L. Hospital reports.

“Unless otherwise provided by law, all medical records . . . are privileged and confidential.”  A.R.S. § 12-2292.  “Medical record” includes “all communications related to a patient’s physical or mental health or condition that are recorded in any form or medium and that are maintained for purposes of patient diagnosis or treatment, including medical records that are prepared by a health care provider or by other providers.”  A.R.S. § 12-2291(5).  Thus, medical or other records containing personally identifiable information may only be disclosed pursuant to statute. See, e.g., A.R.S. § 36-160(A) (state or county home health services); A.R.S. § 36-404(A)(2) (health care institutions); A.R.S. § 36-568.01 (developmental disabilities); A.R.S. § 36-509 (behavioral health); A.R.S. § 36-664(F) (communicable diseases); A.R.S. § 36-887(B) (child care facilities); A.R.S. § 36-897.12 (child care group homes); A.R.S. § 36-2152 (parental consent or court proceedings pertaining to unemancipated minors who want abortions); A.R.S. § 36-2220 (emergency medical services).

“The governing body of each licensed hospital or outpatient surgical center shall require that physicians admitted to practice in the hospital or center organize into committees or other organizational structures to review the professional practices within the hospital or center for the purposes of reducing morbidity and mortality and for the improvement of the care of patients provided in the institution.”  A.R.S. § 36-445.  All proceedings, records, and materials prepared in connection with these peer reviews are confidential.  A.R.S. § 36-445.01. 

Many health care related boards acquire hospital and medical records during their investigations; these records are often statutorily protected as confidential. See, e.g., A.R.S. § 32-1451.01(E) (Arizona Medical Board); A.R.S. § 32-1551.01 (Naturopathic Physicians Medical Board); A.R.S. § 32-1664(M) (Board of Nursing); A.R.S. § 36-2245(M) (Department of Health Service’s oversight of ambulance services); A.R.S. § 32-3553(K) (Board of Respiratory Care).  Not only are the Arizona Medical Board’s investigative files not subject to A.R.S. § 39-121, they are absolutely privileged and not discoverable in civil litigation.  Ariz. Bd. of Med. Exam’rs v. Superior Court, 186 Ariz. 360, 361-62, 922 P.2d 924, 925-26 (Ct. App. 1996); but see State v. Ditsworth, 216 Ariz. 339, 342, 166 P.3d 130, 133 (Ct. App. 2007) (finding that § 32-1451(O) requires the Arizona Medical Board to make investigatory evidence available to the appropriate criminal justice agency if it “determines that a criminal violation may have occurred involving the delivery of health care”). 

Several statutes delegate the authority to form rules of confidentiality about health care records.  See, e.g., A.R.S. § 36-107 (giving the Department of Health Services the power to designate confidentiality), A.R.S. § 36-2903(I) (directing the Director of the Arizona Health Care Cost Containment System to “prescribe by rule the types of information that are confidential and circumstances under which such information may be used or released”).

Disclosures of medical records also need to comply with the HIPAA privacy regulations.  See 45 C.F.R. Parts 160, 162 & 164.  Similarly, records maintained in connection with the performance of a program or activity relating to substance abuse education, prevention, training, treatment, rehabilitation or research that is regulated or directly or indirectly assisted by the United States government must comply with the regulations implementing the federal substance abuse law.  See 42 C.F.R. Part 2.