Most records transfers go smoothly. When they do not, the problem is usually one of four things: a fee, an unpaid balance, a delay, or a practice that no longer exists in the same form. This page covers each, under US federal rules as of October 2026.
The short version
- Your own copy: HIPAA limits fees to a reasonable, cost-based amount (labor for copying, supplies, postage). No search or retrieval fees.
- Records sent to another doctor or a third party: since Ciox Health v. Azar (2020), the federal patient-rate cap does not apply; state law and the practice's policy do. Many offices send records to treating providers free.
- Unpaid bills: a provider may not deny you access to your records because you owe money for care.
- Deadline: 30 days for your own copy, plus one 30-day extension with written notice. Some states are faster.
- Closed or sold practices: records go to a custodian; state rules require them to be kept for a period of years.
- Complaints: HHS Office for Civil Rights for access violations; your state medical board for professional conduct; ASTP/ONC for electronic information blocking.
Fees: two different rules
When you request records for yourself
Under the HIPAA right of access (45 CFR 164.524), a provider may charge only a reasonable, cost-based fee covering labor for making the copy, supplies (paper, a CD or USB drive), postage, and preparing a summary if you agree to one. It may not charge for searching for or retrieving records, for verifying your identity, or for maintaining systems. HHS guidance also allows a flat fee of up to $6.50 for electronic copies of electronically maintained records as an alternative to calculating actual costs. Records you can view or download in a patient portal are free.
The HHS Office for Civil Rights has enforced this rule repeatedly: its Right of Access Initiative reached its 55th enforcement action in August 2026, most involving providers that failed to respond on time.
When records go directly to another provider or third party
In January 2020 a federal court (Ciox Health, LLC v. Azar) vacated the part of HHS guidance that extended the patient-rate fee limit to records sent to third parties at the patient's direction. As a result, the HIPAA fee cap applies to copies you receive yourself, not to copies sent elsewhere. Fees for third-party transfers are governed by state law (many states set per-page caps or flat fees, and some bar fees for transfers to other treating providers) and by the practice's own policy.
Practical tip: if an office quotes a high fee to send records to your new doctor, ask whether it charges for a provider-to-provider transfer for continuing care (many do not), or request a copy for yourself at the patient rate and give it to your new doctor.
"We won't release your records until you pay your balance"
For your own copy, this is not permitted. HHS's Office for Civil Rights states that a covered entity may not withhold or deny an individual access to their health information because the individual has not paid for health care services. The office may still require payment of the permitted copying fee for the request itself. If you hear this, ask for the refusal in writing and cite the HIPAA right of access; if it continues, file a complaint with OCR at hhs.gov/ocr within 180 days.
The debt itself is a separate matter. Paying it, disputing it, or setting up a payment plan does not change your right to the records.
How long the office has
For a right-of-access request: 30 calendar days from receipt, with a single 30-day extension if the provider tells you in writing, within the first 30 days, why it needs more time and when you will get the records. A 2021 HHS proposal to shorten this to 15 days has not been finalized as of October 2026. Some state laws set shorter deadlines, and the shorter one applies.
For a provider-to-provider transfer for treatment, there is no single federal deadline, which is why a parallel request for your own copy is useful when a visit is coming up.
When a practice has closed, retired, or been sold
- Sold or merged practice: the buyer usually becomes the records custodian. Contact the new owner's records department, or the health system that acquired the practice.
- Retired or deceased doctor: states commonly require notice to patients and arrangements for a custodian (another physician, a hospital, or a records-storage company). Check the doctor's old website or voicemail, the local hospital, or your state medical board.
- Closed hospital: the state health department usually knows who holds the records.
- Retention periods are set by state law (commonly somewhere between about 5 and 10 years for adults, longer for minors). HIPAA itself does not set a medical-record retention period. Once the period has passed, records may lawfully be destroyed.
Other common refusals
| What you are told | What the rules say |
|---|---|
| "You have to come in to sign." | HIPAA does not require an in-person visit. Reasonable identity verification is allowed, but it cannot create unreasonable delay. |
| "We can only send a summary." | You are entitled to the underlying records in the designated record set, not just a summary (unless you agree to a summary). |
| "We only fax / only print." | If records are kept electronically and are readily producible electronically, you can get an electronic copy. |
| "Those records came from another hospital, so we can't release them." | Records from other providers that are part of your chart are generally part of the designated record set and are covered by your right of access. |
| "Your therapist's notes are excluded." | Only separately kept "psychotherapy notes" are excluded; diagnoses, treatment plans, medications and session dates are not. |
Where to complain
- HHS Office for Civil Rights (hhs.gov/ocr): access denials, excessive fees for your own copy, missed deadlines. Free; generally within 180 days.
- Information Blocking Portal (healthit.gov/report-info-blocking): electronic health information being withheld or delayed by a provider, EHR vendor or network.
- State medical board: professional conduct, including some states' records rules.
- State attorney general or health department: state records-fee laws and closed facilities.
Frequently asked questions
Can a doctor's office charge to transfer medical records to another doctor?
Often yes, but it depends. When you request a copy for yourself, HIPAA limits the fee to a reasonable, cost-based amount. Since the 2020 court decision in Ciox Health v. Azar, those federal patient-rate limits do not apply when records are sent to a third party at your direction, so state law and practice policy govern that fee. Many practices send records to another treating provider free of charge as a courtesy, and some states cap or prohibit these fees.
Can a doctor refuse to release my records because I owe money?
Not for your own copy. HHS's Office for Civil Rights says a covered provider may not withhold or deny your right of access because you have not paid a bill for health care services. The office can charge the permitted copying fee for the request itself.
How long does a doctor have to send my records?
For a request for your own records, HIPAA gives the provider 30 calendar days, with one 30-day extension if it notifies you in writing with the reason. Some states set shorter deadlines. Provider-to-provider transfers for treatment have no single federal deadline, which is one reason to request your own copy as well.
What happens to my records when a doctor retires or a practice closes?
State law and medical board rules generally require the practice to keep records for a set number of years and to tell patients how to get them. Records are often transferred to another practice, a hospital, or a commercial records custodian. Your state medical board can sometimes tell you who has them.
Related reading
Not medical advice. This site provides general educational information about navigating remote healthcare. It does not diagnose, treat, or recommend treatment for any condition, and it is not legal advice. For personal medical questions, talk to a licensed clinician. If you think you may be having a medical emergency, call 911 (US) or your local emergency number now; for a mental health crisis in the US, call or text 988.