In the past, state law has governed the procedures by which patients can access and amend their medical records. The recent implementation of the HIPAA Privacy Regulations substantially altered this legal framework. After HIPAA, patients' access to and ability to amend their medical records will be governed by a combination of state and federal law. Currently, there are no readily available resources for consumers to consult to determine their rights under this combined regulatory scheme. The objective of this study is to create reference materials that will explain in practical terms the interaction of the HIPAA Privacy Regulations with state laws governing patients' rights to access and amend their health information. The audience for these reference materials will consist of health care consumers, consumer advocacy groups, and providers in small group practices. We plan to identify current state laws governing patients' rights to access and amend their medical records that are maintained by doctors and hospitals. We will then conduct a preemption analysis, comparing the state law provisions to the comparable requirements of HIPAA and determine which laws control. Using this information, we will draft a separate guide for each state and territory that will explain in practical terms the procedures for patients' obtaining and amending their medical records. Working one state at a time, we will use existing resource materials and legal search engines to identify pertinent state laws. We will use a matrix to compare each state's laws with the requirements under HIPAA. Using the standards set out in HIPAA we will determine which state laws are preempted by HIPAA and which remain in effect. We will then determine how a doctor or hospital can comply in practice with the resulting combination of federal and state laws. We will create a master template for the guides, altering the template as necessary to reflect the practical procedures in each state. We will produce a separate stand-alone guide for each state and U.S. territory and will post them on the Internet.
