"Comment: One commenter stated that the rule should require rather than permit disclosure pursuant to court orders.
" fed's Response: Under the statutory framework adopted by Congress in HIPAA, a presumption is established that the data contained in an individual's medical record belongs to the individual and must be protected from disclosure to third parties. The only instance in which covered entities holding that information must disclose it is if the individual requests access to the information himself or herself."
The comments and response to the rules you posted have some relevance, but the considerations are different. LE use was mainly for LE and public safety. Overall, HHS's considerations in the cases given for release of ID cleased records are meet here. The fed court Ashcroft is defending the law in also has proper jurisdiction. The subpoena is for ID cleased records that contain relevant evidence regarding what is essentially empty claims of the plaintiffs. There is no criminal fishing expedition and no prosecutions could result from this. The fed rules of evidence and FDA regs for docs apply. The HHS regs don't prohibit the subpoena.
Section 164.512(e)--Disclosures for Judicial and Administrative Proceedings
"Comment: A few commenters suggested that the final rule not permit disclosures without an authorization for judicial and administrative proceedings.
" HHS Response: We disagree. Protected health information is necessary for a variety of reasons in judicial and administrative proceedings. Often it may be critical evidence that may or may not be about a party. Requiring an authorization for all such disclosures would severely impede the review of legal and administrative claims. Thus, we have tried to balance the need for the information with the individual's privacy. We believe the approach described above provides individuals with the opportunity to object to disclosures and provides a mechanism through which their privacy interests are taken into account."
ie. ID cleansing.