Fraud probes don't override doctor-patient privileges

But physicians can't use patient confidentiality simply as a means to avoid an inquiry, Utah's Supreme Court says.

By Amy Lynn Sorrel, AMNews staff. April 17, 2006.

Utah's highest court made a strong statement to protect physician-patient privilege when it ruled that doctors and law enforcement officials are both responsible for guarding patient's private medical records in state fraud investigations, state doctors say.

Although the case that spurred the ruling involves a chiropractor, the decision will affect physicians as well. The Utah Supreme Court declared that doctors have the right to claim the privilege when they are subpoenaed for medical records in an insurance fraud investigation.

But the court was firm in ruling that doctors cannot invoke the privilege simply to shield themselves from an inquiry. In such cases, the court emphasized, the burden of protecting patients' medical records shifts to the state and lower courts, which must take precautions to ensure privacy.

The ruling likely will make it difficult for physicians to try to protect themselves from a fraud investigation by relying on patients' interests, said Chet Loftis, counsel to the Utah Medical Assn. But the decision underscores the importance of the privilege, recognizing that it belongs foremost to the patient, he said.

"The court has said it's really going to protect the privilege, and it's not going to make any exceptions unless they are very clear and unless they are in the patient's best interest," Loftis said. The UMA did not take a position on the case, but to the extent that it addresses privilege, "we believe the ruling supports patient confidentiality," he said.