Opinion ID: 1155855
Heading Depth: 1
Heading Rank: 2

Heading: HIPAA Preempts Georgia Law

Text: This Court recently held: HIPAA and the related provisions established in the Code of Federal Regulations expressly supercede any contrary provisions of State law except as provided in 42 U.S.C. § 1320d-7 (a)(2). Under the relevant exception, HIPAA and its standards do not preempt state law if the state law relates to the privacy of individually identifiable health information and is more stringent than HIPAA's requirements. More stringent means laws that afford patients more control over their medical records. (Citations, punctuation and emphasis omitted.) Allen v. Wright, supra at 12, 644 S.E.2d 814. After reviewing HIPAA, Georgia law, and the case law of other jurisdictions, we find that HIPAA preempts Georgia law with regard to ex parte communications between defense counsel and plaintiff's prior treating physicians because HIPAA affords patients more control over their medical records when it comes to informal contacts between litigants and physicians. Under Georgia law, once a patient files suit and puts his medical condition in issue, his treating physicians can then disclose his medical records and defendant's lawyer can informally contact those physicians and orally communicate with them about plaintiff's medical condition. HIPAA, on the other hand, prevents a medical provider from disseminating a patient's medical information in litigation, whether orally or in writing, without obtaining a court order or the patient's express consent, or fulfilling certain other procedural requirements designed to safeguard against improper use of the information. See 45 CFR § 164.512(e). In other words, HIPAA requires a physician to protect a patient's health information, unless the patient is given reasonable notice and an opportunity to object. Georgia law stands in sharp contrast: it facilitates and streamlines the litigation process; it was not designed to protect a patient's private health information in the course of oral communications between the patient's physicians and defense counsel. It follows that HIPAA is more stringent and that it governs ex parte communications between defense counsel and healthcare providers. Allen v. Wright, supra. This is not to say that all oral communications between defense counsel and a plaintiff's prior treating physicians are forbidden. Certainly, counsel can contact a physician and make inquiries which are not intended to elicit protected health information. Such contact could include discussion of many benign topics, including but not limited to, the best methods for service of a subpoena, determining convenient dates to provide trial testimony, or the most convenient location for the anticipated deposition of the physician. However, HIPAA clearly regulates the methods by which a physician may release a patient's health information, including oral medical records. Law v. Zuckerman, 307 F.Supp.2d 705, 708 (D.Md.2004). See also Bayne v. Provost, 359 F.Supp.2d 234 (N.D.N.Y.2005) (ex parte contacts with medical provider are permissible if HIPAA requirements are satisfied). These methods include a subpoena, discovery request or other lawful process with assurances pertaining to notification or a protective order. 45 CFR § 164.512(e)(1). See Arons, supra at 415, 850 N.Y.S.2d 345, 880 N.E.2d 831 (privacy rule does not prohibit informal discovery, it merely superimposes procedural prerequisites). See also McCloud v. Bd. of Directors of Geary Community Hosp., Case No. 06-1002-MLB, 2006 WL 2375614 (D.Kan.2006) (defendants complied with HIPAA by seeking court order permitting production of medical records and ex parte contact with treating physicians); Holmes v. Nightingale, 158 P.3d 1039 (Okla. 2007) (ex parte communication with physician may be sought pursuant to a court order issued in compliance with HIPAA). Thus, in order for defense counsel to informally interview plaintiff's treating physicians, they must first obtain a valid authorization, or court order or otherwise comply with the provisions of 45 CFR § 164.512(e). See Crenshaw v. MONY Life Ins. Co., 318 F.Supp.2d 1015, 1029 (S.D.Cal.2004) (HIPAA does not authorize ex parte contacts with healthcare providers). In this case, service of a request for production of documents is insufficient because, although it gave plaintiff notice and an opportunity to object to the production of written documents, it did not give plaintiff an opportunity to object to the ex parte oral contact and the discovery of the physicians' recollections and mental impressions.