As a patient, you have the right to access and obtain a copy of your medical records from a hospital in the state of New Jersey. These records are crucial for understanding your health history, making informed decisions about your care, and seeking second opinions. To protect your rights and ensure smooth access to your medical records, it is essential to be aware of the regulations governing this process. In this blog, we will highlight the most important things you need to know about obtaining a copy of your records under the guidelines of New Jersey law(N.J. Stat. § 26:2H-5n).
Who Can Request Medical Records?
The following individuals are authorized to request medical records:
- Patients: You have the right to request your own medical records. This includes both electronic and paper records.
- Legally Authorized Representatives: If you are unable to request your records personally, your legally authorized representative can act on your behalf. This may include your spouse, domestic partner, civil union partner, immediate next of kin, legal guardian, attorney, automobile insurer, or worker’s compensation carrier (limited to relevant records for a specific claim).
- Authorized Third Parties: A third party, with a valid authorization, subpoena, legal process, or court order, may request access to a patient’s medical or billing records.
Timelines for Obtaining Medical Records
Upon receiving a written request for medical records, the hospital must provide a legible paper or electronic reproduction of the requested records within 30 days. However, if you request your own medical records in accordance with the federal “Health Insurance Portability and Accountability Act of 1996” (HIPAA), the time requirements specified in 45 C.F.R. 164.524(b) will apply.
Fees for Obtaining Medical Records
The fees for reproducing medical records are regulated as follows:
- Patients and Legally Authorized Representatives: If you or your legally authorized representative request a medical record, the fee for reproducing the record should not exceed $1 per page or $50 per individual admission record, whichever is less. Additionally, the fee for reproducing a medical record should not exceed $50 per individual admission or patient record, excluding any additional fees.
- Billing Records: Hospitals cannot charge any fee for providing an electronic or paper reproduction of a billing record requested by a patient or their legally authorized representative.
- Authorized Third Parties: For requests made by authorized third parties, the fee for reproducing medical and billing records not stored on microfilm or microfiche should be no more than $1 per page. For records stored on microfilm or microfiche, the fee should be $1.50 per image.
- Special Materials: If the requested materials, such as x-rays or other non-standard documents, cannot be routinely copied, the hospital may charge a fee. This fee should not exceed $15 per printed image or $30 per compact disc (CD) or digital video disc (DVD), in addition to an administrative fee of $10.
Additional Charges and Policies
In addition to per-page fees, the hospital may apply the following charges:
- Search Fee: A search fee of no more than $20 per request may be charged, except when a patient requests their own record. This fee applies even if no medical records are found as a result of the search.
- Certification Fee: The fee for certifying a copy of a medical record should not exceed $10 per certification.
- Delivery Costs: The hospital may charge costs for delivering records in any medium, plus applicable sales tax.
Access for Patients with Financial Hardships
Hospitals are required to establish a policy ensuring access to copies of medical records for patients who cannot afford the fees. These policies aim to ensure that even individuals with financial constraints can access their essential medical information.
Access Restrictions and Denials
While patients have the right to access their medical records, access may be limited if necessary to protect the patient. If a denial of access occurs, the attending physician must provide a verbal explanation for the denial and document it in the medical record. However, if direct access to a copy is medically contraindicated, the hospital cannot restrict access solely to the attending physician or other authorized representatives.
Exemptions from Fees
Certain individuals and organizations are exempt from paying fees for obtaining medical records. These include patients who lack the ability to pay and provide proof of eligibility for or enrollment in state or federal assistance programs. Not-for-profit corporations representing patients, health care practitioners, pro bono attorneys (with certification), and patients or attorneys with pending or receiving federal Social Security disability benefits are also exempt from fees.
Understanding your rights as a patient regarding the acquisition of medical records is crucial for maintaining control over your healthcare. In the state of New Jersey, the law provides clear guidelines on the process of obtaining medical records from hospitals. By familiarizing yourself with New Jersey law, (N.J. Stat. § 26:2H-5n), you can confidently exercise your rights to access and obtain copies of your medical records, ensuring that you have the necessary information for informed decision-making and continuity of care.