When patients can and can't access their medical records

HHS' Office for Civil Rights has issued guidance to help individuals understand their rights to access their health information under HIPAA.

In general, HIPAA covered entities must provide individuals who request it access to protected health information in "designated record sets" maintained by or for the covered entity.

The designated record sets have three key characteristics:

1. Medical and billing records about individuals maintained by or for a covered healthcare provider

2. Enrollment, payment, claims adjudication and case or medical management record systems maintained by or for a health plan

3. Other records that are used in some way by or for the covered entity to make decisions about individuals

There are two categories of information to which individuals do not have a right to access, which are generally categorized by information not used to make decisions about individuals. These categories are:

1. Psychotherapy notes that are maintained separately from the rest of a patient's medical record

2. Information compiled for use in a civil, criminal or administrative motion.

"The regulations under HIPAA…have always recognized the importance of providing individuals with the ability to access and obtain a copy of their health information," according to the guidance. "With limited exceptions, the HIPAA Privacy Rule provides individuals with a legal, enforceable right to see and receive copies upon request of the information in their medical and other health records maintained by their healthcare providers and health plans."

To read the full guidance on patient rights to access health information, click here.

More articles on HIPAA:

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Why healthcare may see more HIPAA fines in the coming year

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