AHIMA Publishes New Resource Confirming Patients’ PHI Access Rights under HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) permits patients to obtain a copy of their medical records in electronic or paper form. Last year, the Department of Health and Human Services released a series of videos and documentation to explain patients’ right to access their health data.

Yesterday, the American Health Information Management Association (AHIMA) also published guidance – in the form of a slideshow – further explaining patients’ access rights, what to expect when requests are made to healthcare providers, possible fees, and the timescale for obtaining copies of PHI.

AHIMA explains that copies will not be provided immediately. Under HIPAA Rules, healthcare providers have up to 30 days to provide copies of medical records, although many will issue designated record sets well within that timeframe. However, in some cases, provided there is a justifiable reason for doing so, a healthcare provider may request a 30-day extension. In such cases, it may take up to 60 days for patients to obtain copies of their health data.

AHIMA has explained to whom healthcare providers are allowed to disclose the information: Patients or a nominated personal representative. In the case of the latter, guidance has been issued on who that person may be.

There are various models that can be adopted by healthcare providers for charging patients for copies of PHI. While the actual cost for providing copies of medical records may not be provided at the time the request is made, healthcare providers must advise patients of the approximate cost at the time the request is made. AHIMA points out that if electronic health data is being provided via a patient portal, a charge will not apply.

Since HIPAA serves to protect patient privacy, healthcare providers are required to verify the identity of the person making the request or a personal representative if one is used. A healthcare provider will therefore require a photographic ID to be produced prior to any records being released. A waiver will also need to be signed verifying identity.

AHIMA explains that obtaining copies of medical records is important. Access to health data improves patient engagement and empowers them to make more informed choices about their healthcare.

While providers should be able to obtain health data from other providers, that process is not always straightforward due to data incompatibility issues. It is therefore important that patients have complete copies of their medical records so they can provide complete sets to new providers. Doing so improves the coordination of care.

Patients should also check their health records for any errors and omissions – known allergies for instance. If an error or omission is discovered, a request to change the records should be submitted to the appropriate healthcare provider.

The AHIMA slideshow can be viewed here. Further information for patients on medical record access can be found in an accompanying blog post.

Penalties for Failing to Provide Patients with Copies of their Medical Records

Healthcare providers should be aware that failure to provide patients with copies of their medical records can result in a financial penalty for non-compliance with HIPAA Rules.

41 patients of Cignet Health of Prince George’s County in Maryland were denied access to their medical records and complained to OCR. The investigation revealed that the HIPAA Privacy Rule had been violated. Cignet eventually settled with OCR for more than $4.3 million.

AHIMA recommends that healthcare providers regularly review their policies and procedures for providing patients with copies of their medical records. Many healthcare providers have unintended barriers in place that make it difficult for patients to exercise their right to access their health data. Only by understanding HIPAA Rules on patient PHI access rights – and ensuring HIPAA Rules are followed – will healthcare providers be able to ensure that their patients enjoy the benefits that come from them taking a more active role in their healthcare.

Author: Steve Alder has many years of experience as a journalist, and comes from a background in market research. He is a specialist on legal and regulatory affairs, and has several years of experience writing about HIPAA. Steve holds a B.Sc. from the University of Liverpool.