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San Antonio Express-News, /98

How Broad Is Your Right to Access Medical Records?

© 1989-2004, Paul Premack

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Dear Mr. Premack: I have a question about my medical records. I am retired military, and have been very careful to keep track of my own records. I usually ask my doctors to give me copies. Most doctors willingly hand over the information, but some steadfastly refuse. They say the records cannot be released (and since they are at the military hospitals, they are hard to argue with). I say that the records are about me, and I'm entitled to a copy. What is the law here? -- K.

Two sets of laws apply: those of the United States, and those of the State of Texas. Both sets of laws generally operate in your favor and give you legal access to your medical records.

Federal regulations adopted by the Department of Defense require your medical records to be disclosed to you under ordinary circumstances. The records themselves are the property of the government, but the information must provided when you request it. Only one exception applies: disclosure can be denied if, in the judgment of the physician, access to the records could have an adverse effect on your mental or physical health.

Even if disclosure could be harmful, DoD regulations require the medical records be forwarded to any other physician you specify. Further, when sending the records to the other physician, the military hospital must explain why direct access could be harmful to you.

The State of Texas, in the Medical Practice Act, also allows you to obtain a copy of your medical records (or to request a copy be sent to another doctor or individual). State law requires the doctor to release copies of your medical records when you submit a written request.

The request must tell the doctor exactly which records are being requested, must give a reason for the release, and must identify the person to whom the data is to be given. You should send the request by certified mail or hand deliver it to your doctor to be certain it is received.

Texas allows an exception quite similar to the DoD's: if the doctor determines that access to the information would be harmful to your physical, mental, or emotional health then release can be denied.

When release would not be harmful, the doctor must provide the copies (or a summary of your records) within 30 days after receiving the written request. The doctor can require reasonable fees for furnishing the copies. The Texas Board of Medical Examiners has determined that a "reasonable fee" is no more than $25 for the first twenty pages and 15¢ per following page. The doctor may also charge you the actual costs of delivery.

Do you have to pay the doctor in advance? Legally, yes. The doctor can waive any payment requirement, but is entitled to ask for money up-front. If you don't include money with your written request for copies, the doctor must respond to you within ten days about the amount needed for payment. However, the doctor cannot refuse your request just because you still owe money on an existing medical bill.

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Disclaimer: This column answers a specific legal question offered by an individual in the South Texas area. The answer may or may not match your individual situation. Be careful not to treat this column as specific legal advice that meets your individual needs. It may give you a solid basis for discussion with your own attorney. Also, please be aware that laws change. You should consult with your personal attorney before you take any action on this or any legal issue.

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