Why Patients Struggle Getting Access to Medical Records

Have you ever requested your medical records, but had trouble actually receiving them? Or perhaps you did receive the records but had to pay a hefty fee for them? Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, you have a right to view and get copies of all of your medical records, and hospitals, doctors’ offices, clinics, nursing facilities, and other healthcare professionals must provide them to you. And they should provide them at a reasonable cost—the federal government’s recommendation is $6.50 per record.

What the Research Shows

Unfortunately, as illustrated in this Consumer Reports article, healthcare providers sometimes make it very difficult for patients to obtain their own records.  The article discusses a recent study of more than 80 hospitals throughout the country and how they responded to requests for records. The hospitals were all highly ranked in the U.S. News & World Report Best Hospitals ranking for 2016-2017.

What study researchers found was discouraging. Information provided by these top hospitals related to records release was often confusing at best and sometimes even incorrect. Some of the hospitals did not follow federal law when responding to requests for records.

  • When asked how long it would take to receive records, some hospitals told researchers it would take more than 30 days, which is outside of the federal HIPAA requirement that records be provided within 30 days. Some states, including California, Hawaii and others, have laws requiring that records are delivered even faster. However, in Illinois, the time limit is generally within 30 days—or, if more time is needed, the provider must give the patient an explanation of why and then provide records within 60 days.
  • Some hospitals sought to grossly overcharge patients for records—quoted prices for records varied from free to over $500.
  • In some cases, hospitals were noncompliant with the law when it came to the format of records, telling researchers they could not get records in their desired format (email, CD or paper).

A Larger Problem

Does this problem of patients’ struggling to obtain their own medical records reflect a much larger transparency and accessibility problem in our complicated and convoluted healthcare system? The answer may be “yes.”

Consumers choosing health insurance and comparing plans often complain that it is difficult to understand what is covered, what isn’t covered, why it isn’t covered, and what they will actually have to pay out of pocket for different procedures. Because of the lack of transparency in the industry, finding clear and honest answers to these questions can be a real struggle. Also, information about the quality of care provided by different physicians, hospitals, nursing homes and healthcare facilities, isn’t easily accessible.

While some insurance and medical providers are starting to consider consumer transparency and publish quality and cost information and even quality metrics and cost calculators on their websites and elsewhere, the healthcare industry as a whole still has a long way to go when it comes to consumer transparency.

If you have run into difficulty with a healthcare provider you believe has caused you significant harm and you’d like to consider your legal options, we encourage you to contact Cirignani, Heller & Harman. Call us today for a free case evaluation.