Multnomah County Medical Society v. Scott

The Multnomah County Medical Society (the Medical Society) filed an action under § 552 of the Freedom of Information Act 1966 (FOIA) to compel James Scott, the deputy administrator of the Health Care Financing Administration (HCFA) tasked with the administration of the State Medicare program, to disclose the names and addresses of all Medicare beneficiaries in the area.

FOIA § 552(a)(3) provides that an agency must disclose all records upon request by “any person” unless a statutory exemption applies. Section 552(b)(6) exempts disclosure of “matters that are . . . personnel and medical files and similar files the disclosure of which would constitute a clearly unwarranted invasion of personal privacy.”

The FOIA request stated that the information would be used for the purposes of distributing a newsletter, which explained the recent changes in the Medicare law and contained a directory of both participating and non-participating physicians.

The court held that the release of the Medicare beneficiaries’ names and addresses was a “clearly unwarranted invasion of personal privacy” under FOIA § 552(b)(6). The court balanced four factors adopted from: (1) the plaintiff’s interest in disclosure; (2) the public interest in disclosure; (3) the degree of the invasion of personal privacy; and (4) the availability of any alternative means of obtaining the requested information.

1. Plaintiff’s interest in disclosure

The court held that, under FOIA, commercial interest did not warrant disclosure of otherwise private information, such as a name and address list. It declared that “the actual content” of the Medical Society’s directory demonstrated that its motivation was “overwhelmingly commercial,” which did not weigh in favor of disclosure. The court held that the Medical Society’s directory added “little or no information to that contained in the government-sponsored directory.” The court noted that the government-sponsored directory was intended to be an incentive to doctors to become participating physicians in the Medicare program, and thus it listed only such participating physicians; however, the Medical Society's publication failed to distinguish between participating and nonparticipating physicians.

2. Public interest in Disclosure

The court addressed the District Court’s finding that the public's interest in disclosure was in receiving a publication “more available, accurate and complete than the government publications.” The court stated that availability was increased because the Medical Society’s directly mailed the lists; however, it noted that since the directory failed to adequately define and distinguish participating and nonparticipating physicians it was nonetheless of “questionable public interest and value.” The court noted that while the Medical Society’s directory did correct inaccuracies in the original government publication, the government had since corrected the inaccuracies. The court declared that the evidence was “overwhelming that the society was primarily interested in including in the list its members who [were] nonparticipating physicians so that they would not fall from public notice in light of the government's directory [which listed] only participating physicians."

3. Degree of invasion of personal privacy

The court held that Medicare beneficiaries had a right not to have their age and disability status made public in the absence of more compelling public and private interests favoring disclosure. The court held that the beneficiaries’ privacy interests had been “seriously undervalued” by the lower court, as the disclosure of the citizens’ identities would reveal that they are senior citizens or disabled. If the information were disclosed, “Medicare beneficiaries could be subject to mailings and solicitations if the name and address list were accidentally or otherwise revealed to other organizations.” The court also noted that HCFA patient lists were treated as confidential in the members’ own offices. The beneficiaries’ privacy interests were thus found to be “more than minimal.”

4. Availability of alternative means of obtaining the requested information

The court noted that the Medical Society sought disclosure of the Medicare beneficiaries in order to “clarify the supposed confusion surrounding HCFA's list of nonparticipating physicians.” However the court held that the Medical Society could have resolved this problem by having its members mail their own patients literature on the supposed confusion.

“Commercial interest does not warrant disclosure of otherwise private information, such as a name and address list, under FOIA.” 825 F.2d, p. 1413.

“In enacting its 1984 amendments to the Medicare law, Congress announced that it was in the public interest to provide incentives for physicians to become ‘participating physicians’ and to accept assignment for all Medicare claims. The Medical Society's directory does nothing to advance the public interest as determined by Congress.” 825 F.2d, p. 1415.

"The district court seriously undervalued the beneficiaries' privacy interest. Disclosure of the beneficiaries' identities would reveal either that they are senior citizens or disabled.” 825 F.2d, p. 1415.

“Because the balance weighs against disclosure in terms of the society's interest and the public interest, we find that the privacy interest involved is more than minimal. []. Medicare beneficiaries have a right not to have their age and disability status made public in the absence of more compelling public and private interests favoring disclosure than are found in this case.” 825 F.2d, p. 1416.