Medical Record Request Rules for Hawaii

Introduction

Patients and authorized representatives in Hawaii have the right to access copies of medical records held by health care providers. These access rights are rooted in federal HIPAA privacy rules, which apply nationwide, and in Hawaii state law, which adds some specific provisions about how records are made available and how long they must be retained. Most hospitals, clinics, doctors, and other providers that maintain patient records must follow these rules when you ask for your information.

TL;DR

In Hawaii, you can request your own medical records from a provider. Under federal HIPAA rules, providers generally must fulfill these requests within 30 days, and in some cases may extend that timeframe once for another 30 days with written notice. Providers may charge reasonable, cost-based fees for copying and supplying records, and you can specify whether you want paper or electronic copies. Very sensitive information (for example, psychotherapy notes or certain substance use treatment records under 42 CFR Part 2) may have additional protections.

Who Can Request Medical Records in Hawaii

The following people typically can request medical records:

  • The patient
  • A legal guardian or personal representative for the patient.
  • A person who has a valid authorization signed by the patient.
  • A representative of a deceased patient’s estate in appropriate circumstances. Under Hawaii law certain family members or the personal representative of the estate may obtain records for a deceased person with proper authorization or documentation.

Requests from attorneys or insurers generally require a written authorization from the patient before a provider will release records to them.

How to Submit a Medical Record Request in Hawaii

While procedures vary by provider, the basic components of a typical request include:

  1. A written request (many providers have their own forms).
  2. The patient’s name and date of birth.
  3. The time period or specific parts of the record you want.
  4. A signature from the patient or authorized representative.
  5. Instructions about how you want to receive the records.

You can usually submit requests in person, by mail, by fax, or through an online portal, depending on the provider. Many offices also accept signed forms delivered electronically.

Response Timeframes

Under the federal HIPAA Privacy Rule, health care providers must act on a request for access “without undue delay” and within 30 days of receiving it. If more time is needed, they can notify you in writing and take one additional 30-day extension. That gives a potential total of up to 60 days in limited cases. Providers that deny access must explain how to appeal the decision.

Fees & Costs

Providers are allowed to charge reasonable, cost-based fees for copying your records. These fees can include:

  • The labor to copy records in the format you request.
  • Supplies for paper copies.
  • Postage if the records are mailed.

HIPAA guidance allows a flat fee option in some cases (for certain electronic copies) but does not mandate a specific number of cents per page at the federal level. Hawaii law also allows providers to recover reasonable costs for copying records.

Delivery Formats

You can typically request records in one of the following ways:

  • Paper copies printed for you to pick up or mailed to you.
  • Electronic copies, such as PDF files or through an online portal.
  • Transfer of records directly to another provider (for care coordination).

If you ask for a specific format and the provider can reasonably produce it, they should comply.

State-Specific Exceptions or Considerations

Certain types of records may have additional rules:

  • Psychotherapy notes have special protections under HIPAA and often require separate authorization.
  • Records from federally assisted substance use treatment programs may be covered by 42 CFR Part 2, which has stricter confidentiality rules.
  • Providers may consider factors like patient safety when deciding whether to release certain sensitive information, but denials must include reason and appeal rights.

Under Hawaii law for deceased patients, a personal representative or certain next of kin may obtain records with proper proof of authority.

Common Problems Patients Encounter

People often face delays or confusion when the provider:

  • Doesn’t have a clear written authorization.
  • Charges higher fees than allowed by HIPAA.
  • Fails to provide records in the requested format.
  • Does not send a timely response.

Keeping copies of all requests and tracking dates can make it easier if you need to follow up.

Conclusion

Getting your medical records in Hawaii is generally straightforward if you follow the provider’s process and submit a properly signed request. Federal HIPAA rules set the main timelines and fee standards, with Hawaii state law adding some specifics for things like deceased patient access and retention. Providers must act within reasonable timeframes and supply records in formats you can use, and documentation helps if you need to resolve issues.

Sources

  • Hawaii Revised Statutes Chapter 622: Evidence
  • Hawaii Revised Statutes Chapter 323C: Health Care Data
  • 45 CFR Parts 160 and 164: HIPAA Privacy Rule
  • 42 CFR Part 2: Confidentiality of Substance Use Disorder Patient Records
  • Hawaii Office of Health Care Assurance Compliance Guidelines