LawyerLandLegal Glossary

HIPAA and Your Medical Records

The federal privacy rules for health information - including a right to get a copy of your own records, which is narrower and more practical than the privacy rule people usually mean.

Informational only - this is not legal advice. These definitions explain general legal vocabulary in plain English. They are not advice about your situation, reading them creates no attorney-client relationship, and the law differs from state to state and changes over time. For advice you can rely on, speak to a lawyer licensed in your state.

What it means

The federal health privacy rules apply to health plans, health care clearinghouses and most health care providers, together with the contractors that handle protected health information for them. They restrict use and disclosure of that information without authorisation, subject to defined exceptions such as treatment, payment and health care operations.

The provision individuals use most is the right of access: a person may inspect and obtain a copy of their own records held in a designated record set, in the form and format requested where the records are readily producible that way, within a defined period and for no more than a cost-based fee. A request may not be conditioned on explaining why the records are wanted.

A point of frequent confusion is that these rules do not give an individual a private lawsuit against a provider for a breach. Enforcement runs through a complaint to the federal regulator, which can impose penalties. That is why a privacy problem is often pursued instead under state law - as negligence, breach of confidence, or under a state health-privacy or data-breach statute - with the federal rule supplying the standard rather than the cause of action.

Where this comes from

The Health Insurance Portability and Accountability Act privacy and security rules, 42 U.S.C. §§ 1320d to 1320d-9, implemented at 45 C.F.R. Parts 160 and 164. The individual right of access is 45 C.F.R. § 164.524, permitted uses and disclosures are § 164.506, breach notification is 45 C.F.R. Part 164 Subpart D, and the criminal provision is 42 U.S.C. § 1320d-6. State health-privacy laws that are more protective are not displaced.

When people hire a lawyer for this

Records requests that are refused, delayed well past the required period, or answered with a fee that looks unrelated to the cost of copying are worth raising - and getting the complete record is usually the first practical step in any medical claim, well before anyone decides whether there is one. Where information has actually been disclosed improperly, the useful advice is about state-law routes, because the federal statute is enforced by the regulator rather than by the individual.

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Part of the LawyerLand plain-English legal glossary. Definitions are written from primary sources - statutes and court rules - and each entry states the authority it rests on, or says plainly when the doctrine is state law with no national rule.