NO.  	

STATE OF TEXAS	§	IN THE   	JUDICIAL	
	§		
vs.	§	DISTRICT  COURT	
	§		
	§	DALLAS COUNTY, TEXAS	

MOTION  FOR ORDER TO OBTAIN PROTECTED HEALTH  INFORMATION UNDER HIPAA

TO THE HONORABLE JUDGE OF SAID COURT:

Defendant   	files this Motion for an Order to Obtain Protected Health

Information under the Health Insurance Portability and Accountability Act of 1996, Pub.L. No.

104-191, §264, 110 Stat. 1936 (“HIPAA”):

1.	Defendant	files	this	motion	to	obtain	protected	health	information	of

 	, who is a witness in this case.

2.	(If the witness has signed the release) Defendant seeks an order from the Court

requiring   	

to  execute  an  Authorization  for  Release  of  Protected  Health

Information to produce certain protected health information under C.F.R. § 164.508.   Copies of the releases are attached as Exhibit 1.
3.         (If the witness Alternatively, Defendant requests that the Court enter a qualified protective order under C.F.R. § 164.512(e), addressing the rights and protections that apply to the protected health information under HIPAA.   Defendant requests that the qualified protective order provide that the requested health information protected by HIPAA be produced for the medical records of                                , a witness or person whose health records are relevant in this case, and further provide that the information is to be used only in connection with this litigation and that the parties to this matter, their counsel, the employees of their counsel, and

their respective agents are prohibited from using or disclosing health information protected by

HIPAA for any purpose other than in connection with this litigation.

4.         Under 45 C.F.R. 164.512 “covered entities” are authorized to disclose “protected health information” without written authorization of the individual under 45 C.F.R. 164.508, or the individual being given the opportunity to agree or object under 45 C.F.R. 164.510 in judicial or administrative proceedings in compliance with 45 C.F.R. 164.512(e).
5.	As relevant to this motion, 45 C.F.R. 164.512(e) provides:

(e) Standard: Disclosures for judicial and administrative proceedings—

(1) Permitted   disclosures. A   covered   entity   may   disclose   protected   health information in the course of any judicial or administrative proceeding:

(i) In response to an order of a court or administrative tribunal, provided that the covered entity discloses only the protected health information expressly authorized by such order; or

(ii) In response to a subpoena, discovery request, or other lawful process, that is not accompanied by an order of a court or administrative tribunal, if:

(A) The   covered   entity   receives   satisfactory   assurance,   as described in paragraph (e)(1)(iii) of this section, from the party seeking the information that reasonable efforts have been made by such party to ensure that the individual who is the subject of the protected  health  information  that  has  been  requested  has  been given notice of the request; or

(B) The   covered   entity   receives   satisfactory   assurance,   as described in paragraph (e)(1)(iv) of this section, from the party seeking the information that reasonable efforts have been made by such party to secure a qualified protective order that meets the requirements of paragraph (e)(1)(v) of this section.

(iii) For the purposes of paragraph (e)(1)(ii)(A) of this section, a covered entity receives satisfactory assurances from a party seeking protecting health information if the covered entity receives from such party a written statement and accompanying documentation demonstrating that:

(A) The party requesting such information has made a good faith

attempt to provide written notice to the individual (or, if the individual's   location   is   unknown,   to   mail   a   notice   to   the individual's last known address);

(B) The notice included sufficient information about the litigation or  proceeding  in  which  the  protected  health  information  is requested to permit the individual to raise an objection to the court or administrative tribunal; and

(C) The time for the individual to raise objections to the court or administrative tribunal has elapsed, and:

(1) No objections were filed; or

(2) All objections filed by the individual have been resolved by the court or the administrative tribunal and the disclosures being sought are consistent with such resolution.

(iv) For the purposes of paragraph (e)(1)(ii)(B) of this section, a covered entity  receives  satisfactory  assurances  from  a  party  seeking  protected health information, if the covered entity receives from such party a written statement and accompanying documentation demonstrating that:

(A) The  parties  to  the  dispute  giving  rise  to  the  request  for information have agreed to a qualified protective order and have presented it to the court or administrative tribunal with jurisdiction over the dispute; or

(B) The   party   seeking   the   protected   health   information   has requested a qualified protective order from such court or administrative tribunal.

(v) For purposes of paragraph (e)(1) of this section, a qualified protective order means, with respect to protected health information requested under paragraph (e)(1)(ii) of this section, an order of a court or of an administrative tribunal or a stipulation by the parties to the litigation or administrative proceeding that:
(A) Prohibits the parties from using or disclosing the protected health information for any purpose other than the litigation or proceeding for which such information was requested; and

(B) Requires the return to the covered entity or destruction of the protected health information (including all copies made) at the end of the litigation or proceeding.

6.	The following protected health information of   	is sought from

the following Healthcare Services Providers:

 	, Texas  	

Dates of healthcare services provided:    	

to present.

Requested information: Entire health records in the possession of healthcare provider, including progress notes, laboratory reports, operative reports, discharge summary, radiology reports, consultation reports, X-ray or other images, photographs/videotapes, test results, consultations, correspondence, and hospital records.

 	, Texas  	

Dates of healthcare services provided:                    to present.

Requested information: Entire health records in the possession of healthcare provider, including progress notes, laboratory reports, operative reports, discharge summary, radiology reports, consultation reports, X-ray or other images, photographs/videotapes, test results, consultations, correspondence, and hospital records.

 	, Texas  	

Dates of healthcare services provided:                    to present.

Requested information: Entire health records in the possession of healthcare provider, including progress notes, laboratory reports, operative reports, discharge summary, radiology reports, consultation reports, X-ray or other images, photographs/videotapes, test results, consultations, correspondence, and hospital records.

7.	The protected health information of   	is relevant and necessary in this case because   	(enter all reasons why the records are necessary).

8.	The mental or physical condition and fitness of   	is a primary issue in this case.
Defendant prays that this Court grant this Motion for an Order to Obtain Protected Health

Information under HIPAA.
Respectfully submitted, Michael Mowla
P.O. Box 868
Cedar Hill, TX 75106
Phone: 972-795-2401
Fax: 972-692-6636 michael@mowlalaw.com Texas Bar No. 24048680
Attorney for Defendant

/s/ Michael Mowla
Michael Mowla

Certificate of Service

I certify that on served	on

of	the by email to

, a true and correct copy of this document was
County	District	Attorney’s	Office,
.

/s/ Michael Mowla
Michael Mowla

Order for a Setting on this Motion

The  Court  finds  that  the  party  is  entitled  to  a  hearing  on  this  matter,  and  it  is THEREFORE ORDERED that a hearing on this motion is set for   	. Signed on   	.

Judge Presiding