Lead Opinion
delivered the opinion of the court:
Intervenor-appellant The Southern Illinoisan, a daily newspaper headquartered in Carbondale with readership across a broad swath of southern Illinois, appeals the February 21, 2006, order of the circuit court of Washington County denying The Southern Illinoisan’s request that the court unseal, with respect to the names of patients contained therein, the court’s order of February 18, 2005, in the above-captioned case. For the reasons that follow, we affirm the circuit court’s February 21, 2006, order.
On June 28, 2004, defendant-appellee Washington County Hospital District, a publicly owned hospital, suspended the medical privileges of plaintiff-appellee Dr. Thomas Coy, who was at the time a hospital employee. The hospital cited “several” recent cases of substandard medical care and stated that a suspension was necessary to reduce the likelihood of immediate injury to patients. On January 21, 2005, Dr. Coy sued the hospital. Dr. Coy alleged procedural deficiencies in his suspension, sought the enforcement of a related settlement agreement, and requested various other forms of relief not directly relevant to this appeal. Journalists for the Nashville News, a weekly newspaper in Washington County, and The Southern Illinoisan reported on matters concerning the hospital and Dr. Coy.
On February 18, 2005, presumably pursuant to settlement negotiations, counsel for Dr. Coy forwarded to the hospital an agreed order, which counsel requested that the hospital submit to the court. On the same date, the hospital delivered to the court a letter requesting that the court file the accompanying agreed order under seal. For reasons that neither Dr. Coy nor the hospital has been able to explain adequately, the agreed order contained, inter alia, the names of the seven nonparty patients to whom Dr. Coy had allegedly provided substandard care. The order did not contain any other information about the patients and did not reference the patients’ medical records, conditions, or diagnoses. The court complied with the hospital’s request, entering, under seal, the February 18, 2005, order that is the subject of the present appeal.
Subsequently, reporters from the Nashville News and The Southern Illinoisan who had been covering the case visited the office of the Washington County circuit clerk and inspected the court file in the case, finding, inter alia, the sealed order. In an effort to seek access to the sealed order, the Nashville News and The Southern Illinoisan filed a petition to intervene in the lawsuit. A hearing on the petition was held on June 21, 2005. The petition to intervene was granted on July 22, 2005, and on August 11, 2005, the intervenors filed a motion for access to the sealed order. The hospital filed a response to the motion for access, to which the intervenors in turn replied. On August 15, 2005, Dr. Coy moved to amend the sealed order to prohibit the disclosure of the nonparty patient names contained therein but to unseal the remainder of the settlement agreement.
Eventually, on October 4, 2005, the circuit court granted Dr. Coy’s motion to amend the sealed order, thereby unsealing the order but for the names of the seven nonparty patients. The intervenors moved the court to vacate or, alternatively, to reconsider its decision, and oral argument was held. On February 21, 2006, the court entered an order denying the request of the intervenors to unseal the order with regard to the names of the patients. In support of its decision to deny the request to unseal, the trial court relied upon Tomczak v. Ingalls Memorial Hospital,
We begin our analysis by observing that under the common law, judicial records and documents are presumptively open to the public. Skolnick v. Altheimer & Gray,
The presumptive right of public access to judicial records attaches to court orders and opinions. A.P. v. M.E.E.,
That said, the presumption of public access to court records and documents, although very strong, is not absolute. To overcome the presumption of access, the moving party bears the burden of establishing both that there is a compelling interest for restricting access and that the resulting restriction furthering that interest is tailored as narrowly as possible. Skolnick v. Altheimer & Gray,
Against the above backdrop, we turn to the present case. With regard to the ruling of the trial court in this case, we agree with The Southern Illinoisan that the trial court erred as a matter of law in concluding that the court would violate HIPAA by unsealing its order. We begin by noting that Tomczak v. Ingalls Memorial Hospital,
Nor is a court a “covered entity” for HIPAA purposes. The applicability section of HIPAA provides, in pertinent part, that any standard adopted thereunder applies only to health plans, health care clearinghouses, and health care providers which transmit “any health information in electronic form in connection with a transaction” referred to elsewhere in HIPAA. 42 U.S.C. §1320d — 1(a)(3) (2000). The application of HIPAA’s privacy rule is likewise limited to health plans, health care clearinghouses, and qualified health care providers, each of which is defined as a “covered entity.” 45 C.F.R. §§160.102(a), 160.103 (2002). Accordingly, the plain language of HIPAA demonstrates that the judiciary, which is not a health plan, a health care clearinghouse, or a qualified health care provider, is not subject to HIPAA’s privacy rule. Courts and administrative agencies in a number of jurisdictions have agreed that only the small class of “covered entities” defined in HIPAA is subject to HIPAA’s privacy rule. See, e.g., United States v. Mathis,
Nevertheless, we may affirm the decision of the circuit court on any basis appearing in the record (Material Service Corp. v. Department of Revenue,
In the case at bar, the circuit court found a compelling interest why public access to the names of the nonparty patients should be restricted, in the form of a broad public policy in favor of a medical patient’s right to privacy. In balancing this compelling interest against the public’s right of access, the circuit court came down on the side of protecting a patient’s privacy. The circuit court narrowly tailored its restriction on the right of public access by omitting from the agreed order only the names of the seven nonparty patients and allowing public access to the rest of the document. We should alter the terms of a protective order only if no reasonable person could adopt the view taken by the circuit court. Skolnick,
Illinois has a strong and broad public policy in favor of protecting the privacy rights of individuals with respect to their medical information. This public policy is articulated and reflected in numerous Illinois statutes. See Petrillo v. Syntex Laboratories, Inc.,
The importance of a patient’s right to privacy in his or her medical information has also been recognized in numerous judicial opinions. See Parkson v. Central DuPage Hospital,
Individuals have a right to and an expectation of privacy related to their medical information, and this right and expectation of privacy is reflected in our public policy. This right to privacy is a compelling interest that must be balanced against the public’s right of access to judicial records and documents. In re Marriage of Johnson,
While it is true that the parties could have avoided the attachment of the presumption in favor of public access with regard to the settlement agreement by simply not making it a part of the court record or they could have omitted the names of the seven nonparty patients therefrom, the seven nonparty patients should not be penalized for the mistakes of the parties. The seven nonparty patients are not parties to this litigation and have not in any way consented to the disclosure of the fact that they sought medical treatment from Dr. Coy or that their information was used in a peer review of Dr. Coy by the hospital. They had no say in the settlement agreement and no opportunity to protect their identities from disclosure. The parties to this litigation did attempt to protect the identities of the patients by asking that the settlement agreement be sealed. The circuit court obliged. That the parties could have done a better job of protecting the privacy interests of the nonparty patients does not abrogate those privacy interests. The circuit court acted to protect those privacy interests by narrowly restricting the public’s access to the names contained in the settlement agreement. It did not abuse its discretion in so doing. We uphold the circuit court’s order restricting access to the names of the seven nonparty patients. We do so not to protect the interests of the hospital or Dr. Coy, but to protect the interests of those unrepresented patients, who may even be unaware of the controversy surrounding them.
While it may be argued that there is no expectation of privacy with respect only to the name of a patient, we do not agree. Whether or not that information is technically privileged under the statute (735 ILCS 5/8 — 802 (West 2004); see House v. SwedishAmerican Hospital,
Finally, we do not see how the revealing of the names of the seven nonparty patients will advance the public good or further the rationale behind allowing public access to judicial records. The rest of the settlement agreement has been unsealed by the circuit court and is open to public access. Protecting the identities of the nonparty patients will not impair the public’s ability to “ ‘monitor the functioning of our courts, thereby insuring quality, honesty!,] and respect for our legal system.’ ” Skolnick,
Affirmed.
WEXSTTEN,
Notes
Justice Hopkins participated in oral argument. Justice Wexstten was later substituted on this panel and has read the briefs and listened to the audiotape of oral argument.
Dissenting Opinion
dissenting:
I respectfully dissent. I agree with my colleagues that a court is not a covered entity for HIPAA purposes, that HIPAA does not prevent the unsealing of the court order in this case, and that the trial court erred as a matter of law in ruling that it did. I cannot agree, however, that in addition to its reliance on HIPAA, the circuit court “exercised its discretion in finding that ‘there is good reason to seal the names of the patients’ ” (
Furthermore, even if the circuit court had advanced public policy as an alternative ground for keeping the names of the patients under seal, I would still not agree that the circuit court did not abuse its discretion in so doing, because I do not believe that the parties who seek to keep the order sealed — the hospital and Dr. Coy — have overcome the strong presumption in favor of public access to court documents, records, and orders by establishing both that there is a compelling interest why access should be restricted and that the resulting restriction furthering that interest is tailored as narrowly as possible. See Skolnick v. Altheimer & Gray,
As explained in the majority disposition and elaborated upon below, the posture of this case is essentially as follows. Presumably pursuant to settlement negotiations, the hospital and Dr. Coy worked out a resolution of their dispute. Counsel for Dr. Coy apparently memorialized that resolution in a settlement agreement that included within it the names of the seven nonparty patients to whom Dr. Coy had allegedly provided substandard care but did not reference the patients’ medical records, conditions, or diagnoses. Counsel for Dr. Coy and counsel for the hospital, for reasons unknown, chose to file with the court the settlement agreement itself, rather than a pleading seeking a dismissal and referencing the settlement agreement, and they requested that the agreement be filed under seal. Without a hearing, the court complied. During the June 21, 2005, hearing on the petition to intervene filed by the Nashville News and The Southern Illinoisan, counsel for the petitioners repeatedly questioned why the order needed to be sealed and repeatedly wondered why sensitive information would be included in the agreed order, rather than in separate documents referenced by the order but not filed with the court. Neither counsel for the plaintiff nor counsel for the hospital provided an explanation for the inclusion of the so-called sensitive information (i.e., the names of the patients) they sought to protect. Likewise, when, on August 15, 2005, Dr. Coy moved to amend the sealed order to prohibit the disclosure of the nonparty patient names contained therein but to unseal the remainder of the agreement, Dr. Coy still did not indicate why nonparty patient names had been included in the order in the first place. Accordingly, despite multiple opportunities throughout this case to do so, neither the hospital nor Dr. Coy has been able to explain adequately why the agreement itself, containing the names of Dr. Coy’s alleged victims, needed to be filed with the court. At oral argument before this court, counsel for the hospital conceded that it was not necessary to include the names in the agreed order, indicated that had it been his decision to make, the names would not have been included, and suggested that it was his understanding that the names were included to aid “enforcement of the order.” He did not explain how including the names in the actual order, rather than in a document referenced by the order, would advance that enforcement, if enforcement were to become necessary.
Accordingly, once the circuit court’s errant HIPAA analysis is discarded, the pivotal question for this court becomes whether the intentional, unexplained, and unnecessary inclusion in a court filing of the names of — but not any medical information about — seven nonparty patients establishes a “compelling interest” sufficient to overcome the strong presumption in favor of open public access to court files and therefore to justify sealing that filing from public view.
My colleagues believe that such a compelling interest exists because “Illinois has a strong and broad public policy in favor of protecting the privacy rights of individuals with respect to their medical information” (
The majority holds that although the mere name of a patient is not protected by the physician-patient privilege codified at section 8 — 802 of the Code of Civil Procedure (735 ILCS 5/8 — 802 (West 2004)), “a patient may still have an expectation that the fact that he or she visited with or was treated by a physician will remain private.”
In fact, long-standing precedent in this state holds, very clearly, that the disclosure of a patient’s name does not violate the physician-patient privilege. See, e.g., House v. SwedishAmerican Hospital,
Accordingly, I do not believe the expectation of privacy created by the majority establishes a “compelling interest” sufficient to overcome our state’s strong presumption in favor of open public access to court files. As the statutes cited by the majority demonstrate, the General Assembly has had ample opportunity to shape the law of this state to reflect the state’s public policy with regard to medical information. To date, the General Assembly has not even recognized the expectation of privacy crafted by the majority, let alone elevated it to a status sufficient to overcome the presumption of open public access to court files, and I believe it is unwise and improper for this court to take it upon itself to do so.
It is not only possible, but indeed common practice, to protect the names of nonparties in cases such as this without sacrificing the openness of our judicial system. As Justice Steigmann observed more than a decade ago in his special concurrence in In re Marriage of Johnson,
Although not addressed by the majority, the hospital and Dr. Coy advance in their brief on appeal alternative grounds to affirm the errant decision of the circuit court. The hospital and Dr. Coy do not directly analogize any of the statutes they cite, or even their broad public policy arguments, to the actual facts of this case, which, as detailed above, involve the intentional, unexplained, and unnecessary inclusion in a court filing that is presumptively public of the names of — but not any medical information about — seven nonparty patients. Accordingly, although the statutes referenced by the hospital and Dr. Coy and the policy arguments derived therefrom involve privacy with regard to medical records in general, the strained arguments the hospital and Dr. Coy make fail to connect these statutes to this case in any persuasive manner.
For example, the hospital and Dr. Coy cite both the Medical Patient Rights Act (410 ILCS 50/0.01 et seq. (West 2004)) and the Hospital Licensing Act (210 ILCS 85/1 et seq. (West 2004)) as authorities supporting a generalized public policy argument that the names of the patients should remain sealed. However, by its own language, section 3(d) of the Medical Patient Rights Act is limited to the disclosure of medical information by a “physician, health care provider, health services corporation[,] and insurance company.” 410 ILCS 50/3(d) (West 2004). Likewise, section 6.17 of the Hospital Licensing Act pertains only to the release of medical information by the hospital’s medical staff and its agents and employees. 210 ILCS 85/6.17 (West 2004). Moreover, although the hospital and Dr. Coy are correct in asserting that patient records are exempt from requests under the Freedom of Information Act (5 ILCS 140/7(l)(b)(i) (West 2004)), that fact is irrelevant to the present case. In sum, the situations contemplated by these statutes are so divorced from the facts of the present case that the policy arguments the hospital and Dr. Coy attempt to glean from these statutes and affix to the present case are unconvincing.
Equally unconvincing is the contention that under the medical studies statute (735 ILCS 5/8 — 2101 et seq. (West 2004)), the names of the patients must remain sealed. “The purpose of the [medical studies statute] is to advance the quality of health care by ensuring that members of the medical profession effectively engage in a peer-review process.” Ardisana v. Northwest Community Hospital, Inc.,
Consequently, there are several problems with the arguments advanced by the hospital and Dr. Coy under the medical studies statute. First, as noted above, the medical studies statute is found in the “Evidence” article of the Code of Civil Procedure and is intended to govern the discoverability and admissibility of information in pending litigation; no section of the medical studies statute even comes close to addressing a scenario such as that in the present case where the issue is the intentional, unexplained, and unnecessary inclusion in a court filing that is presumptively public of the names of — but not any medical information about — seven nonparty patients. Second, as noted above, the medical studies statute protects against the disclosure of the mechanisms of the peer-review process, including information gathering and deliberation leading to the ultimate decision rendered by a hospital peer-review committee (see Chicago Trust Co. v. Cook County Hospital,
The majority’s newly minted, judicially crafted public policy holding to the contrary notwithstanding, the hospital and Dr. Coy have failed to demonstrate a compelling interest justifying the trial court’s decision to keep its order sealed. Accordingly, the hospital and Dr. Coy have failed to overcome the strong presumption in favor of public access to court documents, records, and orders. For the foregoing reasons, I would reverse the circuit court’s February 21, 2006, order and remand with directions to unseal the entire February 18, 2005, order. Because my colleagues choose to do otherwise, I respectfully dissent.
