| 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. |