The medical records correction process is heavily in favor of inaccurate records. I went through a convoluted and time-consuming ER records correction process that involved the Department of Health and Human Services. Though the record was highly erroneous, the hospital did not have to correct it. The process confused me about what rights a patient has to a corrected record. The HHS site doesn’t make it clear, and the HHS rep was not helpful. So I asked Chat GPT, which suggests there are some nice big loopholes for providers:
Me: Does federal law give me the right to a corrected medical record, and if so, are there any exceptions?
Chat GPT: Yes, federal law gives you the right to a corrected medical record under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. The Privacy Rule gives you the right to request that your healthcare provider make changes to your medical record if you believe that the information is incomplete or incorrect.
There are some exceptions, however. The Privacy Rule does not require a healthcare provider to make changes to your medical record if the information is accurate and complete, even if you disagree with the information. Additionally, the provider is not required to make changes to your medical record if the information was not created by the provider, unless the provider has the ability to amend the record.
In some cases, the provider may also deny your request for a correction if they believe that the information is accurate and complete, or if they believe that the information was created in good faith and in the course of providing healthcare services. If your request for a correction is denied, you have the right to submit a statement of disagreement that will be included in your medical record.
According to the HHS site:
“If you think the information in your medical or billing record is incorrect, you can request a change, or amendment, to your record. The health care provider or health plan must respond to your request. If it created the information, it must amend inaccurate or incomplete information.
If the provider or plan does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record.”
Chat GPT also wrote:
If you have requested a correction to your medical record under the HIPAA Privacy Rule and the healthcare organization has not taken action, you have a few options:
File a complaint with the Department of Health and Human Services (HHS): The HHS Office for Civil Rights (OCR) is responsible for enforcing the HIPAA Privacy Rule. You can file a complaint with the OCR if you believe that your healthcare provider has violated your rights under HIPAA. The OCR has the authority to investigate complaints and take action against providers who are not in compliance with the law.
Contact a patient advocacy organization: There are several patient advocacy organizations that can provide guidance and support in navigating the process of correcting medical records. These organizations can also provide information about your rights under HIPAA and offer resources for filing a complaint with the OCR.
Consult with an attorney: If you have been unable to resolve the issue through other means, you may want to consider consulting with an attorney who specializes in healthcare law. An attorney can help you understand your legal options and can represent you in court if necessary.
It’s important to keep in mind that correcting medical records can be a complex process, and it may take time to resolve the issue. Persistence and patience may be necessary to achieve the desired outcome.”
Who do I contact in HHS if OCR doesn’t answer questions or follow through on a medical records correction?
If you have filed a complaint with the Office for Civil Rights (OCR) and have not received a response or if the OCR has not followed through on a medical records correction, you may escalate your complaint to a higher level within the Department of Health and Human Services (HHS).
You can contact the HHS Regional Director for your area to escalate your complaint. The HHS Regional Director is responsible for overseeing the OCR’s activities in your region and can provide additional guidance on how to resolve your complaint.
To find the contact information for the HHS Regional Director in your area, you can visit the HHS website and search for “Regional Offices.” From there, you can select your state and find the contact information for the Regional Director in your region.
It’s important to note that the OCR is the primary enforcement agency for HIPAA, and the HHS Regional Director may refer your complaint back to the OCR for further investigation. However, escalating your complaint to the Regional Director may help to expedite the resolution of your issue.
So, in other words, much of the time, the best advice is to save yourself the trouble. Still, if it would help you feel like you have some agency, you can file a complaint here.