The Third Department, reversing Supreme Court, determined the NYS Comptroller had the power to issue a subpoena for patients’ billing records as part of an audit of a health services provider paid under the state’s Empire Plan. Neither the CPLR, which governs the confidentiality of medical records sought in discovery as part of litigation, nor the Health Insurance Portability and Accountability Act (HIPAA), precluded the Comptroller from accessing the billing records:
We find that, contrary to petitioner’s claims and the holding of Supreme Court, the subpoena was validly issued in furtherance of [the Comptroller’s] constitutional and statutory authority and obligation to audit payments made by the state for medical services provided under the Empire Plan … . In Matter of Martin H. Handler, M.D., P.C. v DiNapoli (23 NY3d at 242-243, 245-248) … the Court of Appeals outlined … the obligations of participating and nonparticipating health care providers with regard to billing patients, and [the Comptroller’s] independent authority and obligation to audit the state’s payments to both categories of providers. As the Court of Appeals outlined, respondent is constitutionally obligated to audit state payments to health insurance vendors … . …
The plain language of CPLR 3122 (a) (1) and (2), read together, makes clear that the provisions apply to subpoenas issued during the discovery phase of litigation, and are not applicable to the subpoena issued by [the Comptroller] here pursuant to its authority under State Finance Law § 9 … . …
… HIPAA’s privacy regulations provide that “[a] covered entity may disclose protected health information to a health oversight agency for oversight activities authorized by law, including audits; civil, administrative, or criminal investigations; . . . criminal proceedings or actions; or other activities necessary for appropriate oversight of . . . [e]ntities subject to government regulatory programs for which health information is necessary for determining compliance with program standards,” without the written authorization of the patient … . Matter of The Plastic Surgery Group, P.C. v Comptroller of The State of New York, 2017 NY Slip Op 08247, Third Dept 11-22-17
ADMINISTRATIVE LAW (NYS COMPTROLLER, AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))/CIVIL PROCEDURE (NYS COMPTROLLER, AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))/COMPTROLLER AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))/PATIENT BILLING RECORDS (NYS COMPTROLLER, AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))/CIVIL PROCEDURE (NYS COMPTROLLER, AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))/CPLR 3122 (NYS COMPTROLLER, AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))/HIPAA (NYS COMPTROLLER, AUDIT OF HEALTH SERVICES PROVIDERS, NYS COMPTROLLER HAS THE CONSTITUTIONAL AND STATUTORY RIGHT TO SUBPOENA PATIENT BILLING RECORDS FROM HEALTH SERVICES PROVIDERS PAID UNDER THE STATE’S EMPIRE PLAN TO FACILITATE AN AUDIT, SUPREME COURT REVERSED (THIRD DEPT))