PHOENIX — Fraud investigations trump Arizona’s physician-patient privilege, the Arizona Supreme Court ruled Monday.
In a unanimous decision, the justices upheld the conviction and 10-year prison term for Chalice Zeitner on charges of defrauding the state’s Medicaid program, identity theft and fraud.
They rejected her claims that the testimony and medical records of her doctor could not be used in her trial accusing her of faking a claim of cancer in order to obtain a state-funded abortion.
Justice John Lopez, writing for the high court, acknowledged the statute that protects patient communications with a physician apply in criminal cases. That, he said, is designed to “ensure that a patient will receive the best medical treatment by encouraging full and frank disclosure of medical history and symptoms by a patient to his doctor.”
Lopez said that law also protects patient medical records.
But the court also said that privilege is not absolute, citing examples like requiring doctors to disclose wounds that may have resulted from illegal activity, as well as evidence of contagious or infectious diseases.
In this case, he said, physicians providing services under the Arizona Health Care Cost Containment System, the state’s Medicaid program, are required to report “any cases of suspected fraud.” And the agency is required to investigate.
The charges against Zeitner stem from her 2010 claim that she needed a state-financed abortion because she discovered she was pregnant after recently undergoing radiation and chemotherapy treatments for cancer. AHCCCS pays for abortions only in cases where the life or health of the mother is threatened.
Part of that scheme also included providing the obstetrician a letter purportedly written by an out-of-state doctor who Zeitner claimed had treated her. The letter recommended she receive an urgent abortion to relieve third-term, life-threatening conditions.
The obstetrician, relying on that information, concluded the abortion was necessary to protect Zeitner’s health.
The plan began to unravel a year later when the obstetrician, performing a Cesarean section on Zeitner for another pregnancy, found no physical evidence to support her previous claims of uterine cancer. The obstetrician reported his suspicions about her to the health plan, which forwarded the matter to AHCCCS.
She eventually was indicted on 11 charges, including defrauding AHCCCS, which otherwise would not have paid for the abortion. Prosecutors also charged her with identity theft and forgery for impersonating the doctor who recommended the abortion.
Over her objections, the trial judge allowed her medical records into evidence and her physicians to testify.
In Monday’s ruling, Lopez pointed out the federal government, which picks up most of the cost of the AHCCCS program, has specific requirements for disclosure of patient records.
He also said there are some parallel state laws and rules that allow for release of information in civil or criminal proceedings.
