QUESTION
can my primary care physcian withhold my medical records?
Asked on Dec 06th, 2013 on Medical Malpractice - Pennsylvania
More details to this question:
My primary care doctor is refusing to send my medical records to a new pcp I have chosen until I pay of a remaining co-pay balance. This has been going on for months and I am unable to pay the balance at this time. My husband lost his job 3 months ago aNd we are on public assistance currently. I believe my total balance is less than $100.00. My health has deteriorated drastically over the past 6-8 months and as a result of his refusal to send my records my new chosen PCP will not see me either until she receives them. I need medical care immediately. Is this legal for him to withhold my records and also refuse to see me until total balance is paid? Thank you so very much for any input! According to my pain management physcian this is not legal as I now need a referral to see them and cannot obtain one without my PCPs involvement. I am totally frustrated and as I mentioned need medical help and have needed medical help for months!
1 ANSWER
According to the Pennsylvania State Board of Medicine, the doctor cannot withhold your medical records for failure to pay for professional services. The FAQ's on the Board's website states: "Prior payment for professional services may not be required as a condition for making the copies available." See, http://www.dos.state.pa.us/portal/server.pt/community/state_board_of_medicine/12512, then click on FAQ's and see question and answer number 22. The website and FAQ's will also have helpful information regarding how to file a Complaint, if you decide to do such. In addition, HIPAA laws also prohibit medical providers from refusing to give you medical records for non-payment. See, http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/medicalrecords.html.
I recommend you make a formal request, in writing, including a timeframe for the records you want. Also, you can request the records to be certified, but that will cost a bit more. Likely an additional $25. However, that would "certify" that the records are complete. The doctor's office can charge you a reasonable fee for making copies, etc. of the records. In your formal request, you should states that both your State laws and HIPAA regulations prevent the denial of these records based on non-payment. If you still get denied, it might be time to contact a local personal injury attorney. Best of luck!
NOTE: This response is general in nature and should not be considered legal advice. No attorney-client privilege exists or is formed by this response.
Answered on Dec 10th, 2013 at 11:40 AM