Legal Pearls

Medical Records Cannot be Held “Hostage” for Unpaid Medical Bills

Ann W. Latner, JD
08/21/2024

  • The Background

    The patient had an open bill with the podiatrist, which his insurance refused to pay, and he attempted to appeal the decision by the health insurance company. After calling the office in September and October 2018 with no results and coming into the office in November to fill out a written request, the patient was finally told to “be patient” in December after he called again. By the end of January 2019, the patient’s patience had run out and he called the podiatrist again. This time, he was told that his bill was unpaid and that if he or his insurance didn’t pay the bill, the office would not release the medical records.

    The patient filed a complaint with the OCR which enforces HIPAA violations. The doctor’s officer received a “technical assistance letter” from the OCR advising him about the patient’s right to access his personal health information, that the request must be acted on within 30 days, and that the doctor could not withhold access on the grounds that a bill had not been paid.

    Despite this, when the patient went to the office in April 2019 to pick up the records, he was sent away empty handed. A month later, the patient filed a second complaint with OCR.

    The Resolution

    This time, OCR requested the physician submit evidence that either the violation did not occur or that it had taken prompt action to correct it. The doctor’s office did not reply. The OCR contacted the physician’s office several times in early July by phone and sent another letter to the office mid-month. Finally, the podiatrist’s office sent the patient his records—618 days after his written request. After an investigation, OCR determined that the podiatrist’s office had willfully neglected to provide the records to the patient and had not corrected their error after being informed of it and imposed a penalty of $100,000 on the office.

    The Bottom Line

    A patient’s medical records cannot be held hostage to compel the patient to pay a bill. A patient is always entitled to his or her own medical records.

    Ann W. Latner, JD, is a freelance writer and attorney based in New York. She was formerly the director of periodicals at the American Pharmacists Association and editor of Pharmacy Times.