As discussed in my post "New Texas Privacy Law Increases Privacy Protections and Physician Cyber Liability Risks", Texas House Bill 300 (HB 300) strengthens protection of patients' electronic health information in Texas beyond HIPAA and becomes effective on September 1, 2012. Through a series of blogs I am illustrating a variety of these new protections. Today we contrast a patient's right to access their electronic health record (EHR) under HIPAA against HB 300 requirements in Texas. Case history:
A patient alleged that a physician failed to provide him access to his electronic medical record within 30 days of a written request as required by HIPAA. After the Office of Civil Rights (OCR) notified the physician of this allegation, he provided the records but charged the patient a $100.00 “administrative fee” because the patient was delinquent on bills. HIPAA permits only a reasonable cost-based fee (copying and postage) with an explanation or summary if agreed to by the individual. To resolve this matter, the physician refunded the $100.
When state and federal privacy laws diverge, the more protective law prevails. In Texas HB 300 combined with other state laws are more protective than HIPAA such as with a patient’s right to access their electronic health records (EHRs). HB 300 mandates physicians who use EHRs to provide patients the requested record in electronic form not later than 15 business days after receiving a written request unless there is an allowable exception. The EHR may be provided in another format if the physician’s EHR is incapable of producing an electronic copy or if agreed upon by the patient in advance. Physicians in Texas should align with HB 300 by revising policies on patient access to their EHR and updating their Privacy Notice as needed.
Physicians should also consider purchasing cyber liability insurance (or increasing current liability limits) and consulting with their Regional Extension Center, such as the North Texas Regional Extension Center (NTREC), about assistance with security risk analysis and management.
More on other HB 300 provisions next week...