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A 16-year-old in Tucson books a visit at a clinic on her own. On the way home she wonders: will my mom get a call, a letter, or a copy of my chart? The answer comes from two layers of law. The federal layer is the HIPAA Privacy Rule, a set of rules for doctors, clinics, and health insurers about who can see your health information. The second layer is your state's law, and HIPAA often hands the final word to it.
The starting rule: parents usually act for you
Under HIPAA, a parent or guardian of an unemancipated minor (a person under 18 who is not legally living as an adult) is usually treated as the minor's 'personal representative'. That term means the person the law lets act for you on your health records. A personal representative can generally see the record and make choices about it.
So for most checkups, a parent can ask for the chart. That is the default, and it is written into the federal rule at 45 CFR 164.502(g).
Three times you are in charge of the record
The same rule lists three exceptions. In each one, you are treated as the person in charge of the information about that visit.
First, you consented to the care yourself, and no other person's consent was required by law. Second, the law lets you get that care without a parent's consent, and you, a court, or another person allowed by law consented to it. Third, your parent agreed that the visit would stay confidential between you and the provider.
Even then, HIPAA defers to your state. If state law allows a provider to tell a parent, the provider may. If state law forbids it, the provider may not. If state law says nothing, a licensed health professional decides, using professional judgment.
Which kinds of care a minor can consent to alone is set by each state. HIPAA does not make that list, so check your own state before you assume.
What the courts have said about mature minors
In Bellotti v. Baird (1979), a case about a pregnant teenager and a parental consent law in Massachusetts, the U.S. Supreme Court said states that require a parent's consent must also offer another path, where a minor can show a judge she is mature enough to decide with her doctor. The case was narrow, and state laws on that subject have changed a lot since.
The idea it described is still in HIPAA today. The second exception above covers care that a court consented to.
Questions to ask at the front desk
Ask before the visit: who will be able to see the notes from today? You are allowed to ask, and the staff hear this question often.
You can also ask the provider to reach you a different way, such as your own cell phone instead of the home number. Under 45 CFR 164.522(b), a provider must go along with reasonable requests like this and cannot make you explain why. It can ask you to put the request in writing. A health insurer has to agree only if you say that sharing the information could put you in danger.
One more protection: if a provider reasonably believes a parent is abusing or neglecting a young person, or that treating the parent as the personal representative could put the young person in danger, the provider can choose not to treat that parent as one. If you are not safe at home, tell the provider.
À retenir
- Under HIPAA, parents are usually a minor's 'personal representative' and can generally see the record.
- You control the record for a visit if you legally consented alone, a court consented, or your parent agreed to confidentiality.
- State law decides which care a minor can consent to and often whether a parent can be told.
- Ask who will see the notes, and ask to be contacted by your own phone or address.
Sources
Cet article donne des informations éducatives générales, pas un conseil juridique personnalisé. KidsKnowRights n'est pas un cabinet d'avocats, et lire cet article ne crée pas de relation avocat-client. Les lois varient selon l'État, l'âge et les circonstances, et elles changent avec le temps. Pour un conseil sur une situation réelle, adresse-toi à un avocat agréé ou à un organisme d'aide juridique.