By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    bowl of vegetable salad
    Raw Foods: benefits and harms
    November 9, 2021
    pros and cons of the keto diet
    Read This Before You Follow the Keto Diet
    May 18, 2022
    spinal cord injuries
    4 Potential Causes of Spinal Cord Injuries (and How to Seek Compensation)
    May 25, 2022
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    The key stakeholders involved in improving healthcare policy
    The Key Stakeholders involved in Improving Healthcare Policy
    October 26, 2023
    medical erros avoid
    How to Report Medication Errors and Why It’s Important
    November 17, 2024
    Essential Steps for Developing a Life Care Plan
    Essential Steps for Developing a Life Care Plan
    December 26, 2024
    Latest News
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
    Strengthening Healthcare Systems Through Clinical and Administrative Career Development
    June 13, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Individuals’ Rights to Their Health Information: The Federales Awaken
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Individuals’ Rights to Their Health Information: The Federales Awaken
Health ReformPolicy & Law

Individuals’ Rights to Their Health Information: The Federales Awaken

David Harlow
Last updated: February 3, 2016 2:34 pm
David Harlow
Share
8 Min Read
SHARE
HHS is taking a cue from Horton (via Dr. Seuss): “I meant what I said, and I said what I meant.”

A long time ago (in internet years), the original HIPAA regulations were promulgated.

HHS is taking a cue from Horton (via Dr. Seuss): “I meant what I said, and I said what I meant.”

A long time ago (in internet years), the original HIPAA regulations were promulgated. (The final Privacy Rule was published in 2000.) They’ve been tweaked and updated over the years, most notably in the “mega-reg” promulgated a few years back in order to implement the updates included in the HITECH Act. For purposes of the present discussion, I am interested in the patient right to medical record information included in HIPAA, rather than privacy and security protections for patient data. The core elements of the HIPAA rule relevant to patient access to medical records have not changed since the rule was originally promulgated. That original rule did not expand all that much on the access to records rules in some of the more enlightened states in the Union, though it has pulled up some of the laggards. 

In essence, the rule requires that if a patient requests a medical record, the “covered entity” (health care provider or health plan) must provide the record, in the format requested (if it is reasonably possible to do so, or in another format acceptable to the patient if it is not), within 30 days. (The HITECH “mega-reg” made only a minor change to this rule with respect to records stored off-site: an extra 30 days to retrieve records in cold storage. Meaningful Use regulations governing health care providers with certified electronic health records require much quicker responses for a certain percentage of patients, so in a perfect world a request could be acted on within 48 hours.) Federal and state rules differ with respect how much a patient may be charged for a copy, and state rules control in this instance, sometimes leading to significant fees charged for paper copies. Given the current environment, a “per-page” charge does not make much sense, particularly if a requested record is transmitted electronically to a repository of the patient’s choosing. (In fact, the official commentary on the draft Meaningful Use Stage 3 regs noted that when records are available via APIs — the notion of the federales designing standards for certification of APIs is a topic for another day — perhaps no copying fees should be permitted since there is virtually no cost to sharing an individual record. An argument may also be made that the many federal dollars paid for patient care and in Meaningful Use incentives ought to cover the cost of delivering a copy of the record.)

Most forward-thinking health care providers and other covered entities recognize the value of being in partnership with patients, and recognize the value of having “e-patients” (the “e” is for equipped, enabled, empowered and engaged; today, the usual meaning of “e-” often applies to e-patients as well.) Many also recognize the value of lifetime health records — and there are multiple means of helping patients/consumers gather and update such lifetime health records (e.g. Free Our Health Records, a free service powered by Flow Health, a client.)

More Read

Mississippi Becomes Bolder with Anti-Abortion Legislative Push
What Will Machine Learning Do With Healthcare In 2020?
How Healthcare Workers Can Smoothly Change Careers
Contaminated Water and Disease:Are We Safe?
Caring For Chronic Illnesses Should Be Different

The U.S. Dept. of Health and Human Services, Office for Civil Rights (OCR) enforces the HIPAA regulations and recently issued a new fact sheet and series of FAQs entitled Individuals’ Right under HIPAA to Access their Health Information 45 CFR § 164.524. This is the first in a promised series of issuances and it lays out individuals’ rights clearly. (OCR has a global collection of HIPAA FAQs which is a good resource as well.)

So far, so good – right?

Well, while the new issuance may be helpful, and while it is easier than ever to file a complaint with OCR about health data privacy or security violations, the substance of the publication has been posted before, with annual cover letters by current and former OCR directors (patients get to get copies of their records; it’s the law), and yet many readers of this post are likely shaking their heads, thinking about a close encounter with the medical-industrial complex where a simple record request was not responded to adequately.

It is disappointing that fifteen years after the promulgation of the HIPAA Privacy Rule many health care organizations are less than fully compliant, given the plain language of the statutes and regulations, and it also disappointing that the federales seem not to have done much to move the dial on compliance. (A colleague sought me out as recently as this week for assistance with an individual’s Sisyphean struggles to obtain copies of health records from health care providers.) Pro Publica recently ran a series of stories on the issue of lax HIPAA enforcement (related to data breaches), accompanied by HIPAA Helper, which is an enhanced version of the Wall of Shame (the public government database of HIPAA breaches). Some folks are mad as hell about this. We have heard from a number of OCR directors over the years that important steps are being taken to improve compliance, to ensure that individuals are able to avail themselves of their HIPAA-guaranteed right of access to their medical records.

The proof is in the pudding: so let’s reserve judgment for a bit and see how the current team at OCR manages to improve compliance with record requests overall as this and other guidance is rolled out to the regulated community and the general public. I hope the persistence and patience of the current team is rewarded, just as Horton’s was.

It’s about time. I’m ready. Are you?

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

A version of this post first appeared on e-patients.net, the blog of The Society for Participatory Medicine. I serve as chair of the Society’s Public Policy Committee.

TAGGED:HIPAAregulations
Share This Article
Facebook Copy Link Print
Share
By David Harlow
Follow:
DAVID HARLOW is Principal of The Harlow Group LLC, a health care law and consulting firm based in the Hub of the Universe, Boston, MA. His thirty years’ experience in the public and private sectors affords him a unique perspective on legal, policy and business issues facing the health care community. David is adept at assisting clients in developing new paradigms for their business organizations, relationships and processes so as to maximize the realization of organizational goals in a highly regulated environment, in realms ranging from health data privacy and security to digital health strategy to physician-hospital relationships to the avoidance of fraud and abuse. He's been called "an expert on HIPAA and other health-related law issues [who] knows more than virtually anyone on those topics.” (Forbes.com.) His award-winning blog, HealthBlawg, is highly regarded in both the legal and health policy blogging worlds. David is a charter member of the external Advisory Board of the Mayo Clinic Social Media Network and has served as the Public Policy Chair of the Society for Participatory Medicine, on the Health Law Section Council of the Massachusetts Bar Association and on the Advisory Board of FierceHealthIT. He speaks regularly before health care and legal industry groups on business, policy and legal matters. You should follow him on Twitter.

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025
recovering from injury
Rebuilding After Injury: Path to Physical and Emotional Recovery
News
June 22, 2025
scientist using microscope
When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
Global Healthcare
June 18, 2025

You Might also Like

medical monopoly image
BusinessFinanceHospital AdministrationNewsPublic Health

More Medical Monopoly-Yes, Medical Bills Are Killing Us!

February 21, 2013
Health care

Stop Worrying About Your Lifespan – Your Healthspan Really Matters

October 12, 2019

How Many Uninsured Will Medicaid Cover After Health Reform?

October 31, 2011

MedStar SiTEL Achieves Accreditation by SSH

May 16, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?