Healthcare laws and regulations help protect patients, their rights, and ensure they receive quality care.
Four healthcare laws that are instrumental in protecting patients’ rights include:
The Affordable Care Act (ACA)
This act is often associated with insurance as it helps patients connect with programs to help them pay for medical expenses. However, this law also provides regulations about covered care and preexisting conditions through the “Patient’s Bill of Rights.” The “Patient’s Bill of Rights” continues to evolve with additional protections like allowing for some preventative care at no cost and the right to appeal a denial of payment.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
This act includes rules and protections to protect patients’ health information, such as privacy and security of your medical records and how (and what) information can be used.
The Emergency Medical Treatment and Labor Act (EMTALA)
This act gives patients access to emergency room care for an emergency medical condition regardless of their insurance status or ability to pay.
The Genetic Information Nondiscrimination Act (GINA)
This act makes sure that patients who participate in genetic testing aren’t penalized or discriminated against by employers based on the results.
What patient rights are covered under HIPAA?
As discussed earlier, HIPAA is a federal law that gives patients rights over their personal health information (PHI). HIPAA helps ensure that patients’ healthcare information is treated more sensitively, stored safely, and gives them rights regarding access to their medical records.
Additionally, care providers and organizations are required by law to explain and provide patients with a summary about their privacy practices and how patients can get a copy of their medical record. Patients must sign that they received the document, typically called Notice of Privacy Practices.
The Privacy Rule within HIPAA limits who can see and get your health information, while also giving you control over who can access it. Key patient rights involving this rule include:
- Ability to see and get a copy of your health records
- Have corrections added to your medical information
- Being able to decide if your health information can be shared for certain purposes, like marketing
- Receive a report on when and why your medical information was shared
- Requiring your authorization before sharing your records unless allowed by law or if it’s for your treatment or to pay for your care
- Ability to state who cannot have access to your health information
- Ability to report or complain about a suspected violation
One aspect of HIPAA that concerns many patients is their right to medical records. HIPAA allows you to request your own medical records or someone else’s records if you’re a designated representative or legal guardian.
But there are some restrictions on access to medical records. While you have the right to view your medical records, some types of records can be withheld, including:
- Psychotherapy notes
- Medical information the provider thinks could reasonably endanger your safety, life, or the safety of another person
- Information being gathered for lawsuits
If access to your request for your records is denied, the provider must provide the reason in writing, which you can appeal. Additionally, providers must provide copies of medical records within 30 days.