Citizens for Health v. Leavitt

Congress passed the Health Insurance Portability and Accountability Act (HIPAA) for the dual purposes of (1) improving the efficiency and effectiveness of the country’s healthcare systems, especially electronic-record processes and systems, and (2) protecting the privacy of an individual’s personal health information. Congress then put the secretary of the United States Department of Health and Human Services (the secretary) (defendant) in charge of creating a rule to implement HIPAA’s standards. Using the established administrative rulemaking procedures, the secretary first proposed and adopted a rule that required healthcare providers to get a person’s consent before using the person’s protected health information even for such routine uses as the person’s treatment or billing. Before this original rule went into effect, there was an industry outcry about the potentially significant inefficiencies and problems that could result from requiring consent for routine uses. In response, the secretary proposed an amended version of the rule that eliminated the need to get a person’s consent before using personal health information for (1) treatment, (2) billing, or (3) healthcare operations. Healthcare operations included a wide range of functions such as quality control, student training, and business planning and development. The amended version of the rule was formally adopted and titled the Privacy Rule. Citizens for Health and others (plaintiffs) sued the secretary, alleging that the Privacy Rule’s amended provision allowing personal health information to be used for routine purposes without the person’s consent violated (1) the Fifth Amendment’s right to privacy, (2) the First Amendment’s right to free speech between a patient and a doctor, (3) HIPAA’s purpose of protecting individual privacy, and (4) the requirements of the Administrative Procedure Act (APA) for changing existing policies. The district court granted summary judgment for the secretary, dismissing all the claims. Citizens for Health and others appealed the dismissal to the Third Circuit.