Lawyers Requesting Medical Record • Gynecology Exam Handout • DEA Agents

QUESTION: We received a request from a lawyer for one of our patients’ medical records. This lawyer also wants all of the previous records from the previous physicians that this patient had care with. We have these records in our possession because the patient provided them to us when we took over their care. Do we have to provide these records as well?

ANSWER: Yes. Prior to the filing of any action or the appearance of a defendant in an action, an attorney or an attorney’s representative may present a physician with a written authorization for a records release signed by an adult patient, the guardian, or conservator of the patient or his or her estate, the parent or guardian of a minor, or the personal representative or heir of a deceased patient. That form must meet the requirements imposed by the HIPAA privacy rules (for an example of what this form should contain, please see CMA ON-CALL document #1127, “Attorney Pre-litigation Request for Medical Information”). The physician must then make all the patient’s records in his or her custody available for inspection and copying by the attorney or attorney’s representative during business hours within five days. When a patient requests records, a physician may exclude information that has been provided in confidence by the patient’s spouse or others, except that a physician may not exclude information and records that have been provided by other physicians or healthcare providers or the patient.

QUESTION: I remember reading about a law requiring us to give patients a handout at the time of their annual gynecology exam. Do you know what law this is or what handout is required?

ANSWER: According to the Medical Board of California, “Gynecologic Cancers … What Women Need to Know” is a quad-fold pamphlet prepared by the California Department of Health Services. California law (H&S Code § 109278) requires medical providers to distribute to their patients information regarding women’s gynecologic cancers, including signs and symptoms, risk factors, benefits of early detection through appropriate diagnostic testing, and treatment options. This pamphlet is available in 10 different languages and can be downloaded at the following Department of Health Care Services link: www.dhcs.ca.gov/services/owh/Pages/GCIP.aspx.

QUESTION: I just received a message from a person identifying himself as a DEA agent. He wants to meet with me to ask about a former patient and show me a “photo lineup.” I’m concerned about violating patient confidentiality. In addition to checking with my malpractice carrier, is there a resource you know of that can address this issue?

ANSWER: You are not legally bound to meet or speak with law enforcement, due to physician/patient confidentiality rules. Any admission of treatment, familiarity or identification of an individual would be a breach of that confidentiality. If you receive a subpoena, it is recommended that you consult with an attorney. If you work at a hospital, other facility, or medical group, they should have attorneys on staff.