In the current case, Jennifer Alley is the owner of Real Time Medical Data, LLC, a business that provides Medicare claims data to hospitals and other health care organizations for marketing and strategic planning purposes. Alley filed a FOIA request with HHS for data on all Medicare claims paid in 2002 for procedures performed in Florida, Georgia, Mississippi, and Tennessee. She requested Current Procedural Terminology (CPT) codes for each Medicare-paid medical service and procedure, and the providing physician's name and address. HHS initially denied the request, and after exhausting administrative remedies, Alley filed the lawsuit with the District Court in 2007. HHS then withdrew its decision and notified Alley that it would provide some of the data requested, but not any Medicare Part B outpatient claims data that could, in conjunction with public information already available, lead to disclosure of individual physician reimbursement amounts. HHS later went on to say it would disclose the part of the Part B outpatient data, but not the names, addresses, cities or zip codes of individual physicians or small group practices. HHS justified that exception to FOIA as an unwarranted invasion of personal privacy under the FOIA Exemption 6.

In the District Court case, the court construed Florida Medical's injunction very narrowly and held that it does not cover the information Alley sought. If the information did not fall under the rubric of the injunction, then the principles of GTE Sylvania, Inc. v. Consumers Union of the United States, Inc., 445 U.S. 375 (1980), would not apply. In GTE Sylvania, an agency that complies with a court order forbidding disclosure does not violate FOIA.


The District Court determined the injunction does not apply because the data requested was "raw data" rather than the actual annual Medicare reimbursement amounts. The Court considered the "substantial public interest" in disclosure (allowing the public to evaluate physicians and understand what the government was "up to") stronger than the "very limited privacy interest" implicated in the injunction, and determined that disclosure would not constitute a clearly unwarranted invasion of privacy under Exemption 6.

The Appellate Court decision interpreted the Florida Medical injunction differently--that it does cover the information the District Court ordered HHS to disclose. Therefore, while the Florida Medical injunction is in effect, the GTE Sylvania decision bars any court from ordering disclosure. While appellate courts are usually loathe to reinterpret a lower court's decision in the same case, in this situation the interpretation is of an injunction by another district judge, and therefore the appellate court felt comfortable in its differing interpretation.

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