Georgia lives in a nursing home and she wants to see her medical records. Can her doctor refuse to allow her to read her medical chart? John wants to change doctors. He has requested a copy of his medical chart. The doctor's office told him they will send a copy to his new doctor, but they will not give it directly to him.

When do you have the right to see your medical chart, or to get copies? When can you see your elder's chart and get copies?

A patient's right to see and obtain copies of his or her medical chart is covered by the Health Insurance Portability and Accountability Act off 1996 (HIPAA). This is the same law that requires you to give permission before your doctor and your hospital may share your medical information with some others. Although it's called the "Health Insurance Portablility, etc., etc." HIPAA also applies to your medical records and privacy.

HIPAA requires that your doctor permit you to see your medical records in the doctor's office.

It also requires that your doctor and your hospital give your medical records directly to you if you request them. However, it does not require that these records be made available immediately at the time you ask.

If you asked to read your records, your health care provider must arrange a convenient time and place for you to do so. If you requested a copy, your provider must either send it to the address you have specified or permit you to pick up your copy.

Most medical offices and facilities will provide information about how to get your medical records on the "Notice of Privacy" that they request you to sign as a new patient. Most require that you complete their written request for records form. You will usually be best served if you use their form whenever you can, as trying to change procedures often confuses office personnel.

According to HIPAA regulations they are permitted to charge you a "reasonable" fee for copying your records and for postage (but not for locating the records). If you have requested a summary of your medical records instead of the full medical chart, the doctor or facility may charge you for preparing the summary.

They may not charge you for the time and labor of searching and retrieving the information.and they may have as long as 30 days to provide you with a copy. The law allows for that 30 days to be stretched to 60 days in some circumstances, but they must give you an explanation for the delay.

Under the rules of HIPAA there is one circumstance under which a doctor may refuse to provide you with all of the information in your medical record: If the doctor believes that having access to certain information in your medical chart may endanger you or someone else, he or she may withhold this information. In particular this rule generally applies to mental health professionals.

In some cases your doctor may not have a particular record in which you have an interest. If you saw a specialist, your primary doctor will probably have only a summary report. You will have to go to the individual specialist for those records. If you had x-rays, a CT scan or other radiologic procedures, your doctor likewise will usually have only a summary report from the radiologist. If you need a copy of the actual films you will have to request these from where you had the procedure done, and you will have to pay for these separately.

If you are trying to see the medical records of your elder, if you haven't been appointed Guardian you will have to have either a properly executed Power of Attorney For Health Care or a Release of Information form signed by your elder. The Release of Information form must specify that you have the right to read and obtain your elder's medical records. Depending on how it is written, your Power of Attorney document may specify that your elder must have been declared incompetent before it can be used. All in all, the Release of Information form is often easier to use.

If you want to review the medical record of someone who is deceased, it can usually be obtained if you are either the executor or trustee of the estate, or if you are next of kin.

While the federal HIPAA laws apply to all the states, if an individual state has a more restrictive law, then the state law prevails. For instance, although HIPAA permits 30 days for fulfillment of a request for a review or copies of a medical record, some states specify a shorter period. In this case, the shorter period is the law.

Georgetown University has generously made available a compilation of state laws concerning medical records so you can look up the Medical Records law where you live. Find your state on the right side of the page.