Judge says physician
must permit HMSA
to review files

Elsie Wang had gone to court
to protect the confidentiality
of her patients' records

By Ian Lind

Honolulu physician Elsie Blossom Wang must turn over hundreds of medical records to the Hawaii Medical Service Association within three weeks or face possible contempt charges and other sanctions.

The decision last week by Circuit Judge Kevin Chang dealt another blow to Wang's efforts to protect the confidentiality of her patients' medical records.

Wang had refused to release the records unless HMSA obtained specific authorizations from the patients. She went to court last year after the insurer threatened to cut off payments to her.

Chang ruled earlier that the insurer is legally entitled to the records because of general authorizations the patients' signed when first applying for HMSA coverage, some as long as 30 years ago.

During a hearing last week, Chang scolded Wang's attorney, Stephen M. Shaw, for continuing to raise privacy issues.

"This is not a case in which broad issues of patient confidentiality are involved," Chang said. "To the extent that you are trying to make it that, it is wholly inappropriate."

HMSA's attorneys have argued that the insurer has an extremely broad right to examine confidential medical records for virtually any reason and without any authorization from patients.

Attorney Troy Fukuhara told Chang last week that HMSA is not seeking to publicly disseminate the records.

"HMSA merely wants to review the medical records to assess medical treatment provided patients," Fukuhara said. "It cannot make a determination for payment (to Wang) without it."

Fukuhara said full patient histories are needed "to assess the reasonableness of (Wang's) treatment."

Shaw said Wang is worried about reports that temporary workers, clerks, and possibly others would have access to the records if given to HMSA.

"Who is going to receive the records?" Shaw asked. "Who's going to look at them?"

Wang "is only trying to provide some protection for individual privacy," Shaw said. "We're only asking for reasonable assurances that records will not be available to everybody with a key to HMSA's front door."

Chang agreed to impose a protective order to retain confidentiality "to the maximum extent possible."

Chang ordered Wang to turn over the original records, and directed HMSA not to make copies, and to return the originals when the review is completed. Chang also ordered HMSA not to disclose any information to third parties except medical consultants involved in the review.

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