Entry Regarding United States’ Supplemental Motion to Reconsider Court’s Order Regarding Grand Jury Subpoena
This is the second time issues surrounding the grand jury subpoena (No. KMS-41-02) of [the Corporation]
Despite [the Corporation’s] pleas to the contrary, motions to reconsider are not ill-founded step-children of the federal court’s procedural arsenal, but rather effective yet quite circumscribed methods of “correct[ing] manifest errors óf law or fact or to present newly discovered evidence.” Rothwell Cotton Co. v. Rosenthal & Co.,
First, while motions to reconsider exist to correct manifest errors in law, they are “not appropriate vehicles to again advance arguments already rejected by the court.” All Assets,
Second, it is equally inappropriate to employ a motion to reconsider to proffer a new legal theory or new evidence to support a prior argument when the legal theory or evidence could, with due diligence, have been discovered and offered during the initial consideration of the issue. DeBruyne v. Equitable Life Assur. Soc.,
The records obtained from [the Corporation’s] garbage may, however, satisfy this “new evidence” test and actually support the Government’s motion. That conclusion is hesitant because, while some (but not all) of the records are dated as if made subsequent to [Corporation] Grand Jury I, the Government is, in all other respects, silent as to the date these records were actually discovered. Moreover, the Government does not suggest it was unable to utilize this investigative technique earlier, although it is obvious that a record which came into existence after [Corporation] Grand Jury I could hardly have been discovered any earlier. Not only does the Government fail to provide historical information about the documents, but it also offers a confusing array of denominations for the information, creating confusion as to the actual source of the records. In a short statement attached to the documents the Government calls the mish-mash of telephone notes and other short records contained in Exhibit C, “[p]hotocopy [sic] of documents obtained pursuant to grand jury subpoena;” the cover sheet preceding these records, however, entitles . these records “[p]hotocopies of corporation’s patient files found in the trash.” A similar reference to these as documents procured from [the Corporation’s] garbage is found in the Government’s brief in support of its motion to reconsider. The source of Exhibit D, a photocopy of patient intake sheet from the [Corporation’s] clinic, is a complete mystery but presumably it was handed over by [the Corporation] in response to the grand jury’s subpoena. This is all surmise, however, because the Government simply offers all these documents and suggests the court review them in deciding whether to modify the previous order with little explanation as to the source of the material or its date of discovery. Admittedly, it is a little difficult to conclude with absolute certainty, based on the information provided by the Government, that the Government knew or could have discovered all this evidence during the pendency of [Corporation] Grand Jury I. Fortunately, however, even giving the Government every benefit of the doubt, consonant with the broad discretion conferred on the grand jury, United States v. Williams, - U.S. -, -,
Included within the packet of records are notes made by one or more psychotherapists of counseling sessions with patients. A review of the content of these notes ironically completely confirms the conclusion reached in the prior ruling that the records sought by the Government include communications of a personal and confidential nature between patients and their therapist made for the purpose of counseling. For instance, one document (which will be discussed in some detail later) reflects a patient confiding in the therapist about the effects of a pending divorce on the patient’s mental state, making reference to a goal of alleviating stress and agitation. Another record for a different patient, discusses the patients tendency to “soil” himself/herself in school and the embarrassment such conduct causes. These types of frank disclosure, necessary to successful psychiatric counseling, are only encouraged if guaranteed to be confidential by the psychotherapist-patient privilege. Instead of supporting the Government’s position, presentation of this evidence solidifies the propriety of extending the privilege in [Corporation] Grand Jury 1. The remainder of Exhibit C, consisting mostly of prescription forms, telephone messages and patient bills, are most likely not protected by the privilege and therefore subject to the grand jury’s subpoena in the first place; their relevance to the Government’s motion to reconsider the court’s prior decision regarding the psychotherapist-patient privilege is unknown.
But an even more basic reason exists to reject the Government’s argument and its proffered new evidence as a basis for altering the prior decision. Syllogistically the Government’s theory of proof of criminal conduct, at least with respect to the evidence protected by the psychotherapist-patient privilege, goes something like this: (1) A direct correlation exists between the length of a physician’s notes documenting a visit with a patient and the actual length of the visit; (2) [the psychotherapist under investigation] took short notes when he represented lengthy patient visits to medicare; (3) therefore [the psychotherapist] misrepresented the length of his patient visits to medicare. The sought evidence must be necessary to confirm the minor premise (2); unfortunately, even if the minor premise is proved true, the conclusion is doubtful because of the suspect reasoning contained in the major premise. To conclude few notes are indicative of short meetings, and long notes represent long meetings, has neither empirical or common sense support. Its at least as likely a long meeting can be summarized in a single sentence (especially if the meeting is inefficient) as a short meeting can be recounted by pages of detailed observations. Moreover, different individuals might employ vastly different styles of note-taking — some prefer nearly verbatim transcripts while others rely on their memory. Anyone who has attended college or law school remembers the students who left an hour-long lecture with nary a single note while others emerged with pages of notations. These hypothetical examples aptly demonstrate the absence of a relationship between the length of written notes and the length of a meeting or conversation — and the questionable validity of the Government’s major premise. Moreover, and stepping away from the abstract, the counseling notes from the session with the patient facing a divorce which were referred to above, and which are contained in Government’s Exhibit C, confirm this conclusion. These notes, consisting of one paragraph containing some 15 lines of text, are simply written too generally and broadly to support any meaningful inference regarding the actual amount of time spent with the patient. Specifically, this entry appears as follows, redacted and modified to preserve the confidentiality of the patient:
Patient: [name] Date: [date]
Therapy: Individual Psychotherapy
Therapist: [psychotherapist]
The patient is reporting that [he/she] is hoping [his/her] [spouse] will go ahead and finalize the divorce. The patient states that [he/she] is “letting [him/her] have everything” but [he/she] feels that this is indicated preserve [his/her] “peace of mind”. [He/she] feels she will be under less stress and less agitated once the divorce is finalized. [He/she] is looking for joint custody of [his/her] children. The*1410 patient does continue [Drug X] 1 mg TID and [Drug Y] 50 mg 3 at hs. [He/she] was given a 2 week prescription for each medication with no refills. The generic may be substituted. [He/she] also was prescribed [Drug Z] 5 mg 1 q 4 hours prn for nausea #30 with no refills. Again, the generic may be substituted. Benefits, side effects and precautions to observe with [his/her] medication regimen were again reviewed with the patient. We discussed the need for the patient to focus on future plans and goals and developments of “a new start” for [himself/herself]. Another appointment is scheduled.
Did the underlying meeting, in which the doctor observed “[b]enefits, side effects and precautions to observe with medication regimen were again reviewed with the patient,” take five minutes, fifteen minutes, or an hour? No one besides those present at the counseling session can know with any degree of certitude the amount of time necessary to discuss this topic.
Last, the photocopies of patient intake sheets contained in Exhibit D, assuming again they qualify as “new evidence” as that term is employed, are wholly irrelevant to the applicability of the psychotherapist-patient privilege. Only documents reflecting the content of confidential psychotherapist-patient communications are protected by the privilege. Intake sheets merely list the name of the patient, the treating psychotherapist, and the amount the patient was charged for the treatment, not the least bit of which is privileged information. Presumably the Government expects the court to look at the sheet, notice the amount charged each patient, and conclude that the only way to establish overbilling occurred is to allow the Government to procure notes of counseling sessions to compare their length against the amount the patient was charged. Having already determined the poverty of the Government’s presumed logical relationship between the length of notes and the amount of time spent -with a patient, not much more need be said to discount Exhibit D. The materials contained therein add nothing to the Government’s argument for alteration of the decision in [Corporation] Grand Jury I. Critically important, in evaluating the relief requested by the Government, is the fact that the Government must, and does, bear the burden of satisfying the preconditions to reconsideration, and, if those conditions are met, persuading the court that the earlier decision was clearly wrong. In that task it has failed and so must its motion for reconsideration. For this and the other reasons discussed above, the Government’s Motion to Reconsider is DENIED and the original or
Notes
. To preserve both the secrecy of the grand jury investigation and the privacy of those being investigated by the grand jury, all names, titles, or references in this entry which might in any manner identify those subject to investigation have been replaced with non-identifying, generic terms. Each substitution in the original text, made for the purposes of publication, is contained within brackets ([]).
. Included in the first entry is a detailed recital of the background surrounding this subpoena and the investigation of [the Corporation] by the grand jury. To avoid repetition, the parties should refer to that document for any necessary factual information. Familiarity with the contents of that entry is assumed and are incorporated into this decision.
. Procedurally, the Government filed, and the court granted on February 7, 1994, what the Government now recognizes was a Motion for Leave to File Motion to Reconsider. On March 3, 1994, subsequent to the submission of briefs from both parties on this motion, the Government filed under seal “new” evidence which is seeks the court to consider in ruling on the motion. The following day the court entered an order sealing the evidence from disclosure to [the Corporation], Although [the Corporation] vehemently protests the sealing of the evidence, and moves to strike the Government’s submission, this satellite dispute need not be addressed because, in resolving this motion, regardless of the substantive import of the "new” evidence, the Government's motion fails.
. Or maybe three interpretations. If, in this motion, the Government is actually requesting the court to decide that the privilege does not protect a psychotherapist’s notes which merely indicate medication was renewed or prescribed, it already has what it seeks in the [Corporation] Grand Jury I decision. There the court held the privilege only protects notes that reflect confidential communications—a category into which a simple note regarding prescribed medicine would probably not fall. Nor does the privilege protect the physical circumstances of the records which might be indicative of the length of the notes. For instance, the Government could request all the patient records, allow the psychotherapist to redact or "black-out” all confidential patient communications contained in those records, but possibly still be able to discern the length of the notes based upon the size of the blacked-out portion. No protected information would be divulged and the Government gets what it purportedly wants—some indication of the length of [the
. The Government's allegation that the [Corporation] Grand Jury I decision erroneously relied on state law, rather than the common law, in construing and applying the psychotherapist-patient privilege is simply incorrect and based on a misinterpretation of the previous entry. A close reading of [Corporation] Grand Jury I clearly demonstrates that the common-law regarding the psychotherapist-patient privilege provided the basis for applying and construing the privilege in this case, as required under Federal Rule of Evidence 501. [Corporation] Grand Jury I,
. Another possible source of this evidence could be a person stationed outside the session, such as an employee, who could observe the time the therapist and patient spent behind closed doors. But, as these examples indicate, only observation of the session, in one form or another, or the testimony of a participant in the session could confirm the amount of time. Of course, the Government may, for one reason or another, have reservations about interviewing patients about the length of their sessions; but that course of investigation remains available. While such patient interviews may be somewhat intrusive, questioning a patient about the length of particular session is generally far less intrusive than ordering disclosure of confidential communications between therapist and patient.
