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Nurse Practitioner Response to an Arizona Medical Records Subpoena

Different Types of Subpoena Individuals (NP) Must Comply

How should a nurse practitioner respond to a medical records request through a subpoena in Arizona?  There are five different types of avenues for someone to send a subpoena for medical records that a nurse practitioner must comply with. And I’m just going to read what those are. The first one is obviously a subpoena with written authorization from the patient. Now, anytime a patient requests a medical record, the nurse practitioner must respond and provide that person with the record. But via a subpoena, if the subpoena requests the record and it’s accompanied by written authorization from the patient, then you must send it back. Next, if the subpoena is accompanied by a court order. If a court has ordered you to provide the documents, then you have to do it.

Next, a grand jury subpoena for a criminal investigation. If they request the medical records, then the NP must respond to that as well. The fourth is from a healthcare board in Arizona. If you’re an NP, maybe a complaint has been filed against you, and the nursing board sends you a subpoena for the medical records, you obviously must provide those records. Other boards as well. Psych board, med board, maybe it’s in relation to a complaint against a physician, and you’re in the chart. Once again, the healthcare regulatory boards in Arizona do have the authority to subpoena records. And so, you’d have to provide those as well. And then there’s a catchall that just says you’re required by another state law to release the records to the seeking party.

Rules of Issuing a Medical Records Subpoena

Those are the five types, at least via subpoena that you have to respond to. Now, there are certain rules that anyone who’s issuing a subpoena must follow, and there are potential objections if it is not followed correctly. Now, in the case of a board, there’s almost no chance that they’re not going to send the proper subpoena, meaning it contains all the things that need to be contained. It’s served properly. Most of the time where you’ll see issues is if it’s through an attorney. If maybe there’s malpractice claim against another provider in the NPS on the chart or who knows, personal injury, or whatever, I find many of the personal injury attorneys or plaintiff’s attorneys for med mal or whatever else, don’t necessarily understand the rules associated with subpoenaing medical records.

How Individuals respond to a Served Subpoena

So, if you do have a question about whether you’ve been served a proper subpoena or how you can respond to it, object to it, or whatever, feel free to give us a call. There are also a few caveats if the provider is concerned that providing the records will be potential hardship or can cause some serious mental health or medical problems for the patient. However, those are infrequent, and you are not going to be able to use those objections as far as a board’s concerned or a court’s concerned. And even if you did, then you’d file an under seal with the court, and then the court would determine whether they are going to agree with your position or not.

Most of those five that I listed have brought authority to issue subpoenas, and they certainly are entitled to receive medical records from the nurse practitioner. I find most NPs, or I guess probably most healthcare providers for that matter, don’t understand that almost all the records can be obtained. That’s why the necessary record keeping is important. As you know, my firm has represented probably over a thousand nurses before the Arizona Board of Nursing by now. Documentation issues can always pop up during an investigation, and so it can maybe start in one place, and then once the board receives the documentation and they review it, if the NP isn’t following the rules or their documentation isn’t complete, that can be a violation and can end up in potential discipline.

HIPAA Privacy Rule

It is a national rule that protects individual medical information and records that sets limits on the uses that may be made of such disclosure without a patient’s clearance. It gives individuals a right to obtain their health records, direct an entity to disclose them to third parties, and request any corrections. In Arizona, HIPAA guards against subpoenas by presenting conditions that must be met before medical records are released.

  1. For subpoenas issued by a judge or magistrate, the medical practitioners must comply with the information demanded, or attract fines.
  2. For subpoenas issued by grand juries, the practitioner must strictly comply with its terms. Since grand jury proceedings are confidential, HIPAA does not require additional protections.

For subpoenas issued by an attorney, the practitioner has to meet the following conditions:

  1. The practitioner should contact the patient orally or by letter, explain that they have received a subpoena requiring disclosure of the patient’s information, and notify the patient that they are required to respond unless the patient quashes the subpoena and notifies the practitioner before the deadline for responding to the subpoena. Once the practitioner sends such notice, the burden is on the patient to reject the subpoena if they want to protect their personal information
  2. The practitioner may obtain written assurances from the entity issuing the subpoena that either: 

(a) the entity made a good faith attempt to give the patient written notice of the subpoena, the notice included sufficient information to permit the patient to object to the subpoena, and the time for raising objections has passed, or the court ruled against the patient’s objections, or 

(b) the parties have agreed on a protective order, or the entity seeking the information has filed for a protective order. (45 C.F.R. § 164.512(e)(1)(iii)-(iv)).

  1. Or the practitioner may obtain a valid HIPAA authorization executed by the patient. To be valid, the authorization must contain the elements and statements required by 45 CFR § 164.508.

If the practitioner cannot satisfy one of the above, they may not disclose protected health information, nor may they ignore the subpoena without subjecting themselves to possible contempt sanctions. The practitioner may need to appear in response to the subpoena, assert an objection based on HIPAA, and wait for the court to order disclosure.

Subpoenas are issued by attorneys in Arizona to obtain patients’ records for use in personal injury claims, medical malpractice claims, or any other kind of civil lawsuit or even a criminal suit.

How Can Chelle Law Help?

At Chelle Law, we help medical professionals who have struggled to respond to medical records subpoenas. Usually, such records can only be provided through the authorization of a judge, a licensed attorney, and the express authority of the patient.

We help medical professionals respond to various medical record requests by third parties. Contact Chelle Law for assistance if you struggle to respond to medical records.

Call Us Now: 602.344.9865

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Links of Interest

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  • Arizona Medical Records Subpoena Attorney
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2023-06-08
Very professional, courteous, quick response, and a Positive outcome with the Board of Nursing. Case dismissed!!! I am glad I contacted Chelle Law. I highly recommend Chelle Law, thank you, Katrina and the entire team. A special thank you to Mr Robert.
Linda Stover
Linda Stover
2023-06-07
Excellent service - fully recommended!!
Psychic Medium
Psychic Medium
2023-06-06
I cannot say enough amazing things about this team! I came in for some clarification on my documents for an application process. I left knowing exactly what I needed to do & feel SO MUCH better about it all. It really pays to have professionals like these help guide you. Also their YouTube videos are incredibly helpful! 10/10
Elani Dodd
Elani Dodd
2023-06-04
I found Chelle Law when looking for a team to review my contract for a nurse practitioner job. I highly recommend the team. The office was quick to answer questions and respond to my emails. Scheduling & payment was simple and straightforward. The hour-long phone meeting with Erin was extremely helpful. Worth the cost. Having someone who understood the legal terms and could clearly help me understand the contract was refreshing. I appreciated her willingness to compare each section against industry norms and make recommendations for negotiations. The post call summary was promptly sent and most helpful - worded in first person to improve my negotiations with my employer.
Gary Miyasaki
Gary Miyasaki
2023-06-03
I had detailed questions about my physician contract. I found Chelle Law through YouTube and realized their team would help me best. Erin was very thorough, patient, and helped answer all my questions. I felt confident about my options after being consulted. Would highly recommend!
vladymir gratia
vladymir gratia
2023-06-03
They reached out back to me fairly quickly and they walked me through the process step by step supplying clear explanations along the way and providing sound advice throughout the entire process. Thank you.
Esmeralda Jonko
Esmeralda Jonko
2023-06-02
Chelle law certainly deserves 5 stars. Working with Katie and Erin was suchba flawless process. Erin did a wonderful job explaining my contract review and Katie explained the entire process to me. Everyone responded to me in a timely fashion. Working with Chelle law was worth every penny. Thank you!
Christine Fernandez
Christine Fernandez
2023-06-01
Great service! Will definitely use them again.
Stacy Lusher
Stacy Lusher
2023-05-25
Amazing All around. They stay on top of everything and keep you updated 100% of the time.
manjusha k
manjusha k
2023-05-17
Great experience with Renne Osipov.Reviewed entire contract in detail.Very professional.

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