May 09, 2012

The physician-patient privilege and HIPPA both held to yield to a subpoena duces tecum issued by an administrative agency pursuant to its statutorily assigned functions


The physician-patient privilege and HIPPA both held to yield to a subpoena duces tecum issued by an administrative agency pursuant to its statutorily assigned functions
New York City Health & Hosps. Corp. v New York State Commn. of Correction,2012 NY Slip Op 03571, Court of Appeals

The New York State Commission of Corrections, on behalf of its Medical Review Board, served a subpoena duces tecum on Elmhurst Hospital, a health care facility operated by the New York City Health and Hospitals Corporation (HHC), seeking its records concerning its care and treatment of a deceased correctional inmate in the custody of the City of New York.

Initially the subpoena was quashed upon the ground that it sought material shielded from disclosure by the physician-patient privilege.* The Court of Appeals, however, ruled that the records sought were not properly withheld from the Commission by reason of the alleged physician-patient privilege and that the subpoena should be honored.

The court noted the Board has statutorily assigned functions, powers and duties in the "[i]nvestigat[ion] and review [of] the cause and circumstances surrounding the death of any inmate of a correctional facility."

However, HHC refused to turn over the sought records, contending that the inmate had been treated at Elmhurst in a non-prison unit, and, in view of that circumstance, HHC argued that the Commission had no special entitlement to the deceased inmate's medical records.

The Court of Appeals disagreed, holding that the Legislature intended for the Board to have plenary authority to "investigate and review the cause and circumstances surrounding the death of any inmate ofa correctional facility" and the “Legislature cannot be supposed to have allowed that the thoroughness of the Board's inquiry would vary with the site of an inmate's pre-mortem medical care — that the inquiry respecting the death of an inmate who in the period preceding his or her death was treated in a prison or a prison unit in a hospital would be conducted with the benefit of a full medical record, whereas one respecting an inmate who had received pre-mortem treatment in a non-prison unit would have to be performed without such a record in the event that a waiver of the physician-patient privilege could not be obtained.”

The Court of Appeals then considered an alternative argument advanced by HHC -- the HIPPA Privacy Rule. The court said that the Privacy Rule does not prohibit disclosure of the records sought by the Commission as HIPPA specifically allows for disclosures "required by law," citing 45 CFR 164.512 [a]. This, said the court, includes disclosures pursuant to "subpoenas . . . issued by . . . an administrative body authorized to require the production of information."

The subpoena HHC sought to be suppressed, which the court ruled was enforceable despite CCH’s claim of physician-patient privilege, was held to fall “comfortably within” 45 CFR 164.512 [a].

* On the issue of physician-patient privilege, CPLR 4504 (a) provides, in pertinent part: "[u]nless the patient waives the privilege, a person authorized to practice medicine, registered professional nursing [or] licensed practical nursing . . . shall not be allowed to disclose any information which he [or she] acquired in attending a patient in a professional capacity, and which was necessary to enable him [or her] to act in that capacity. The relationship of a physician and patient shall exist between a medical corporation . . . and the patients to whom [it] . . . render[s] professional medical services."

The decision is posted on the Internet at:
http://www.courts.state.ny.us/reporter/3dseries/2012/2012_03571.htm