Both the HIPAA Privacy Rule and Tennessee law give you rights to your medical record. The HIPAA Privacy Rule sets standards that apply to records held by health care providers across the nation. Tennessee law sets standards for records held by health care providers within the state. If a standard is different under the HIPAA Privacy Rule than it is under Tennessee law, your health care provider must follow the law that is the most protective of your rights.

Summary of Your Rights

In Tennessee you have the right to:

See and get a copy of your medical record.
Doctors, dentists, and other health care professionals usually must let you see your medical record or give you a copy of it no more than 10 working days after receiving your written request. Hospitals must let you see your medical record or give you a copy of it without unreasonable delay, usually no later than 30 days after they receive your request.

In most cases, your health care provider is allowed to charge you for copies of your medical record. They can also charge you for postage.

Have information added to your medical records to make them more accurate or complete.

This right is called the right to amend your record. In some limited cases your health care provider can deny your request to amend your medical record. If your provider denies your request, you have the right to add a short statement to your record explaining your position.

• File a complaint.
  
  You have the right to file a complaint with the Office for Civil Rights, U.S. Department of Health and Human Services if you believe your health care provider has violated your right to see, get a copy of, or amend your medical record. You can also file a complaint with the state agency that regulates your health care provider.

• You have the right to sue in state court if your hospital violates your rights under Tennessee law.
  
  You have the right to sue your hospital in state court if it violates Tennessee laws that give you the right to get a copy of your medical record. You might have the right under state law to sue a doctor or other health care practitioner for such violations.

You can learn more about these rights in the following sections of this guide.

Who Has to Follow These Laws?

Most Tennessee health care providers (such as medical doctors, chiropractors, and hospitals) must follow both the HIPAA Privacy Rule and state laws that give patients rights in their medical records.

There are some health care providers, however, that do not have to follow the HIPAA Privacy Rule. The HIPAA Privacy Rule only applies to health care providers that use computer technology to send health information for certain administrative or financial purposes (such as filing claims for insurance).

Sometimes Ashley goes to a doctor at a free clinic for medical treatment. The doctor does not accept private insurance, Medicaid, or Medicare. The doctor does not file any insurance claims. Ashley’s doctor probably does not have to follow the HIPAA Privacy Rule. This is because the doctor does not appear to send health information for the types of administrative or financial purposes that would make her a covered health care provider under the HIPAA Privacy Rule. 

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If you have questions about whether your health care provider must follow the federal HIPAA Privacy Rule, you can contact the Office for Civil Rights, U.S. Department of Health and Human Services (OCR), the agency that is in charge of enforcing the HIPAA Privacy Rule. Section 4 of this guide lists contact information for OCR.

What happens if my provider does not have to follow HIPAA?

Even if your provider does not have to follow the HIPAA Privacy Rule, they still have to follow Tennessee laws that give you rights to your medical record. Section 6 lists some resources where you can read these state laws.

This guide, however, only explains how to get your medical record from Tennessee providers who have to follow the HIPAA Privacy Rule and state law.

What Records Do I Have the Right to Get and Amend?

You have the right to see and get a copy of your medical record. This right is often called the right to access your record. You also have the right to correct your medical record by having information added to it to make it more complete or accurate. This right is called the right to amend your record. (This guide will call these rights the right to "get and amend.")

Your medical record includes such things as:

• Information that identifies you, such as your name and Social Security number.
• Information that you tell your doctor or health care provider, such as:
  • Your medical history.
  • How you feel at the time of your visit.
  • Your family health history.
• The results of your examination.
• Test results.
• Treatment received in a hospital.
• X-rays, records made by heart monitors, and similar items.
• Medicine prescribed.
• Notes your doctor makes about you.
• Other information about things that can affect your health or health care.

You have the right to see, get a copy of, and amend these records whether they are kept on paper, on a computer or in another format.

Do I have the right to get and amend records about my mental health treatment? Maybe. The rules for when you can get and amend your records related to mental health can be different. For example, psychotherapy notes are treated differently than other records under the HIPAA Privacy Rule. Because the rules for mental health records can be different they are not discussed in this guide. You can find some resources about your rights in these types of records in Section 6.

What happens if my medical record has information in it that came from a different health care provider?

Generally, if your provider has the medical information that you request, they must give it to you. You have the right to get the information no matter who originally put it in the record. Your right to amend this information may be limited, though. For more information about to amend information in your record you can read Section 3 of this guide.

Who Has the Right to Get and Amend My Medical Record?

You have the right to see and get a copy of medical records that are about you. You also have the right to correct medical records that are about you by having information added to them. (This guide calls these rights the right to "get and amend" your medical record.) If there is someone who acts as your personal representative, they usually have the right to get and amend your record on your behalf. Generally, a personal representative is a person who has the legal right to make health care decisions on your behalf.

Do I have the right to get and amend my minor child’s medical records?

Usually, yes. As a parent or guardian, you usually have the right to get and amend your minor child's medical record. In Tennessee, parents generally have these rights when a child is younger than 18 years old.

As a parent, do I always have the right to get and amend my child’s medical record?

No. A parent does not always have the right of access to a minor child’s medical record. For example, when a provider reasonably believes that a parent is abusing or neglecting a child, the provider does not have to give the parent access to the child’s medical record.

Some other situations where parents do not have the right to get and amend their child’s medical records are discussed in the following questions and answers. 

Who has the right to get and amend my child’s medical record once she turns 18?

Once your child turns 18, she has the right to get and amend her own medical record. This includes the right to get records that were created when she was still a minor. Once your child turns 18, you usually no longer have the right to get and amend her medical record just because you are her parent.

I am under 18 and am emancipated. Who has the right to get and amend my medical record?

In Tennessee, if you are under 18 and emancipated, you have the right to consent to your own medical treatment. You also have the right to get and amend medical records that are related to treatment for which you have given consent.

I am an unemancipated minor but I can legally consent to certain kinds of medical treatment without my parents’ permission. Who can get and amend my records that are related to this treatment?

Under Tennessee law, as an unemancipated minor you can consent to certain types of medical treatment without the permission of your parents. For example, unemancipated minors in Tennessee do not need parental consent for the following treatments:

• Contraceptive procedures, supplies and information
• Prenatal treatment
• Treatment of a sexually transmitted disease

When you consent to these treatments, you have the right to get and amend your medical record related to this treatment. According to the Tennessee Medical Association, doctors in Tennessee may not give parents access to medical records related to treatment for which minors have lawfully given their consent.

The rules may be different when you, as a minor, obtain treatment from other providers or obtain other sorts of testing or treatment without parental consent.

If you have questions or concerns about whether your parent will have access to your medical information, you should talk to your health care provider.

My mother named me as her health care agent in her appointment of health care agent form. Do I have the right to get and amend her medical records?

Yes. If you are your mother’s health care agent, you generally have the right to get and amend the part of her medical record that is relevant to making health care decisions on her behalf, unless the appointment of health care agent form limits your access. You have these rights for as long as you have the authority to act as her health care agent.

Maria’s mother signed an Appointment of Health Care Agent form. (This form is also known as a Durable Medical Power of Attorney form.) If Maria’s mother is not able to make decisions about her health care, this form gives Maria the power to make such decisions. The form does not limit the agent's ability to obtain medical information or records. Maria’s mother was in a bad accident and is not able to make decisions about her health care. Maria now has the right to make decisions on her mother’s behalf. She also has the right to get and amend medical records that are relevant to making these decisions. For example, Maria has the right to see the records about her mother’s current medical condition and treatment.

Maria is curious about the time her mother had a miscarriage. Maria wants to look at these old medical records. Maria does not have the right to get and amend these old medical records because the records have nothing to do with her mother’s current condition or treatment.

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It depends. You do not have the right to get a deceased person’s medical records just because you are a close relative of theirs. You have the right to get a deceased person’s medical records from a Tennessee health care provider if you are the personal representative (such as the executor or administrator) of the deceased person's estate.

How Long Does My Provider Have to Keep My Medical Record?

Tennessee law requires many health care providers to keep medical records for a specific period of time. For example, doctors and hospitals must keep most medical records at least 10 years after their last professional contact with you. Doctors and hospitals must keep minors’ medical records for at least 10 years after their last professional contact or until the minor is 19 years old, whichever is longer. Some records, such as original x-rays and mammograms, are subject to different rules.

You have a right to get and amend your medical record for as long as your health care provider has it.