Every time a subpoena for medical records arrives, it creates angst. The medical records custodian experiences pressure to release records from the moment he/she receives a call from the requesting attorney's office, often arguing about whether the subpoena provides enough authority to release the records.
A Connecticut Supreme Court case  is getting a lot of attention for allowing state negligence claims based on noncompliance with HIPAA standards. For health information management professionals, the case underscores the need to resist releasing clinical information merely on the basis of a subpoena or at the insistence of an attorney. The court ruled that state court pretrial practices must be HIPAA compliant and that HIPAA requirements extend to responses to subpoenas. The court cited HIPAA regulations, 45 C.F.R. § 164.512(e)(1)(ii), to reaffirm that a healthcare provider cannot transfer protected health information (PHI) to an outside entity without receiving satisfactory assurances that the person whose medical records are the subject of the subpoena has been given notice of the request. [45 C.F.R. §165.512(e)(1)(ii)(A)] Usually the subpoena includes some notice language. However, satisfactory assurances requires all of the following:
Thus, before the requested medical record can be released, the provider needs to make sure there are no objections from the affected individual.
Alternatively, a provider may release PHI if it receives satisfactory assurances from the party seeking the information that it has made reasonable efforts to secure a qualified protective order. [45 C.F.R. §165.512(e)(1)(ii)(B)] Satisfactory assurances requires:
Thus, it is not enough for the subpoena to include a statement that a protective order will be filed or to include draft language for the protective order. The party seeking the PHI needs to have filed the qualified protective order with the court.
Under the new CT Supreme Court case, any healthcare provider in Connecticut who fails to comply with the HIPAA requirements outlined above is now risking a lawsuit by the patient and possible damages for negligence and emotional distress under state law as well as a complaint and possible investigation for violation of HIPAA requirements.
A reasonable and simple best practice in responding to subpoenas for PHI is (1) call the person whose PHI is the subject of the subpoena, (2) inform him/her of the subpoena for PHI, and (3) request authorization to release the PHI. The person can agree to the release or not. If the person agrees, the medical records department can follow its normal process for release of PHI. If the person disagrees, the medical records department should not release the information and should inform the requesting attorney of the individual's objection to the release of his/her PHI. These communications, both call and response, should be documented. If there are questions about the application of the CT Supreme Court case, you should consult with a HIPAA attorney.
 Byrne v. Avery Ctr., 314 Conn. 433 (2014).
 A subpoena issued by an attorney or "officer of the court" is not the same as a subpoena issued by a judicial officer (usually a judge or a magistrate) or a grand jury, which would be considered a court order and allowed under 45 C.F.R. §165.612(f)(1)(ii).
Susan Huntington and Alexandra MacKenzie Pearsall authored the section on CT law in "State Response to Opioid Crisis and Opioid Prescribing Requirements: A 50 State Survey," a resource published by the American Health Lawyers Association (AHLA).
Day Pitney Alert
Beth Alquist, chair of Day Pitney's Intellectual Property and Technology group, was featured on the MetroHartford Alliance radio show, "Pulse of the Region," to discuss the role of women in technology in connection with the Connecticut Technology Council's 15th Annual Women of Innovation (WOI) Awards
Susan Huntington served as a primary author of "Issues and Considerations in an Evolving Liability Environment: Summaries and Checklists Regarding Protections for Board of Directors and Executive Officers," a toolkit published by the American Health Lawyers Association's (AHLA) Business Law and Governance Practice Group.
On September 20, Susan Huntington presented during an educational call-in discussion, "Insurance and Coverage Risk Management Approaches to Address the Opioid Crisis," for the American Health Lawyers Association (AHLA).
Tom Zalewski is quoted in an article, "Careful Care: Health Care Companies Must Be Aware of Legal Risks That Come with New Technology," published by ROI-NJ.
Day Pitney partners Elizabeth Sher and Susan Huntington are recipients of Profiles in Diversity Journal's 18th Annual "Women Worth Watching" Awards, which recognize esteemed women leaders and acknowledge their talents, commitment, achievements and leadership.
Susan Huntington and George Mikhail were quoted in an article, "STRATEGIC PERSPECTIVES: U.S. Supreme Court Decides Allina and Analysis, Predictions Follow," published in Health Law Daily by Wolters Kluwer Legal & Regulatory U.S. Following the U.S. Supreme Court decision in Azar v. Allina Health Services, the article provides an overview of the court's decision and perspective on what it means for providers.
Susan Huntington, chair of the firm's Healthcare and Life Sciences practice group, was quoted in an article, "Attorneys React To High Court's HHS Rulemaking Decision," published by Law360.
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