Releasing a young adult's records; sending records to the government, charging for copying
Answers to your questions about . . .
Q: Does the HIPAA privacy rule give parents the right to see or amend the medical records of a child legally considered a young adult?
A: Generally, no. Once a child reaches the age of majority, typically 18 to 21 years of age, a parent is no longer entitled to see or amend the child's medical record. If a parent continues to pay for the child's care, however, some information may be disclosed so the parent can obtain payment from an insurer. You're permitted to exercise your reasonable professional judgment about when to disclose information. For example, if a young adult doesn't object to a parent accompanying her to the exam room, you can reasonably assume that disclosing health information to the parent is permissible.
When in doubt, ask your young adult patient for written permission. Also consider modifying your patient intake forms to authorize communication with specific relatives and significant others.
Q:Under what circumstances, if any, am I required to send medical records to the government?
A: Contrary to recent press accounts, HIPAA doesn't require doctors to send medical records to a government database. But it does permit doctors to continue to make disclosures to government agencies and public health authorities, as required by law.
Thus, you should obey the laws in your state regarding when and in what manner to report communicable diseases to public health officials. Also cooperate with government efforts to detect and track outbreaks of infectious disease and food-borne illnesses. Similarly, report to the FDA any adverse events related to drugs and medical devices. You should also report suspected child abuse or neglect to the appropriate social service agencies.
Q:If a patient requests copies of her medical records, must she pay for those copies?
A: HIPAA permits, but does not require, practices to charge a reasonable fee for copying and postage. Many states have additional limits on how much and under what circumstances practices can charge for copies. In such cases, state law governs. For example, Connecticut prohibits charging a fee for records requested to appeal a claim under the Social Security Act.
Under HIPAA, the only fees practices may charge for medical records are those related to postage and copying (supplies and labor)even if state law permits other fees. Thus, while Pennsylvania law allows practices to charge a nominal retrieval fee for medical records, practices subject to HIPAA may no longer do so.
Sofia R. Plotzker is an attorney with The Health Care Group in Plymouth Meeting, PA. She can be reached at splotzker@healthcare group.com. This department answers common HIPAA-related questions. It isn't intended to provide specific legal advice. If you have a question, please submit it via e-mail to email@example.com, or by regular mail to Medical Economics, 5 Paragon Drive, Montvale, NJ 07645. ATTN: HIPAA CONSULT. If we select your query, we'll address it in an upcoming issue. Your name will not be used.
Sofia Plotzker. HIPAA Consult: Answers to your questions about . . .. Medical Economics Sep. 19, 2003;80:24.