delivered the opinion of the court:
This is an interlocutory appeal filed by the defendant, Ingalls Memorial Hospital (Ingalls), pursuant to Supreme Court Rule 308 (155 Ill. 2d R. 308), from an order that granted the plaintiffs, Debra Giangiulio, motion to compel discovery and required Ingalls to answer certain interrogatories and to produce an object. Ingalls argues that the information and the object sought to be discovered by the plaintiff were protected from disclosure by the physician-patient privilege (735 ILCS 5/8 — 802 (West 2002)), the Mental Health and Developmental Disabilities Confidentiality Act (Confidentiality Act) (740 ILCS 110/1 et seq. (West 2002)), section 8 — 2102 of the Code of Civil Procedure, commonly known as the Medical Studies Act (735 ILCS 5/8 — 2101, 8 — 2102 (West 2002)) and privacy rules and regulations created under the authority granted by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Pub. L. No. 104 — 191, 110 Stat. 1936; 45 C.F.R. §§ 160 through 164 (2005)). The trial court certified the following question for our review:
“[W]hether the Defendant Hospital is prohibited from responding to the Plaintiffs discovery requests pursuant to the Physician-Patient Privilege (735 ILCS 5/8 — 802), the Mental Health and Developmental Disabilities Confidentiality Act (740 ILCS 110/3), the Medical Studies Act (735 ILCS 5/8 — 2102) and the Privacy Rule set forth in Pub. L. 104 — 191, 45 C.F.R. Parts 160-164.” 1
The appellate court granted Ingalls’ Rule 308 petition for leave to appeal. 155 Ill. 2d R. 308.
BACKGROUND
On July 11, 2001, Giangiulio filed her first amended complaint against Ingalls. The complaint alleged that the plaintiff was the victim of a criminal assault; that she was attacked by another patient during her stay at the hospital; and that Ingalls was negligent in preventing the attack by a third party. The alleged attacker was not named as a party defendant in Giangiulio’s complaint.
Before filing her first amended complaint, on April 10, 2001, Giangiulio served Ingalls with 22 interrogatories and with a demand for production of nine documents, objects or tangible things. In its answers to the interrogatories, Ingalls objected to interrogatories 2, 3, 5, 7, 8, and 10 as follows:
“2. State the full name, address, and telephone number of the ‘JANE DOE’ alleged in Plaintiffs Complaint.
ANSWER: Objection. INGALLS HOSPITAL will not be producing any documents, records, information or tangible objects relating to ‘JANE DOE.’ See Exhibit ‘A’ attached hereto for the basis for the refusal to provide these records.
3. State the full name, address, and telephone number of all doctors, physicians, nurses, and any other staff who were treating the ‘JANE DOE’ alleged in Plaintiffs Complaint.
ANSWER: See answer to Interrogatory #2 above.
* * *
5. State the full name, address, and telephone number of the Defendant’s employee or staff member who assigned the ‘JANE DOE’ to Room 417E.
ANSWER: See answer to Interrogatory #2 above.
Ht * *
7. State the full name, address, and telephone number of all staff members who took and retrieved the knife from the ‘JANE DOE’ alleged in Plaintiffs Complaint.
ANSWER: See answer to Interrogatory #2 above.
8. State the full name, address, and telephone number of the patient assigned to Room 417E, bed number 2 on the date of the accident alleged in the Complaint.
ANSWER: See answer to Interrogatory #2 above.
Hi * *
10. State the period of time which ‘JANE DOE’ alleged in Plaintiffs Complaint was a patient at Defendant’s facility immediately preceding the date of the accident.
ANSWER: See answer to Interrogatory #2 above.”
As indicated in its answer, Ingalls attached Exhibit “A” to its response to the interrogatories and demand for production. Exhibit “A” was a letter addressed to plaintiffs counsel (John Brattoli) in which Ingalls’ counsel explained the bases for the hospital’s refusal to answer. In-galls’ refusal to disclose the information was based on the following: the attorney-client and work product privileges in Supreme Court Rule 201(b)(2) (166 Ill. 2d R. 201(b)(2)); the physician-patient privilege in section 8 — 802 of the Code of Civil Procedure (735 ILCS 5/8 — 802 (West 2002)); sections 8 — 2101 and 8 — 2102 of the Medical Studies Act (735 ILCS 5/8 — 2101, 8 — 2102 (West 2002)); and the Mental Health and Developmental Disabilities Confidentiality Act (740 ILCS 110/1 et seq. (West 2002)).
In her request for production entitled “demand for production,” Giangiulio requested certain documents, objects or tangible things. In request “f,” Giangiulio sought production of the knife that Jane Doe allegedly had in her possession which was later taken from her by In-galls’ staff members. Ingalls objected to request “f ’ as follows:
“f. The knife which the ‘JANE DOE’ alleged in Plaintiff’s Complaint has in her possession and which was later taken from her by Defendant’s staff members.
RESPONSE: See response to (e) above.”
In (e), Ingalls made the following response:
“RESPONSE: Objection. INGALLS HOSPITAL will not be producing any documents, records, information or tangible objects relating to ‘JANE DOE.’ See Exhibit ‘A’ for the basis for the refusal to provide these documents.”
It should be noted that in support of the objections to the requests to produce, Ingalls attached a copy of the same letter to plaintiffs counsel that it used in its answers to the interrogatories. In the letter, Ingalls identifies the same bases for its objections.
Thereafter, Giangiulio filed a motion to compel responses to written discovery. Giangiulio argued that interrogatories 2, 3, 5, 7, 8, and 10 are permitted by case law and not barred by privilege. Giangiulio further argued that Ingalls should be ordered to respond to paragraph “f ’ of her demand for production, wherein she requested the knife. Giangiulio argued that the knife had nothing to do with the medical or psychiatric ailment for which Jane Doe was being treated, so the production of the knife would not violate the Confidentiality Act.
Ingalls responded to the motion by reiterating its position that the information sought in interrogatories 2, 3, 5, 7, 8, and 10 is protected by the physician-patient privilege. 735 ILCS 5/8 — 802 (West 2002). In-galls also responded that the Confidentiality Act prevents it from revealing the information requested in interrogatories 2, 3, 5, 7, 8, and 10. 740 ILCS 110/1 et seq. (West 2002). Ingalls further argued that the knife sought in request to produce “f ’ has no bearing on the ultimate question of the hospital’s liability in this case. Also, information regarding the knife would be protected by either the physician-patient privilege, the Confidentiality Act and/or the Medical Studies Act. In-galls made the same argument with respect to requests to produce “e” and “h.” Request “e” sought medical bills, records, notes, reports, statements, doctors’ notes, nurses’ notes, radiological reports, and any other documents regarding Jane Doe’s care and treatment. Request “h” sought receipts, notes, records, reports, incident reports, investigation reports, accident reports, files, documents and bills related to the attack. We note that Ingalls objected to requests for production “e,” “f,” and “h” based upon the privileges delineated in its Exhibit “A.” However, we also note that Giangiulio’s motion to compel only requested that the trial court order the production of the knife which was requested in request “f ’ but did not seek to compel production of the document in requests “e” and “h.”
In a supplemental response to Giangiulio’s motion to compel, In-galls objected on the basis of HIPAA. Pub. L. No. 104 — 191, 110 Stat. 1936; 45 C.F.R. §§ 160 through 164 (2005).
On July 18, 2003, the trial court entered an order that granted Giangiulio’s motion to compel responses to her interrogatories and compelled production of the object requested in demand “f.” The trial court also found, pursuant to Rule 308, that there was a question of law as to which there is substantial ground for difference of opinion and that an immediate appeal may materially advance the ultimate termination of the litigation. Ingalls’, petition for leave to appeal was granted by the appellate court.
ANALYSIS
Giangiulio initially argues that Ingalls should be deemed to have waived any objection to the interrogatories and demands for production that were sent to Ingalls on April 10, 2001. According to Supreme Court Rule 213(d), the discovery was to be answered within 28 days. 177 Ill. 2d R. 213(d). Ingalls’ response was not received until January 13, 2003. As a result, Giangiulio argues Ingalls’ objections should be deemed waived for failure to file those objections within 28 days.
Giangiulio also argues that, because Ingalls made no argument in its opening brief with respect to interrogatories 4, 6, 14, 15, and 16, the trial court’s ruling on those should be affirmed. Giangiulio insists that it is for the court, not the defendant, to determine whether the privilege actually attaches. Giangiulio argues that, pursuant to Supreme Court Rule 341(e)(7) (Official Reports Advance Sheet No. 21 (October 17, 2001), R. 341(e)(7), eff. October 1, 2001), points not argued are waived.
Ingalls responds that questions concerning the timeliness of its responses to the discovery requests are beyond the scope of the certified question forming the sole basis of this appeal. Ingalls argues that none of its objections should be deemed waived because it made a broad attack based on various different statutory provisions.
Our examination of an interlocutory appeal brought pursuant to Rule 308 is strictly limited to the certified question presented to the court. Fosse v. Pensabene,
Physician-Patient Privilege
Ingalls argues that the trial court erred in compelling responses to the written discovery because the information is protected by various statutes and regulations. According to Ingalls, the information is protected because Jane Doe, whose medical records are sought, has never been made a party to the litigation. Because she is a patient and a nonparty to the litigation, Ingalls argues that Jane Doe’s situation falls squarely within the intended protection of the physician-patient privilege. 735 ILCS 5/8 — 802 (West 2000). Ingalls also argues that it would be insufficient to attempt to protect Jane Doe’s confidentiality simply by deleting her name from the records because the cumulative impact of information in a patient’s medical records can make the possibility of recognition very high. According to Ingalls, it does not matter that the information contained in the records is extremely relevant because it is outweighed by the need for protection.
Giangiulio argues that the information sought in interrogatories 2, 3, 5, 7, 8, and 10, as well as the knife sought in the request for production, are not protected by the physician-patient privilege. Giangiulio argues that the disclosure of a patient’s name does not violate a physician-patient privilege. Similarly, Giangiulio argues that learning the identity of and deposing the doctors and staff involved in Jane Doe’s treatment, the person who assigned Jane Doe to Giangiulio’s room and the person who retrieved the knife from Jane Doe does not automatically amount to the revelation of privileged, protected information. According to Giangiulio, Ingalls’ arguments are based upon the idea that the information sought was medical treatment information, medical records, discharge summaries and other types of factual data. The interrogatories at issue are seeking the identity of people, not anything relating to Jane Doe’s medical records or treatment. Finally, Giangiulio argues that the knife has nothing to do with the treatment received by Jane Doe or the medical or psychiatric conditions for which she was being treated at the time of the incident.
Ingalls replies that Giangiulio’s response exceeds the parameters of the certified question. Additionally, because the certified question does not limit this court’s inquiry to certain of the interrogatories, In-galls argues this court’s review is generally directed to whether the information sought in discovery is protected by privilege.
The physician-patient privilege is codified in section 8 — 802 of the Code of Civil Procedure. Tomczak v. Ingalls Memorial Hospital,
According to Tomczak, the physician-patient privilege protects the medical records of nonparties. Tomczak,
In interrogatories 2, 3, 5, 7, 8, and 10, Giangiulio primarily sought identification information. She requested the name, address and telephone number of Jane Doe, of hospital staff members who treated her, and of any employee or staff member who was assigned to Jane Doe’s hospital room. In request “f,” she sought the knife used in the assault. According to House, “[s]imply revealing the patient’s identity, in and of itself, will not result in the disclosure of confidential communications.” House,
Where Giangiulio sought the identity of the doctors and other employees and staff members who had contact with Jane Doe, she did not ask for Jane Doe’s medical or psychiatric records. Similarly, asking for the names and other information about the employees who retrieved the knife allegedly used by Jane Doe during the assault or the name of the person who shared a hospital room does not automatically involve the release of Jane Doe’s medical records or the treatment information contained therein. We note that Ingalls did not present any facts which established that Jane Doe’s name, address and telephone number were necessary to enable her physician to care for or treat her. We find no nexus between the information sought and the care or treatment that Jane Doe received or the medical or mental condition from which she suffered. We simply do not believe that the information sought by Giangiulio in interrogatories 2, 3, 5, 7, and 8 would reveal details about Jane Doe’s medical or mental condition or her diagnosis and treatment that would compromise her privacy rights.
In addition, in interrogatory 10 Giangiulio requests “time data” or nonmedical factual information about the length of Jane Doe’s stay in the hospital. The “time data” requested in interrogatory 10 is not related to Jane Doe’s diagnosis or treatment. There is no nexus between the “time data” sought and the care or treatment Jane Doe received at Ingalls. Therefore, the “time data” falls outside the scope of the physician-patient privilege. See Tomczak,
Ingalls also invoked the physician-patient privilege with regards to the knife. We note that the physician-patient privilege prohibits the disclosure of information but does not prohibit the disclosure of objects that are not related to the patient’s medical care. 735 ILCS 5/8 — 802 (West 2000). We also find that request “f,” requiring production of the knife, does not involve the release of information regarding Jane Doe’s medical or mental condition, diagnosis or treatment.
Accordingly, we hold that the information Giangiulio sought in interrogatories 2, 3, 5, 7, 8, and 10 and the knife sought in request for production “f” are not protected by the physician-patient privilege. 735 ILCS 5/8 — 802 (West 2000).
Medical Studies Act
Next, Ingalls argues that the information sought is protected under sections 8 — 2101 and 8 — 2102 of the Medical Studies Act. 735 ILCS 5/8 — 2101, 8 — 2102 (West 2002). Ingalls argues that such information is defined and, with notable exception, placed within the scope of a privilege in section 8 — 2101. Section 8 — 2102 of the Medical Studies Act provides that privileged information shall not be admissible as evidence or discoverable in proceedings before courts, tribunals, boards, agencies or people. 735 ILCS 5/8 — 2102 (West 2002). According to Ingalls, the hospital’s customary practice is to include a written reference to the Medical Studies Act, which contains a disclosure privilege, on every confidential report it generates that would be relevant to this case.
Giangiulio argues that the Medical Studies Act does not apply to this situation because that Act deals with privileged materials in peer-review situations. According to Giangiulio, the Medical Studies Act is premised on the desire to encourage physicians to participate in frank professional evaluations and peer review. Because there is no medical malpractice in the case at bar, Giangiulio argues there is no peer-review-oriented reason to invoke the Medical Studies Act to prevent disclosure of the information requested in interrogatories 2, 3, 5, 7, and 8. Additionally, Giangiulio argues the Medical Studies Act does not apply to interrogatory 10 because it seeks no medical or psychiatric records.
Section 8 — 2101 of the Medical Studies Act provides, in pertinent part, as follows:
“All information *** used in the course of internal quality control or of medical study for the purpose of reducing morbidity or mortality, or for improving patient care or increasing organ and tissue donation, shall be privileged, strictly confidential and shall be used only for medical research, increasing organ and tissue donation, the evaluation and improvement of quality care, or granting, limiting or revoking staff privileges or agreements for services, except that in any health maintenance organization proceeding to decide upon a physician’s services or any hospital or ambulatory surgical treatment center proceeding to decide upon a physician’s staff privileges, or in any judicial review of either, the claim of confidentiality shall not be invoked to deny such physician access to or use of data upon which such a decision was based.” (Emphasis added.) 735 ILCS 5/8 — 2101 (West 2002).
The purpose of the Medical Studies Act is to ensure that members of the medical profession can maintain effective professional self-evaluation and to improve the quality of healthcare. Pietro v. Marriott Senior Living Services, Inc.,
It is a generally accepted rule of statutory construction that a statute should be read so that no term is rendered superfluous or meaningless. Doe v. Illinois Masonic Medical Center,
Mental Health and Developmental Disabilities Confidentiality Act
Next, Ingalls argues that the information sought in interrogatories 2, 3, 5, 7, 8, and 10 and the object sought in request “f” is protected from disclosure by section 3(a) of the Confidentiality Act. 740 ILCS 110/3(a) (West 2002). Ingalls argues that section 3(a) provides a broader protection from disclosure for all records and communications. According to Ingalls, it does not matter that the information sought is extremely relevant.
Giangiulio argues that, as with the physician-patient privilege, the Confidentiality Act deals with medical information, medical records, discharge summaries and factual data contained in medical records. Because the information sought has nothing to do with Jane Doe’s treatment or her underlying medical or mental condition, Giangiulio argues no privilege should attach.
“The Mental Health and Developmental Disabilities Confidentiality Act provides that ‘any record kept by a therapist or by an agency in the course of providing mental health or developmental disabilities service to a recipient’ and ‘any communication made by a recipient or other person to a therapist or to or in the presence of other persons during or in connection with providing mental health or developmental disability services to a recipient,’ including ‘information which indicates that a person is a recipient,’ ‘shall be confidential and shall not be disclosed except as provided in this Act.’ ” Norskog v. Pfiel,
According to the United States Supreme Court, “[e]ffective psychotherapy *** depends upon an atmosphere of confidence and trust in which the patient is willing to make a frank and complete disclosure of facts, emotions, memories, and fears. Because of the sensitive nature of the problems for which individuals consult psychotherapists, disclosure of confidential communications made during counseling sessions may cause embarrassment or disgrace. For this reason, the mere possibility of disclosure may impede development of the confidential relationship necessary for successful treatment.” Norskog,
Unlike in Norskog, where the Illinois Supreme Court found that records and communications concerning mental health treatment that a patient received are subject to the privilege in the Mental Health Act (Norskog,
The Confidentiality Act defines both communication and confidential communication as being “any communication made by a recipient or other person to a therapist or to or in the presence of other persons during or in connection with providing mental health or developmental disability services to a recipient. Communication includes information which indicates that a person is a recipient.” 740 ILCS 110/2 (West 2002). Mental health or developmental disabilities services “includes but is not limited to examination, diagnosis, evaluation, treatment, training, pharmaceuticals, aftercare, habilitation or rehabilitation.” 740 ILCS 110/2 (West 2002). The Confidentiality Act also defines a record as information “kept by a therapist or by an agency in the course of providing mental health or developmental disabilities service to a recipient concerning the recipient and the services provided.” 740 ILCS 110/2 (West 2002).
The Confidentiality Act prohibits the release of information that would tend to identify Jane Doe as a recipient of mental health services. 740 ILCS 110/3 (West 2002). There is a document in the record that alleges that Jane Doe was being treated for mental illness. The first amended complaint alleges that, “prior to the date and time” of the attack, Jane Doe “had exhibited dangerous propensities both toward [Giangiulio] and other persons.” The complaint also alleges that Jane Doe “suffered from various mental and emotional illnesses thereby making her a danger to the health and well-being of other patients.” The aforementioned allegations in the complaint identify Jane Doe as a possible recipient of mental health services. Given the allegations in the complaint, interrogatories 2 and 10 violate both the letter and spirit of the Confidentiality Act. Interrogatory number 2 asks for Jane Doe’s name, address and telephone number. Similarly, because interrogatory number 10 asks for the period of time Jane Doe was a patient at Ingalls before the attack, it is a request for information found in her hospital records which is privileged if she is a mental patient, so it violates the Confidentiality Act. 740 ILCS 110/1 et seq. (West 2002). Conversely, it is not necessary to identify Jane Doe in order to answer interrogatories 3, 5, and 7. In those interrogatories, Giangiulio seeks information regarding the doctors, nurses, staff, and employees with whom Jane Doe had contact. Because Giangiulio is suing the hospital, its employees and staff for their negligence in allowing her to be attacked while a patient, no information about Jane Doe’s medical or mental condition is required when answering those interrogatories. While continuing to designate her as Jane Doe, Ingalls is required to answer interrogatories 3, 5, and 7. The remaining interrogatory, number 8, asks for information concerning another patient in bed 2 in hospital room 417E. In the event the patient in bed 2 in room 417E is suffering from a “medical condition,” her name, address, and telephone number are discoverable; however, if the patient is suffering from a “mental illness” or “psychological condition” that would come within the purview of the privilege in the Confidentiality Act, the Act bars the release of that patient’s name, address and telephone number. 740 ILCS 110/3 (West 2002). Because request to produce “f” does not seek mental health information (740 ILCS 110/2 (West 2002)) but, instead, seeks the knife, the Confidentiality Act is not applicable. 740 ILCS 110/3 (West 2002). Finally, we note that the Confidentiality Act will not apply if Jane Doe’s name, address or telephone number is discovered through inadvertence or from some source other than her hospital records. House,
Health Insurance Portability and Accountability Act
Next, Ingalls argues that the information sought is protected under parts 160 through 164 of Title 45 of the Code of Federal Regulations. 45 C.F.R. §§ 160 through 164 (2005). These are United States Department of Health and Human Services rules designed to protect patients’ medical records. Ingalls argues that the HIPAA rules encompass individually identifiable health information including underlying data related to a patient’s physical and/or mental health which identifies that individual. This includes common identifiers such as name, address, birth date, and social security number. However, according to Ingalls, the federal HIPAA privacy rules are not limited to financial transactions related to health care claims. Ingalls argues that, because it is a health care provider that transmits health information in an electronic form, it would be considered a covered entity under the HIPAA privacy rules. Without express written consent from the patient, Ingalls argues that it would be prohibited from disclosing any of the protected health information. According to In-galls, Giangiulio never obtained approval from Jane Doe for the release of her private medical records.
Giangiulio argues that the information sought is not protected from disclosure by the federal HIPAA privacy rule. According to Giangiulio, HIPAA protects electronic transmissions from disclosure which concern health care claims, benefits, plans, enrollment, eligibility, premiums, the payment of premiums, referrals and reports of injury. Giangiulio argues that the underlying interrogatories do not request financial information that is related to health care claims protected by the United States Department of Health and Human Services.
HIPAA is a federal Act “intended to provide a baseline of health information privacy protections, which states are free to rise above in order to best protect their citizens.” D. Wirtes, Jr., R. Lamberth, & J. Gomez, An Important Consequence of HIPAA: No More Ex Parte Communications Between Defense Attorneys and Plaintiff’s Treating Physicians, 27 Am. J. Trial Advoc. 1, 4 (2003) (Important Consequence of HIPAA). Pursuant to HIPAA, the United States Department of Health and Human Services (HHS) adopted privacy rules to regulate protected health information and when that information could be disclosed. 42 U.S.C. § 1320d(6) (2000); also see Moss v. Amira,
HIPAA contains a preemption provision that generally supercedes contrary state law provisions. 42 U.S.C. § 1320d — 7(a)(1) (2000). The intended purpose of section 1320d — 7(a)(1) of Title 42 of the United States Code has been implemented by section 160.203 of the Code of Federal Regulation. 45 C.F.R. § 160.203 (2005). However, HIPAA does not preempt state laws that are more stringent. 45 C.F.R. § 160.203(b) (2005); also see Important Consequence of HIPAA,
Where the information sought by a party to litigation involves a nonparty, HIPAA does not preempt Illinois law. Moss,
We find that Giangiulio’s interrogatories and requests for production were made pursuant to Supreme Court Rules 213 and 214 (177 Ill. 2d R. 213; 166 Ill. 2d R. 214). Therefore, we hold that HIPAA does not act as a bar to disclosure of the information requested in interrogatories 2, 3, 5, 7, 8, and 10 or production of the knife in request Up JJ
CONCLUSION
In light of the foregoing, we answer the certified question as follows: (1) Ingalls is not prohibited by the physician-patient privilege from responding to interrogatories 2, 3, 5, 7, 8, and 10 and request for production “f”; (2) the Medical Studies Act does not bar disclosure of the information requested in interrogatories 2, 3, 5, 7, 8, and 10 and request for production “f”; (3) the information requested in interrogatories 2 and 10 is protected from disclosure by the Confidentiality Act because disclosure of the information would tend to identify Jane Doe as a recipient of mental health services. However, the Confidentiality Act does not prohibit Ingalls from answering interrogatories 3, 5, and 7. As stated above, if the patient whose information is the subject of interrogatory 8 is suffering from a medical condition, the information is discoverable, but if the patient is suffering from a mental illness or psychological condition which would come within the purview of the privilege in the Confidentiality Act, Ingalls is not required to answer the interrogatory; and (4) HIPAA does not preempt Illinois law in this area and, therefore, does not bar disclosure of the information requested in interrogatories 2, 3, 5, 7, 8, and 10 and request for production “f.”
Certified question answered.
GALLAGHER, PJ, and O’MARA FROSSARD, J, concur.
Notes
The trial court’s identification of “the privacy rule set forth in Pub. L. 104 — 191, 45 C.ER. Parts, 160-164” is a reference to HIPAA and the rules and regulations created thereunder. 42 U.S.C. § 1320d et seq. (2000); 45 C.ER. §§ 160 through 164 (2005).