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MRA Thought of the Day – Exceptions to Parental ROI Rights for Minors

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Situation:

Kathy Gordon, RHIA, Vice President of Release of Information

Kathy Gordon, RHIA, Vice President of Release of Information

A man brought his 14 year old son to the emergency room for a psychiatric evaluation. According to the father, his son was “out of control”. When he requested a copy his son’s medical record, the father received a notice stating that the therapist had not approved release of the records to him.

Question:

Parents are considered to be the personal representatives of minor children, so why would a father be denied access to his child’s medical records?

Here are my thoughts…

Under the HIPAA Privacy Rule, parents are allowed the right to see their child’s medical records. However, there are three exceptions where the parent would not be the minor’s personal representative under the Privacy Rule:

1. When the minor is the one who consents to the care and the consent of the parent is not required under State or other applicable law.

2. When the minor obtains care at the direction of a court or a person appointed by the court.

3. When, and to the extent that, the parent agrees that the minor and the health care provider may have a confidential relationship.

In addition to the exceptions above, a provider may choose not to treat the parent as a personal representative when the provider reasonably believes, in his or her professional judgment, that the child has been or may be subjected to domestic violence, abuse or neglect, or that treating the parent as the child’s personal representative could endanger the child.

Upon receipt of the letter, the father contacted the Health Information Management Department to complain about his request not being fulfilled. He could not understand why he was being denied access to his own son’s medical records given that he was the parent who brought him to the hospital and signed the consent for treatment.

What are your thoughts?

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