Opinion ID: 1362411
Heading Depth: 2
Heading Rank: 3

Heading: Plaintiffs' Agency Argument

Text: Plaintiffs' case ultimately distills down to their argument that because Mann & Cook acts as Webb's agent, for HIPAA purposes the lawyer who makes the request is the individual, and thus should be charged the reduced fees for the medical records. They rely on California agency law, which provides that an attorney, appearing and acting for a party to a cause, has authority to do so, and to do all other acts necessary or incidental to the proper conduct of the case. Clark Equip. Co. v. Wheat, 92 Cal.App.3d 503, 154 Cal. Rptr. 874, 884 (1979). They cite California state law because the HIPAA savings clause provides that its regulation[s] . . . shall not supercede a contrary provision of State law, if the provision of State law imposes requirements, standards, or implementation specifications that are more stringent than HIPAA's. 42 U.S.C. § 1320d-2 note. More stringent laws are defined, inter alia, as those that permit[ ] greater rights of access for the individual, who is the subject of the individually identifiable health information. 45 C.F.R. § 160.202. Plaintiffs argue that California agency law provides the individual with greater rights of access by allowing attorney-agents to obtain the records at the limited cost, and therefore trumps the HIPAA regulations to the extent they require a contrary interpretation. In fact, however, California law does not support Plaintiffs' claim. In the only casefederal or stateto address directly a claim based on the HIPAA fee limitation at issue in this case, the California Court of Appeal analyzed the same agency argument, advanced by the same law firm  Mann & Cook  on behalf of a different client, and rejected it: We agree that the lawyer is the client's agent, but we do not think that, for the purposes of protecting the privacy of medical, records, a lawyer's request is the same as the client's personal request for his or her own medical records. The problem that appellant's argument sidesteps is that a request by anyone other than the individual or his/her personal representative as defined in the regulations raises serious privacy concerns. DHHS considered but rejected giving lawyers the same status as personal representatives. This court is not empowered to redraft federal regulations, especially when the regulations do not impinge on fundamental rights. . . . [A]ll appellant has to do is to request a copy of his own records. We do not perceive that there is any right to have one's lawyer ask for one's records. Bugarin v. Chartone, 135 Cal.App.4th 1558, 38 Cal.Rptr.3d 505, 510 (2006). We must defer to the California court's interpretation of its own agency law as not granting the rights Plaintiffs assert. [11] See Mullaney v. Wilbur, 421 U.S. 684, 691, 95 S.Ct. 1881, 44 L.Ed.2d 508 (1975) ([S]tate courts are the ultimate expositors of state law, and we are bound by their constructions except in extreme circumstances. (citations omitted)). State law does not, therefore, trump HIPAA in this case. Accordingly, because Plaintiffs have not sufficiently alleged a HIPAA violation, they have not stated a claim under Section 17200, and dismissal under Rule 12(b)(6) was appropriate. [12] Our holding, however, in no way precludes attorneys from assisting their clients in accessing and obtaining their medical records without triggering the hefty fees. Although the plain meaning of individual, as well as the DHHS final commentary and subsequent clarification evidence a clear intent to exclude attorney requests from the reduced fees, this intent does create at least some conflict with DHHS's statement that [t]he fee limitation . . . is intended to assure that the right of access . . . is available to all individuals, and not just to those who can afford to do so. 67 Fed.Reg. 53254. As the California Court of Appeal noted, lawyers routinely request copies of their clients' medical records. The effect of such requests by lawyers is to increase the cost to the client, even though the intent of the legislation, and the regulations, is to minimize the cost of copying, at least when an individual requests his or her own records. Bugarin, 38 Cal.Rptr.3d at 509. It is possible to reconcile this seeming conflict; privacy concerns increase when anyone other than the individual requests medical records, and because privacy is a primary HIPAA goal, it makes sense to make it more difficult for third parties to obtain records, even with authorization. Still, it is circuitous, if not downright silly, to require an individual to request his own medical records . . . and having received them, hand them to his lawyer. Id. at 510. We therefore echo the concurrence in Bugarin by emphasizing that in affirming the district court's judgment, we only uphold[ ] the ability of copying services to charge higher rates when the attorney makes the request on behalf of his or her client than when the patient/ client makes the request directly. . . . [We do] not address such presumably common scenarios in which the client signs the request and asks the documents to be sent to the attorney, or the attorney prepares the documents on his or her letterhead and the client personally signs the request. Id. at 511 (Rubin, J., concurring). In the end, then, we may not be free to deviate from the text of the HIPAA regulations, id. at 509, but we may nonetheless recognize that there is ample room for attorneys to provide important services for their clients. [13] AFFIRMED.