Planned Parenthood of Indiana on Monday filed a lawsuit in Marion Superior Court to prevent Indiana Attorney General Steve Carter (R) from accessing the confidential medical records of low-income patients under age 14 who sought reproductive health services at state family planning clinics, the Indianapolis Star reports. In a statement, Carter said he is using the state Medicaid Fraud Control Unit to subpoena the records to investigate whether family planning clinics are properly reporting cases of rape and molestation for children under age 14. He said his office is "obligated under federal and state statutes to investigate allegations of abuse and neglect by Medicaid providers, which include hospitals, nursing homes and other medical clinics that receive Medicaid reimbursement from the state" (McNeil, Indianapolis Star, 3/15). MFCU already has accessed the records of eight clients from clinics in Bloomington, Franklin and Lafayette, and MFCU Director Allen Pope is seeking the records of 73 additional clients at 19 clinics, according to the lawsuit, the AP/Kansas City Star reports.

Lawsuit Details
The lawsuit seeks temporary and permanent injunctions to prevent Carter and MFCU from searching the records of clients at 40 Planned Parenthood affiliate clinics throughout the state, the AP/Star reports (Kusmer, AP/Kansas City Star, 3/14). It also asks Marion County Superior Court Judge John Hanley to require Carter's office to return the records it already has taken (Indianapolis Star, 3/15). "When first confronted by an agent of the attorney general's office flashing a badge and demanding records, our well-meaning staff believed that they were [required to turn over the records] by law," PPI CEO Betty Cockrum said, adding that the group no longer believes there is a "legitimate investigation in progress," the Evansville Courier & Press reports (Whitson, Evansville Courier & Press, 3/15). "This is a clear-cut case of abuse of power," Cockrum said, adding, "Instead of protecting medical privacy rights, the attorney general is selling them out to his fishing expedition" (AP/Kansas City Star, 3/14).

Medicaid Loophole
Federal health privacy laws do not apply to Medicaid fraud or abuse investigations, and facilities that do not cooperate with investigations or release patient records can lose their federal Medicaid funding, the Star reports. Carter spokesperson Staci Schneider said the investigation is similar to other fraud investigations involving medical records. She also said that the "continued confidentiality of medical records is a high priority" for the attorney general's office, according to the Star (Indianapolis Star, 3/15). However, Emily Stewart, a policy analyst for the Health Privacy Project, said she is unaware of previous cases involving a state Medicaid fraud control unit being used to access private medical records. "It seems to set a dangerous precedent," she said, adding that the case is "part of this broader trend of trying to access this type of information" (AP/Kansas City Star, 3/14).

Similar Kansas Case
The case is similar to a situation in Kansas in which Attorney General Phill Kline (R) has attempted to access the medical records of women who have undergone late-term abortions at certain clinics. Two Kansas medical clinics late last month filed a brief with the state Supreme Court requesting that the court block Kline's investigation involving the medical records of about 90 women who sought late-term abortions at the clinics in 2003. According to the brief, Kline last year issued a subpoena ordering the release of complete, unedited medical records -- including each patient's name, medical history, birth control practices, psychological profile and sexual history -- for all women and girls who sought abortions at or after 22 weeks gestation. The brief claims that Kline issued a subpoena for the records to search for evidence of crimes, including possible violations of laws limiting late-term abortions and requiring mandatory reporting of suspected child sexual abuse (Kaiser Daily Reproductive Health Report, 3/15). None of the records being sought by Carter involved abortions, according to the Star (Indianapolis Star, 3/15).