The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule includes something called individual rights that affect everyone. These individual rights are:
- The right to request privacy protection for your medical information;
- The right to confidential communications;
- The right to access your medical information;
- The right to amend your medical information; and
- The right of an accounting to some disclosures from your medical records.
The meaning of the right to access medical information is found in the HIPAA Privacy Rule in section 45 CFR 164.524. The regulation states that you have a right to review and obtain a copy of your medical information held in a designated record set (DRS).
Earlier this year a HIPAA Blues Article defined a designated record set as your medical and billing records maintained by your physician, hospital and/or health plan that is used to make treatment and payment decisions regarding your medical care and services. In simple terms DRS is the sub-set of your medical and payment information that is used commonly by your physicians and health plan to make decisions about your care. This information only consists of your current medical record and does not include the paper files in the basement of your doctor's office from last year, or the last decade.
Your' Right of Access to Your Medical Information
There are many times when you are making a request for traditional medical information from your records. You need medical information when your son is on a sports team or your daughter is off to camp. Or you ask your doctor to forward part of your records to a specialist for further treatment. And when you decide to go to a new doctor you ask for your entire file to be sent to the new office.
These traditional and specific requests and referrals are not what HIPAA means by access to your medical information. The HIPAA Privacy Rule Right of Access applies if you want to see your current medical record that your doctor is using.
When you use your right of access request you will find that your medical records may be held in both paper files and electronic files in your doctor's office, and in the hospital's medical records department. Plus, when you ask to review your medical information it may come from several different sources within your doctor's office or the hospital. The medical records clerk will gather the information from all types of records, both paper and electronic, and all sources, and present you with a combined current record, most often on paper.
Under the recently signed American Recovery and Reinvestment Act of 2009 there are some new healthcare provisions. Some deal with the privacy of medical records, and one is specific to requesting your medical information that are held in electronic databases.
This section outlines an individual's right to information in electronic format as follows:
- You can ask for medical records in electronic format if your doctor or hospital holds your medical records in electronic format; and
- You many ask your doctor or hospital to send your electronic medical records directly to an entity or person that you name.
So, in applying the HIPAA Privacy right of access section, if your doctor or hospital has an electronic health record [EHR] they must offer you an electronic copy of your medical information and send it to you, your attorney, or another trusted third party. There is a catch — your doctor and hospital do not have to agree to providing you with an electronic copy of your medical information until February 2010.
For now, if you ask for review and access to your medical records before February 2010 you will most likely be given a paper file.