Am I Entitled to My Medical Records?


Website Provided by HG.org


FIND MORE LEGAL ARTICLES
Generally, patients are entitled to a copy of their medical records as provided under state and federal law. However, they must usually follow a specific procedure, and there may be exceptions to access.

General Rules Regarding Access

The Health Insurance Portability and Accountability Act is the federal law that provides for access to medical records. This law provides that patients have a right to nearly all of their medical records. This includes access to electronic records. The right encompasses the patientís legal entitlement to inspect, review and receive a copy of medical records and billing records that are held by health plans and healthcare providers.

This law gives the individual patient, an appointed personal representative and a minorís parents with this right to access medical records. However, parents may not be able to receive copies of the childís medical records if the child consented to medical care and parental consent is not required under state law, if the child receives treatment pursuant to a court order or if the parent agrees that the minor child and the medical provider have a confidential relationship. A personal representative of a personís estate may have the right to access the decedentís medical records.

Additionally, health care providers or health plans can send copies of a patientís medical records to another provider or health plan if it is necessary for treatment or payment. Additionally, the patient can personally request that his or her medical records be sent to a third party.

Generally, the patient is entitled to receive the information that he or she is requesting in the format that he or she requests. For example, a patient has a right to electronic information to be received electronically if the healthcare provider stores it electronically.

State laws may provide even greater access to records than federal law provides, but state laws that provide less access are preempted by the federal law.

Information Not Subject to Disclosure

However, there are some exceptions to the information that patients have a right to access. For example, health care providers are generally not required to provide access to psychotherapy notes taken by a mental health professional during a conversation with the patient. Additionally, healthcare providers can refuse to provide information that they are gathering and compiling for lawsuits.

Another exception to disclosure is if the medical information that is provided could reasonably endanger a patientís life or safety or the safety of another person. Other exceptions may apply based on the individual circumstances. For example, a healthcare provider may deny access if it is conducting research until the research has been concluded. Another exception is if another person or entity besides a healthcare provider gave the provider such information under a promise of confidentiality and access to the medical information would likely reveal the source of the information, the request may be denied. Inmates in correctional institutions may also be denied access to their records if providing access could jeopardize the inmate or other inmatesí health, security, safety or rehabilitation.

Charges

A health care provider cannot deny a patient access to their medical records because the patient still owes on the health care bill. However, a health care provider can charge the patient a reasonable fee for the copying and mailing of records. The health care provider cannot charge a retrieval fee for searching for the records. Some states have laws pertaining to the amount that healthcare providers can charge per copy.

Denials

The provider is usually required to provide a written denial that sets out the reasons and legal basis for the denial. This denial letter should also contain information about whether the patient has a right to have the denial reviewed and how the patient can file a complaint.

In some cases, the patient can ask for such a review. If a review is implemented, a licensed health care professional who was not part of the initial decision-making process reviews the decision.

A patient has the right to file a complaint with the Department of Health and Human Services if he or she feels that a wrongful denial has been issued. Additionally, a patient may choose to file a complaint with the provider, health plan or state medical board.

Copyright HG.org


Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer.

Find a Lawyer

Find a Local Lawyer