Posted by psych chat on November 3, 2009, at 22:07:27
In reply to My doctor won't release my records, posted by gibbons482 on November 3, 2009, at 18:26:16
It can get pretty complicated, and I believe there are some doctors who misinterpret HIPAA. I remember when the law was first enacted, there were certain cases where even general practitioners would not patients have a copy of their own records. There was no reason for this except the office staff would say "we can't give you a copy of the records due to HIPAA regulations". Well the regulation wasn't designed to protect people from finding out stuff about themself, to guard a patient's privacy from the patient-duh.
But-there are rules pertaining specifically to psychotherapy notes under HIPAA. Here is the code pertaining to that section:
Sec. 164.524 Access of individuals to protected health information.
(a) Standard: Access to protected health information. (1) Right of access. Except as otherwise provided in paragraph (a)(2) or (a)(3) of this section, an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a
designated record set, for as long as the protected health information is maintained in the designated record set, except for:(i) Psychotherapy notes;
etc.
http://edocket.access.gpo.gov/cfr_2002/octqtr/45cfr164.524.htm
You could contact HIPAA's Office of Civil Rights to inquire if there are other means to acquire them or to determine if your psychiatrist is in compliance:
http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
There are loopholes. In certain cases, they have to provide the notes to a "designated personal representative".
I believe they also have to provide them to an attorney (unsure if there has to be an ongoing suit-but you could always call a medical malpractice attorney and just ask the question).
I'm not an attorney, but I know there are loopholes to many laws and regulations-I'm not saying you can do this, but you can check into this further - I believe a state's regulation governing psychotherapy notes supersedes HIPAA's. For example, if a doctor believes the notes will cause harm (to you or another) and does not disclose them while still complying with HIPAA, certain states' codes may have a provision that mandates there must be reasonable evidence that the notes will cause harm; for example, direct threats or things you said. You could check your state's code by Googling.
Your doctor may also have to provide written notice concerning the denial of your records.
I'm not sure why he couldn't release the medication portion of your records-that may be unlawful to refuse to do that. However, there are also regulations concerning what constitutes psychotherapy notes and medical records, pertaining to how the records are organized, combined, and maintained.
I think you might find more answers by contacting HIPAA's Office of Civil Rights. They certainly would be more helpful than I would be. If you don't make progress with DHHS, you could contact an attorney and ask them how to get a copy. Another option would be to ask your new therapist about this. Tell your new therapist you don't want him or her to see the records, but you would like to get a copy for yourself. I wouldn't hesitate to ask my therapist about this if I wanted a copy of my records from another therapist. Some therapists don't even want to see prior records to maintain their objectiveness.
In the end, if you do get a copy of the psychotherapy notes, the copy you receive may not actually be the same set of notes the doctor has kept. Only the doctor would know. So it might not even be worth pursuing. Keep that in mind.
The psychotherapy notes provision does protect patients, doctors, and other people in certain cases, but sometimes the law is perverted by those having control over medical records. Maybe he thinks you are going to sue him?
poster:psych chat
thread:924334
URL: http://www.dr-bob.org/babble/psycho/20091022/msgs/924365.html