418 P.3d 990
Ariz. Ct. App.2018Background
- Zeitner sought an abortion in 2010, claiming recent chemotherapy and radiation for cancer made the pregnancy life‑threatening; physicians became suspicious after inconsistencies and lack of corroborating treatment history.
- Zeitner produced a forged letter and medication list purporting to be from a Boston doctor; AHCCCS authorized payment and the abortion was performed.
- Physicians later confirmed the Boston doctor had not treated Zeitner; AHCCCS investigated and referred the matter for prosecution.
- Zeitner was indicted on multiple counts including AHCCCS fraud, theft, forgery, and identity theft; at trial the State introduced her medical records and called her treating physicians to testify.
- Zeitner moved to exclude physician communications and records under Arizona's physician‑patient privilege (A.R.S. § 13‑4062(4)); the trial court denied the motion and she was convicted. She appealed, arguing the privilege was violated.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether physician‑patient privilege barred use of medical records and physician testimony in AHCCCS fraud prosecution | State: statutory AHCCCS reporting and disclosure provisions abrogate the privilege for suspected fraud and permit use in prosecution | Zeitner: privilege protects records and testimony; no statutory authorization to compel physician testimony for prosecution | Court: AHCCCS statutes requiring reporting, disclosure to fraud investigators, and referral to AG abrogate the privilege for suspected AHCCCS fraud; physicians may be compelled to produce records and testify |
| Whether a common‑law crime‑fraud exception applies to physician‑patient privilege | State: common‑law crime‑fraud exception should negate privilege when patient commits fraud | Zeitner: privilege remains because no common‑law exception exists for physician‑patient communications | Court: No common‑law crime‑fraud exception applies (per prior precedent); only legislature may create such exceptions |
| Whether compelled disclosure to AHCCCS can be used for prosecution | State: disclosure statutes and agency rules permit release for investigation and prosecution | Zeitner: even if records must be given to AHCCCS, their use against a patient at criminal trial is not authorized | Court: Disclosure to AHCCCS is tied to referral to AG and prosecution; statutes and rules contemplate use in prosecution, so records and testimony may be used |
| Whether admitting records/testimony violated privacy protections generally | Zeitner: constitutional or statutory privacy protections should prevent compelled testimony | State: statutory scheme balances program integrity against privacy; exceptions apply for fraud | Court: Statutory language "notwithstanding any law to the contrary" and subpoena authority show legislature intended privilege to yield in suspected AHCCCS fraud cases |
Key Cases Cited
- State v. Wilson, 200 Ariz. 390 (App. 2000) (rejected a common‑law crime‑fraud exception to Arizona's physician‑patient privilege)
- State v. Mincey, 141 Ariz. 425 (1984) (physician‑patient privilege protects all information obtained by a physician)
- Tucson Med. Ctr. Inc. v. Rowles, 21 Ariz. App. 424 (1974) (physician‑patient privilege also protects medical records)
- Buell v. Superior Court, 96 Ariz. 62 (1964) (discussing crime‑fraud exception in attorney‑client context)
- State v. Hasson, 217 Ariz. 559 (App. 2008) (statutory construction should effectuate legislative intent rather than frustrate it)