-protection law still applies to your copy and is not scanned here, so confirm any state-specific obligations with counsel. The survey is rechecked on the review clock, because a state can adopt an SUD-marketing statute at any time.
The 31 jurisdictions with no distinctive addiction-marketing statute as of the 2026-07-23 survey: Alabama, Alaska, Arkansas, Connecticut, District of Columbia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Vermont, Virginia, Wisconsin, Wyoming.
Federal sources
- 42 C.F.R. Part 2 (eCFR current text) primary
- 16 C.F.R. Part 255 Endorsement Guides primary
- HHS fact sheet, 42 CFR Part 2 Final Rule (2024)
- 15 U.S.C. 45d (OARFPA 2018) primary
- Google Ads Healthcare and medicines policy primary
- Meta advertising standards, addiction treatment primary
- LegitScript addiction treatment certification
- 15 U.S.C. 7704 verbatim (govinfo.gov) primary
- 15 U.S.C. 7704 (official code viewer) primary
Pre-Trip is a rigorous screen, not legal advice. Counsel decides; we help you arrive prepared.