## Facts

- A podiatrist (“John Doe, D.P.M.”) operating a clinic in the Cleveland area was investigated by federal authorities for an alleged kickback arrangement with two medical testing laboratories.
- The government alleged Doe referred patients for medically unnecessary vascular and electrodiagnostic tests and received payments for referrals, purportedly disguised as rent for a room in his clinic.
- Investigators had information suggesting substantial payments from the laboratories relative to the clinic’s overall rent and suspected false claims submitted to health-care benefit programs connected to Doe’s referrals.
- The Department of Justice issued an administrative subpoena under HIPAA § 248 seeking documents including professional education and ethics training records, personal and business financial records, records of asset transfers to Doe’s children, and patient files.
- Doe moved to quash in the Northern District of Ohio, arguing the subpoena was overly broad, unduly burdensome, and sought irrelevant information; the district court denied the motion and ordered compliance.
- Doe appealed the order compelling compliance.

## Issues

1. Whether HIPAA § 248 authorized the Attorney General to issue an administrative subpoena for the categories of records sought in a federal health-care fraud and kickback investigation.
2. Whether the subpoena satisfied administrative subpoena enforcement standards, including reasonable relevance to a lawful investigatory purpose and lack of unreasonable burden.
3. Whether constitutional or privacy interests in personal financial records and patient files required quashing or narrowing the subpoena.

## Decision

- The Sixth Circuit affirmed the order denying the motion to quash and compelling compliance.
- The court held the subpoena fell within HIPAA § 248’s grant of administrative subpoena authority for investigations of federal health care offenses.
- The court found the requested materials were reasonably relevant to the investigation under the deferential administrative subpoena standard.
- The court held Doe failed to demonstrate that compliance would be unreasonable or oppressive.
- The court rejected Doe’s constitutional and privacy objections to production of financial and patient records in this context.

## Legal Principles

- An administrative subpoena is enforceable if the investigation is within the issuing authority’s power, the demand is sufficiently definite, and the requested material is reasonably relevant to a legitimate investigatory purpose.
- In subpoena enforcement, the government need not show probable cause; it is enough that the material may shed light on the matters under investigation.
- The recipient bears the burden to prove a subpoena is unreasonable or oppressive; generalized claims of burden without specific evidentiary support are insufficient.
- HIPAA § 248 authorizes DOJ administrative subpoenas for records that may be relevant to investigating federal health care offenses, including fraud and kickbacks.
- Privacy and confidentiality interests in financial and patient records do not categorically bar an otherwise lawful administrative subpoena issued for a legitimate health-care fraud investigation.

## Conclusion

The Sixth Circuit required compliance with the DOJ’s HIPAA-based administrative subpoena, holding that the subpoena was statutorily authorized, sought reasonably relevant records, was not shown to be unduly burdensome, and was not barred by asserted privacy or constitutional objections.


In re Administrative Subpoena John Doe, D.P.M., 253 F.3d 256 (6th Cir. 2001)