Medical Records for SSI and SSD in Texas

A physician may not charge a fee for copies (and therefore may not withhold the copies) where the records are requested:

(1) by a licensed Texas health care provider or any American or Canadian licensed physician for acute or emergency medical care; or
(2) to support an application (or an appeal) for disability or other benefits or assistance under:

a. Aid to Families with Dependent Children;
b. Medicaid;
c. Medicare;
d. Supplemental Security Income; and
e. Federal Old-Age and Survivors Insurance.

Where the requestor attempts to avoid fees under number (2), above, the law states:

A person . . . that requests a record under this section shall include with the request a statement or document from the department or agency that administers the issuance of the assistance or benefits that confirms the application or appeal.  Tex. Health and Safety Code, Section 181.102.

Medical Records to Be Provided within 15 Days

Texas state regulations and law require physicians to provide patients with a copy of a patient’s medical record within 15 business days.

See Tex. Occ. Code, Section 159.008 and 22 Tex. Admin. Code Section 165.2.

Hospitals must provide access to a patient’s medical record as promptly as circumstances require, but no later than the 15th day after they receive a written request and payment (if copies are requested). See Tex. Health and Safety Code, Section 241.154.

Under HIPAA, covered entities must respond to a request for access to PHI within 30 days. Because the Texas law is stricter, covered entities in Texas must respond to requests for access to PHI within the 15 business day period.

For Sourcing See:

TEX. ADMIN. CODE §165.2(g). “A copy of the letter regarding the need for payment shall be made part of the patient’s medical and/or billing record as appropriate.”

TEX. ADMIN. CODE §165.2(f).

65 Fed. Reg. 82557