Key Takeaway
Appellate court rules HIPAA doesn't prevent insurers from using medical records in no-fault cases, orders new trial after improper exclusion of evidence.
Eagle Surgical Supply, Inc. v GEICO Ins. Co., 2013 NY Slip Op 51862(U)(App. Term 2d Dept. 2013)
“The abbreviated record now before us provides no justification for the trial court’s sua sponte determination precluding the defendant insurer from offering medical evidence in support of its defense of lack of medical necessity, based on its apparent failure to obtain a HIPAA-compliant authorization from plaintiff’s assignor. Even assuming, without deciding, that defendant is a “covered entity” subject to HIPAA (see 45 CFR § 160.103), an issue not addressed below, defendant should have been given the opportunity to establish that it was entitled to adduce the assignor’s medical records without the need of a HIPAA authorization pursuant to the “payment” and “health care operations” exceptions set forth in the governing federal regulations (see 45 CFR 164.506; 45 CFR 164.501; see also Ops General Counsel NY Ins. Dept. No. 03-07-10 ).”
I think this will put an end to certain judges delaying no-fault trials in a certain venue (for HIPPA reasons) with a certain judge at a certain courthouse located between westchester county, new york county and queens county. That still does not mean that another reason for delaying these trials will not come to fruition.
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