Trumping patients’ interest

An Indiana judge has upheld Indiana Attorney General Steve Carter’s request that Planned Parenthood of Indiana turn over the medical records of 84 patients under the age of 14.

In Indiana, a person under 14 who has been sexually active is by definition a victim of child abuse, meaning that a report has to be filed with child protective services or law enforcement. Planned Parenthood of Indiana has protocols in effect to make sure this reporting is done by its clinics.

“The great public interest,” Marion County Superior Court Judge Kenneth Johnson wrote in his decision, “in the reporting, investigation and prosecution of child abuse trumps even the patient’s interest in privileged communication with her physician because, in the end, both the patient and the state are benefited by the disclosure.”

Under Indiana law, the Medicaid Fraud Control Unit has the right to review and copy records only if it is investigating Medicaid fraud or abuse or neglect of patients in a Medicaid facility. There has been no allegation or evidence of such fraud, and all the records sought by the attorney general’s agents so far are for patients under 14 who are receiving some sort of Medicaid medical service. That service does not include abortions.

“The Fraud Control Unit’s searches and seizures appear to be beyond its statutory authorization, thus violating Indiana law,” says ICLU Legal Director Kenneth J. Falk. “To the extent that the attorney general’s agents have exceeded these boundaries, they are engaging in searches and seizures which violate both the Fourth Amendment rights of Planned Parenthood and the privacy rights, protected by the 14th Amendment, of Planned Parenthood’s patients.”

Johnson rejected Planned Parenthood of Indiana’s claim that the disclosure of patient information in the medical records would have a “chilling effect” on minors seeking reproductive health services in the state.

He also cited a document signed by PPI stating that the organization would cooperate with state and federal officials’ audits and “make available upon demand” any information necessary to “ensure the appropriateness” of Medicaid payments paid to the organization.

According to PPI President and CEO Betty Cockrum, “This ruling puts all our medical privacy at risk, shaking the very foundation of the doctor-patient relationship that is at the heart of good health care. We will appeal the court’s decision in order to defend the privacy of all Hoosiers, including the more than 100,000 patients Planned Parenthood of Indiana serves annually. In the interim, we hope the attorney general will refrain from seeking our patients’ medical records while this case is pending.

“We again remind the public they can count on Planned Parenthood of Indiana to take very seriously the law regarding reporting abuse and neglect,” Cockrum said. “Nonetheless, our patients can be confident that their records will not be released.”

State officials said they would not seek any additional records until all appeals have been exhausted. “It would be our intent to wait until the process has worked itself through,” Carter spokesperson Staci Schneider said.