How to find old medical records from doctor who has retired

How Can Patients Get Medical Records from a Closed Medical Practice? – The Health Care Blog

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Oct 8, 2020• 21

By GRACE CORDOVANO, DEVEN McGRAW, and AARON MIRI

The HIPAA Privacy Rule gives patients the right to copies of their medical records, with rare exceptions. When patients need a copy of their medical records, most start the process by calling their doctor’s office and asking for how to get access. The receptionist or office staff point them in the right direction, whether it’s instructing them to write down their request and sending it to the office, pointing them to contact the medical records or radiology department (if the practice is large enough), or assisting them in setting up their patient portal, if the practice is using an electronic health record (EHR). Being able to connect with a person inside the four walls of medicine is often crucial for many patients and their carepartners who may be unsure of exactly how to request their records.

But what happens to those records when a doctor closes or leaves the practice?

Independent practices close for a variety of reasons. Physicians may merge with a large practice or health system, retire, they may sell or close their practice for personal reasons, they may file for bankruptcy, or they may get sick and die. The COVID19 pandemic has had devastating financial consequences on many small, independent, and rural practices, leading to their consequent closure, acquisition, or merger.

What should patients do when their doctor’s office closes, and they need a copy of their medical records? This is especially challenging when a doctor may not have had an EHR, as is the case with many independent practices as well as more rural settings. On September 26, 2020, a tweet from Cait DesRoches, Executive Director of OpenNotes, inquired about how a family member may get access to medical records from her physican’s practice that closed, triggering a robust conversation that led to the realization that patients and families are not well informed in these circumstances.

Prevention is Worth a Pound of Cure

It can be much more difficult to get copies of records after a practice has closed. Patients should get copies of their medical records as they are generated instead of waiting until they’re needed. HIPAA Privacy Rule guidance states that individuals can get digital copies of digital information (or even digital copies of records kept on paper, as long as the practice has a scanner). Companies are developing tools and services that enable individuals and their care partners to collect, use, and store health records. Request digital (or paper, if that is preferred) copies of blood work, imaging, discharge instructions, and corresponding reports before you leave the practice.

What Happens to Medical Records When Offices Close? The Law

The Health Insurance Portability and Accountability Act (HIPAA) does not require a physician to retain medical records for any particular period of time. (HIPAA covered entities – which include physicians who bill health insurers for care – are required to keep records demonstrating compliance with HIPAA for at least six years – but those records are distinct from medical records. ) However, if the physician still has those medical records – or has placed them in storage for safekeeping – the HIPAA requirements to produce them when a patient requests still apply.

State laws typically set medical record retention requirements for physicians and may also require the physician to take particular steps (such as notifying a patient) prior to or upon closure of a practice.

An example of some of these state laws:

In California, physicians must notify patients in advance of closure of the practice, and are still responsible for safeguarding records and making sure they are available to patients. The California Medical Association recommends physicians keep records for at least ten years from the last date the patient was seen.

New York requires that medical records be retained for six years from the date of the most recent entry in the record, and patients are required to informed when a practice closes.
Virginia prohibits the transfer of medical records as part of the closure or sale of a practice until the provider has first attempted to notify by the patient by mail or by publishing notice in a newspaper of general circulation in the area.
Texas law requires physicians to keep records for a minimum of seven years after the date of last treatment, and physicians leaving a practice are required to notify patients.

During the record retention period, these records are considered to be still “available” and subject to the HIPAA right of access. Consult the medical board or the state medical society in the state where the physician has practiced for further information about physician requirements in the event of closure of a practice. The Medical Board should also have information about how to file a complaint if the physician’s practice has closed without any notice or information about how to obtain records.

Irrespective of legal requirements, the American Academy of Family Physicians recommend that patients be notified by a letter that the office is closing, giving them the opportunity to obtain a copy of their medical records or have records forwarded to a physician of their choosing. The office may post an update on their website or social media page(s), if ones exist or run an ad in the local newspaper. Patients should be notified who will be the custodian of the medical records and their contact information.

Sorry! The Office Is Closed

Unfortunately, the reality is that most individuals do not get copies of their medical records throughout their care journey. This leaves patients and carepartners in need of records facing significant uncertainty, stress, and frustration when they unexpectedly find out that their doctor’s office has closed. Here are a number of critical tips to assist patients in gathering their medical records, directly and indirectly, in the event their doctor’s office has closed.

It is helpful to know when the office may have closed: was it recently or many years ago? As noted above, state laws govern how long records must be retained as well as how they must be handled with respect to confidentiality, privacy, and how they may be destroyed, when and if needed. Typically, records that are about 10 years from the last documented encounter, may be candidates to be destroyed and may be more difficult to obtain as a copy. (As noted above, state laws may allow for them to be destroyed even sooner than 10 years.)

Individuals should refer to the letter they may have received notifying them of the office closing and contact the designated records custodian. Updates may also have been posted to the physician or practice’s website or social media page, if available. The local librarian may assist with researching for the office closure notice in archived newspapers or posts in the public domain.

Insurance companies, current and previous, should be contacted to request any claims that may have been received from the specific physician or provider’s practice. A supervisor should be requested and relayed specific information about the health information needed and why is it critical for one’s care. In the event individuals are encountering difficulty getting traction over the phone, individuals may turn to social media for help. If the respective insurance company has a Twitter account, individuals may tweet their request while including the insurance company’s Twitter handle. Social media managers are often very responsive and may be an additional avenue for connecting individuals to the information they need if it is perceived that delays in response may be detrimental to their company’s reputation.

Is there another doctor or professional now at the same physical office/facility location? Individuals should address the request in-person or via a call. The new office staff often receive many of the same questions from other previous patients and may have contact information for a point person on hand. They may also have the records in question if the practice was acquired (where applicable).

Individuals should contact their local chamber of commerce, borough hall, or local Department of Health. If the office closure was recent, someone may know a way to connect with the doctor or a former staff member for more information.

Did the doctor have other doctors on staff? If so, individuals may search for the other doctors who may still be in practice at another location to see if they may have a contact for where records have been retained.

Individuals may quickly determine if their doctor is on social media, such as LinkedIn, Twitter, and Facebook, and respectfully direct message them with their request for more information.

Individuals may search the internet for any recent press releases that may feature the doctor’s work, activism, or research and contact the respective article’s author or journalist. At minimum, they may be willing to forward the request for records to the doctor.

If individuals need specific information on medications, they may contact the pharmacy that was used to fill respective prescriptions so as to request copies of prescription records.

Individuals should contact their primary care doctor, and other members of their care team, to see if records were forwarded to them for continuity of care purposes.

If an individual’s doctor is deceased, the state medical licensing board may be contacted to determine the care provider’s county of residence. Consequently, the specific state’s county probate court may be contacted to confirm if there is a designated executor of estate that has authority over records retention processes. Alternatively, an obituary may list surviving next of kin which may also be contacted for more information on records retention.

If medical records were available digitally, individuals may look up their state and “health information exchange (HIE)”. An HIE is a secure network that supports the electronic exchange of patient health information among trusted data entities typically across an entire state. Individuals should research if there is an HIE that may serve their local area. An HIE’s website will have a phone number and email to contact directly with your request.

If imaging was performed, individuals may reach out to the respective imaging center or the location where imaging was done to request copies of images on CDs and the corresponding reports.

If bloodwork was performed, individuals may contact the lab, such as Quest or LabCorp, that processed the tests directly for copies of final lab reports. Individuals may contact their insurance company, current or previous, if they are unsure of the names of the labs that may have been in-network via their plan; individuals can also use their right of access to get copies of claims from their health plan, which may identify the lab that processed the tests.

If individuals are in need of immunization records they may contact their state Department of Health as they may have an immunization registry. The Immunization Action Coalition also has information on locating immunization records.

If individuals are working within the framework of a specific diagnosis or condition, they may research non-profits that support patients within that specific disease state and reach out for peer health support, where other individuals diagnosed with the same condition may also be able to assist in navigating these barriers to patient access based on their own lived experiences.

A state’s medical board, Office of the Attorney General (AG) and state’s Department of Health are all resources for additional support.

Individuals may also file a complaint with the Office of Civil Rights (OCR) at the Department of Health and Human Services (HHS) if all efforts have been exhausted and the needed medical records have not been obtained.

A closed practice does not need to be a dead end for patient access. Proactively requesting copies of medical records throughout one’s care journey can prevent encountering such patient access barriers. Continuing to share best practices for navigating patient access barriers, from legal, regulatory, and practical standpoints, is in the best interest of all patients.

Grace Cordovano, PhD, BCPA is a board-certified patient advocate specializing in the oncology space, a patient experience enhancer, and information unblocker.

Deven McGraw , JD, MPH, LLM (@healthprivacy) is the Chief Regulatory Officer at Ciitizen (and former official at OCR and ONC). She blogs at ciitizen.com.

Aaron Miri is the Chief Information Officer for The University of Texas at Austin comprising of the Dell Medical School, UT Health Austin clinical enterprise, research, and community impact missions.

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Categories: Uncategorized
Tagged as: Aaron Miri, Deven McGraw, Grace Cordovano, Health Data, HIPAA, Medical Records

Access Records | MBC
California Health & Safety Code section 123100 et seq. establishes a patient's right to see and receive copies of his or her medical records, under specific conditions and/or requirements as shown below. The law only addresses the patient's request for copies of their own medical records and does not cover a patient's request to transfer records between healthcare providers or to provide the records to an insurance company or an attorney. The request to transfer medical records is considered a matter of "professional courtesy" and is not covered by law. No statutes cover record transfers and there is no set protocol for transferring records between providers. Generally, physicians will transfer records without charging a fee; however, some doctors do charge a fee associated with copying and mailing the paperwork. Physicians will require a patient to sign a records release form to transfer records.
If you have followed the requirements outlined in the Health & Safety Code and the physician has not complied with your request, you may file a complaint with the Medical Board. Please include a copy of your written request(s). The physician will be contacted to determine the reason for failing to provide you with access to your medical records.
Section 123110 of the Health & Safety Code specifically provides that any adult patient, or any minor patient who by law can consent to medical treatment (or certain patient representatives), is entitled to inspect patient records upon written request to a physician and upon payment of reasonable clerical costs to make such records available. The physician must then permit the patient to view their records during business hours within five working days after receipt of the written request. The patient or patient's representative may be accompanied by one other person of their choosing. Prior to inspection or copying of records, physicians may require reasonable verification of identity, so long as this is not used oppressively or discriminatorily to frustrate or delay compliance with this law.
The patient or patient's representative is entitled to copies of all or any portion of their records that he or she has a right to inspect, upon written request to the physician. The physician may charge a fee to defray the cost of copying, not to exceed 25 cents per page or 50 cents per page for records that are copied from microfilm, along with reasonable clerical costs. By law, a patient's records are defined as records relating to the health history, diagnosis, or condition of a patient, or relating to treatment provided or proposed to be provided to the patient. Physicians must provide patients with copies within 15 days of receipt of the request.
According to subdivision 123110(d) of the Health and Safety Code, the patient, patient’s representative, or an employee of a nonprofit legal services entity representing the patient is entitled to a copy at no charge of the relevant portion of the patient’s record upon presenting the provider a written request and proof that the records, or supporting forms, are needed to support a claim or appeal regarding eligibility for a public benefit program, a petition for U nonimmigrant status under the Victims of Trafficking and Violence Protection Act, or a self-petition for lawful permanent residency under the Violence Against Women Act. The requestor is entitled to no more than one copy of any relevant portion of their record free of charge. This does not apply to any patient represented by a private attorney who is paying for the costs related to a patient’s claim or appeal, pending the outcome of that claim or appeal. “Private attorney” means any attorney not employed by a non-profit legal services entity. (Health and Safety Code section 123110(d)(3)).
Effective January 2021, Health and Safety Code section 123114 was added establishing that a healthcare provider shall not charge a fee to a patient for filling out forms or providing information responsive to forms that support a claim or appeal regarding eligibility for a public benefit program.
The public health benefit programs include Medi-Cal; the In-Home Supportive Services Program; the California Work Opportunity and Responsibility to Kids (CalWORKS) Program; Social Security Disability Insurance benefits; Supplemental Security Income/State Supplementary Program for the Aged, Blind and Disabled (SSI/SSP) benefits; federal veterans service-connected compensation and nonservice-connected pension disability; CalFresh; the Cash Assistance Program for the Aged, Blind, and Disabled Legal Immigrants; and a government-funded housing subsidy or tenant-based housing assistance program.
Copies of x-rays or tracings from electrocardiography, electroencephalography, or electromyography do not have to be provided to the patient or patient's representative if the originals are transmitted to another health care provider upon written request of the patient and within 15 days of receipt of the request. A patient may request to purchase copies of their x-rays or tracings. All reasonable costs, not exceeding actual costs, may be charged to the patient or patient's representative.
A physician may choose to prepare a detailed summary of the record pursuant to Health & Safety Code section 123130 rather than allowing access to the entire record. This summary must be made available to the patient within 10 working days from the date of the patient's request. If more time is needed, the physician must notify the patient of this fact and the date that the summary will be completed, not to exceed 30 days between the request and the delivery of the summary. If the patient specifies to the physician that he or she is interested only in certain portions of the record, the physician may include in the summary only that specific information requested. The summary must contain information for each injury, illness, or episode and any information included in the record relative to: chief complaint(s), findings from consultations and referrals, diagnosis (where determined), treatment plan and regimen including medications prescribed, progress of the treatment, prognosis including significant continuing problems or conditions, pertinent reports of diagnostic procedures and tests and all discharge summaries, and objective findings from the most recent physician examination, such as blood pressure, weight, and actual values from routine laboratory tests. The summary must contain a list of all current medications prescribed, including dosage, and any sensitivities or allergies to medications recorded by the physician.
If the patient specifies to the physician that he or she is interested only in certain portions of the record, the physician may include in the summary only that specific information requested. The summary must contain information for each injury, illness, or episode and any information included in the record relative to: chief complaint(s), findings from consultations and referrals, diagnosis (where determined), treatment plan and regimen including medications prescribed, progress of the treatment, prognosis including significant continuing problems or conditions, pertinent reports of diagnostic procedures and tests and all discharge summaries, and objective findings from the most recent physician examination, such as blood pressure, weight, and actual values from routine laboratory tests. The summary must contain a list of all current medications prescribed, including dosage, and any sensitivities or allergies to medications recorded by the physician.
There are some exceptions to the absolute requirements shown above: a physician may refuse the request of a minor's representative to inspect or obtain copies of the minor's records if a physician determines that access to the patient records requested by the representative would have a detrimental effect on the physician's professional relationship with the minor patient or the minor's physical safety or psychological well-being.
A physician may refuse a patient's request to see or copy their mental health records if the physician determines there is a substantial risk of significant adverse or detrimental consequences to the patient if such access were permitted, subject to the following conditions:
The physician must make a written record and include it in the patient's file, noting the date of the request and explaining the physician's reason for refusing to permit inspection or provide copies of the records, including a description of the specific adverse or detrimental consequences to the patient that the physician anticipates would occur if inspection or copying were permitted.

The physician must permit inspection or copying of the mental health records by a licensed physician, psychologist, marriage and family therapist, or clinical social worker designated by the patient. These healthcare providers must not then permit inspection or copying by the patient.

The physician must inform the patient of the physician's refusal to permit the patient to inspect or obtain copies of the requested records, and inform the patient of the right to require the physician to permit inspection by, or provide copies to, the health care professionals listed in the paragraph above. The physician must indicate in the mental health records of the patient whether the request was made to provide a copy of the records to another healthcare professional.

Frequently Asked Questions - Medical Records

Lawyer Kiktenko told how long it is necessary to keep certificates from the bank

yesterday at 05:06 Economy 7108

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Konstantin Kiktenko, lecturer at the Faculty of Law at the National Research University Higher School of Economics, indicated in an interview with Prime how long old documents should be kept.

Passport, birth, death, marriage certificates, TIN, medical and pension insurance certificates must be “kept forever,” the specialist emphasized.

You shouldn't get rid of real estate documents either, despite the fact that all the data is in the USRN, in an electronic database.

After closing a mortgage or other loan, certificates from the bank must be kept for at least three years. Kiktenko warned that, nevertheless, even after a three-year limitation period, questions may arise in a client of a financial organization.

Receipts for housing and communal services should be kept for three years, checks for goods - for two weeks. Only within this period can a refund be made. Electronics purchase contracts should be kept for at least three years or until the end of the warranty period, which is indicated..

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22 Available to students

Planning and organizing workflow. Team management. Achievement of pharmacy targets. Posting…
The vacancy suits you if you have one. Education "Pharmacist" or "Pharmacist". Valid certificate of accreditation…

In the company there is still 1 similar vacancy

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March 15

Driver-expedition category E

from 100,000 ₽/watch 21 days

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residents

9000 9000 WATTER

Available for applicants aged 45+

Transportation of goods (consumer goods, food, etc. ) in Moscow and the Moscow region. Work with transport documents for…
Responsibility, punctuality, courtesy, mobility. Experience as a driver-forwarder in category E (CE). Desire…

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March 15,

Doctor-therapist

from 70 000 ₽/month

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Diagnostic Center Temryuk

Moscow

Available for applicants from 45+ years 9000
to collect complaints, anamnesis life and illness of the patient and analyze the information received. Analyze received…
Higher medical education. Possession of a valid specialist certificate: "Therapy". Good PC knowledge. Experience in the specialty ...

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March 15

Welder (electric arc)

by agreement

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LLC "Modern Transport Technologies"

Moscow

District

Available for 45+ years 9000
available for applicants with disabilities

Welding of metal structures and structures
NAKS certification. From 4th digit

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March 15,

Operator on the phone (incoming calls, schedule of a day after two)

from 40 000 ₽/month

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Medical holding

Moscow

Khoroshevskaya

9000 9000 9000
No experience needed

Remote work

Handling incoming calls. Consulting. Call distribution. Entering information into the database
A wide range of areas: Medicine, Banks, Internet stores, Education and many others. To become successful in our company…

In the company there are still 1 similar vacancy

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9000 3

people

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March 15,

Electrician for electrical equipment

45 000 ₽/month

Add to the state 14

Moscow

Kuntsevskaya

and 2 more stations

Available for applicants aged 45+

Maintenance and control of electrical equipment. Repair of electrical equipment
Electrical safety up to and above 1000V

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March 15

Food semi -finished products

from 47 000 ₽/month

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Snezhana+D

Moscow
NECTION FIVE

Experience. Experience. Experience. Experience

Available to applicants aged 45+

Prepare vegetables for work. Watch the process of machine cleaning vegetables. Lead the processing of raw materials in the manufacture ...
Desire to work in production. For foreign citizens, THE WHOLE PACKAGE OF DOCUMENTS and registration in Moscow are MANDATORY

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1

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March 15

Dresser

33 000 ₽/month

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9000 minutesKropotkinskaya

8 minutesPark Kultury

No experience needed

Available for applicants aged 45+

Cleaning the territory of the serviced facility (including lawns and flower beds). Keeping assigned area clean for…
Citizenship of the Russian Federation

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March 15,

Seller

30 000 ₽/month

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Moscow

1 minimum minimum of the Grove

Experience is not needed for applicants from 45+++ years

Select the right size for customers and help with fitting. Work with the cashier. Tell about new arrivals and promotions
Experience in retail is desirable, but candidates without experience can be trained. Communication skills and willingness to help. Responsibility…

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5

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March 15

Engineer MTO

50 000 ₽/month years

Organization of the purchase, delivery, storage and use of equipment and materials according to the profile of the company - cleaning ...
Responsibility, willingness to learn.
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