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Medical records are considered highly confidential because of the very private, personal information they contain. That's why you can't call for a copy of your neighbor's latest lab report. However, you generally have the right to access your own medical information and to control who else can access it. With some exceptions, health care providers will release a copy of your records to others only with your written permission.
Health care providers have specific procedures for handling and releasing medical records because of the confidential information contained in the records and because of federal and state laws concerning HIV, mental health, and substance abuse information. If you want to have a copy of your records sent somewhere, or get a copy for yourself, call your health care provider and ask how to do it. You may be asked to fill out and sign a specific form. A fee may be charged for this service, but you should not be prevented from getting a copy of your records because of outstanding medical bills.
Persons Authorized to Release Records
Generally, only a patient can authorize the release of his or her own medical records. However, there are some exceptions to the rule and generally the following can sign a release:
- Parents of minor children
- Legal guardian
- Agent (someone you select to act on your behalf in a Health Care Power of Attorney)
Under some circumstances, a minor and not the parent must sign the release. If you have questions about who can authorize release of your records, check with your health care provider.
Specially Protected Medical Information
Federal law specially protects substance abuse treatment records. Some state laws specially protect HIV/AIDS information and mental health records. These laws are meant to encourage people with these problems to get the medical treatment they need. In order to obtain a copy of the records or have them sent somewhere, you may need to sign a form that specifically mentions this specially protected information.
Disclosure without Consent
Although medical records are confidential, there are times when they can be released without a patient's consent. In special cases, records are released to:
- Health care workers who have a need for the records to care for a patient.
- Qualified people or organizations that perform services such as data processing, medical record transcription, microfilming, administrative functions, or other such related services.
- Qualified people or organizations for approved research and education functions.
- Certain government authorities, as permitted or required by law, to investigate or regulate health related issues such as child abuse, communicable diseases, and prescription drugs.
- Certain lawyers and parties in a law suit, if a patient's medical condition is an issue in the suit.
Generally, strict rules apply to those who receive medical information. For example, they are often required to have procedures to protect the patient's confidentiality and prevent release of medical information and patient identity.