175 Conn. App. 254
Conn. App. Ct.2017Background
- Department of Public Health opened an investigation (Aug 27, 2014) into allegations of fraudulent billing by dentist Anthony Colandrea after a referral from Verisk (auditor for UnitedHealthcare).
- Verisk had repeatedly requested patient records from Colandrea; he refused, and Verisk filed a complaint with the Office of the Attorney General, which referred it to the Department.
- Pursuant to its subpoena power under Conn. Gen. Stat. § 19a-14(a)(10), the Department issued a subpoena duces tecum (Nov 16, 2015) requesting complete records for 31 patients; Colandrea did not comply.
- Commissioner filed a petition to enforce the subpoena; Colandrea objected, invoking the physician-patient privilege statute, Conn. Gen. Stat. § 52-146o, and arguing the Department had not shown the records were "related to the complaint."
- At the enforcement hearing, the Department presented testimony showing the subpoena arose from the Verisk complaint and targeted only records relevant to that investigation; Colandrea declined to cross-examine the witness.
- Trial court granted enforcement; Colandrea appealed, arguing the Department failed to make the factual showing required by § 52-146o(b)(3).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether § 52-146o(b)(3) permits Department access without patient consent when records are "related to the complaint" | Commissioner: subpoena issued under § 19a-14(a)(10) in connection with a Verisk-originated complaint; records requested were those identified as relevant | Colandrea: Department failed to show how requested records related to the investigation or specify the alleged fraudulent conduct | Held: Enforcement affirmed — testimony and subpoena form showed a clear connection; § 52-146o(b)(3) exception satisfied |
| Sufficiency of factual showing required to establish "related to the complaint" under § 52-146o(b)(3) | Commissioner: department testimony that subpoena targeted only the patients identified in the complaint is sufficient | Colandrea: Department must specify the nature of alleged fraud and how each record would relate | Held: No heightened specificity required; department’s testimony and subpoena on letterhead adequately demonstrated relation |
| Effect of declining to cross-examine Department witness on evidentiary sufficiency | Commissioner: failure to challenge witness testimony leaves Department’s showing unrefuted | Colandrea: (implicit) still required the Department to make an affirmative showing | Held: Court relied on unchallenged testimony; defendant’s choice not to cross-examine supported finding that showing was sufficient |
| Application of Edelstein precedent to scope of § 52-146o(b)(3) exception | Commissioner: Edelstein supports Department access when records are related to complaint in billing-fraud investigations | Colandrea: Edelstein requires more detailed showing of the investigation’s nature | Held: Edelstein does not require the level of specificity Colandrea seeks; it supports the Department’s access under these facts |
Key Cases Cited
- Edelstein v. Dept. of Public Health & Addiction Services, 240 Conn. 658, 692 A.2d 803 (Conn. 1997) (upholding department access to medical records under statutory exception when records are related to an investigation)
- Rene Dry Wall Co., Inc. v. Strawberry Hill Associates, 182 Conn. 568, 438 A.2d 774 (Conn. 1980) (implicit findings can supply statutorily required conclusions)