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Medical Records Access Index 2026

The federal deadline for patient record requests, what public studies found about provider compliance, every OCR Right-of-Access enforcement action, and 50-state tables of copy-fee caps and hospital retention periods. Public sources only, each with its citation and access date.

Published Last updated

Key findings

Four numbers from the public record, each linked to its source below.

  • 30 days

    HIPAA deadline to act on a patient’s access request, with one 30-day extension

    [1]

  • 56

    OCR Right-of-Access enforcement actions, 2019–2026, totaling $3,677,850

    [8]

  • 59%

    of 82 top-ranked hospitals quoted a 200-page record above the $6.50 federal flat-fee option

    [6]

  • 11–497 days

    for OCR to close 437 patient-access complaints, February 2016 to June 2017

    [5]

HIPAA gives a covered entity 30 days to act on a patient’s own request for records, with one 30-day extension. Requests sent with a patient’s authorization, such as from a law firm, carry no federal deadline; state law sets the terms.

OCR has announced 56 Right-of-Access enforcement actions between 2019-09-09 and 2026-10-08, totaling $3,677,850; 7 were civil money penalties and the rest settlements.

Of the 50 states, 33 fee-cap rows and 30 retention rows were confirmed against statute text or two independent sources. The others are marked Unverified rather than guessed.

How long patients and third parties legally wait

The federal clock depends on who asks. A patient’s own request runs on HIPAA’s access rule; a request made with the patient’s authorization does not.

RequestFederal deadlineFee ruleSource
Patient asks for their own records30 days after receipt; one extension of up to 30 days with written noticeReasonable, cost-based fee (164.524(c)(4)); flat fee up to $6.50 is one option for electronic copies of electronic records45 CFR 164.524(b)(2), (c)(4); HHS FAQ 2030
Patient directs an electronic copy of an EHR to a third party30 days, as an access request164.524(c)(4) fee limit does not apply after Ciox45 CFR 164.524(c)(3)(ii); HHS Ciox notice
Third party with the patient’s HIPAA authorization (for example, an attorney)None under HIPAAState law; see fee caps below45 CFR 164.508

A covered entity must act on an access request no later than 30 days after receipt, and may extend once by no more than 30 days if it gives the individual a written statement of the reasons and the completion date within the first 30 days (45 CFR 164.524(b)(2)).

In Ciox Health, LLC v. Azar (D.D.C. January 23, 2020), the court vacated the third-party directive beyond requests for an electronic copy of an electronic health record. HHS states the fee limitation in 164.524(c)(4) now applies only to an individual’s request for their own records, not to a request to transmit records to a third party.

A disclosure made under a patient’s authorization (45 CFR 164.508) is permitted, not required, so HIPAA sets no response time for it. State statutes, below, set fee caps that often cover these requests.

How often providers miss it

Two public studies measured the gap between the rule and what patients get.

Lye et al. (JAMA Network Open, 2018) called 83 top-ranked US hospitals in 29 states as simulated patients between August and December 2017. Only 44 (53%) of authorization forms let a patient request the entire record, though all 83 said by phone they could release it. Quoted costs for a 200-page record ranged from $0.00 to $541.50, and 48 of 82 hospitals (59%) quoted above the $6.50 federal flat-fee option for electronically maintained records. Paper release times ranged from same day to 60 days, and 6 hospitals (7%) were out of line with their state’s processing-time requirement (as corrected).

GAO-18-386 (May 2018) found OCR received 583 patient-access complaints from February 2016 to June 2017 and closed 437 in that period, taking 11 to 497 days; 63% closed within 200 days. OCR’s audit reviewed patient-access policies at 103 covered entities. Patients told GAO of fees above $500 for a single request.

Neither study measures current performance; both predate OCR’s Right-of-Access Initiative, which began in 2019.

Medical-record copy fee caps by state

What a provider may charge for copies requested by the patient or the patient’s representative, as printed in the state statute or rule. Rows link to the statute text; CPI-adjusted amounts note the year.

StateCap (paper)ElectronicCitationSource
Alabama
Max $1.00/page for pages 1–25, $0.50/page after; $5 search fee; actual mailing and X-ray/special record costs extra

Fixed amounts, no CPI adjustment; no separate electronic-copy cap. Applies to any medical provider; HIPAA may limit patient-access fees.

—Ala. Code § 12-21-6.1
Alaska
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Alaska Stat. § 18.23.005
Arizona
No numeric cap; provider may charge a reasonable fee and require payment in advance

No fee for records sent to another provider for continuing care, for health-care access, or if no records are found. Certain agencies are also exempt.

—Ariz. Rev. Stat. § 12-2295
Arkansas
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Ark. Code Ann. § 16-46-106(b), (c)(4)
California
Reasonable cost-based fee (labor, supplies, postage, summary prep); max $0.25/page paper, $0.50/page microfilm

One free copy if records support a public-benefit eligibility claim/appeal; not for patients with a private attorney.

Electronic: same cost-based fee (labor, media, postage, summary); no separate per-page capCal. Health & Safety Code § 123110
Colorado
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—C.R.S. § 25-1-801 (health-care facilities)
Connecticut
Max $0.65/page, including research, handling, related costs and first-class postage; plus materials cost for x-ray copies

No charge if the record supports a Social Security Act claim or appeal. Postage is inside the cap, not an add-on.

—Conn. Gen. Stat. § 20-7c(b)
Delaware
$2.00/page pp. 1–10; $1.00 pp. 11–20; $0.90 pp. 21–60; $0.50 pp. 61+; plus postage; actual cost for films/strips

Board of Medical Licensure rule for physician records; does not bind hospitals. Board must review fees yearly (24 Del. C. § 1761).

Same schedule for paper or electronic records; no separate electronic cap24 Del. Admin. Code § 1700-16.0; 24 Del. C. § 1761
Florida
$1/page paper copies + sales tax and actual postage; up to $1 per year of records requested; nonpaper max $2

No charge if records are for continuing medical care. Physicians (R. 64B8-10.003) and nursing homes (s. 400.145) have separate tiered rates.

Nonpaper records (e.g., X-rays): $2 maximum; no separate electronic-copy capFla. Stat. § 395.3025(1)
Georgia
Up to $25.88 search/retrieval; $9.70 per certification; $0.97/page pp. 1–20, $0.83 pp. 21–100, $0.66 after; plus postage

Statutory base: $20/$7.50/$0.75-0.65-0.50; DCH CPI-adjusts each July 1. Not applicable to disability or vocational rehab applications.

Per-page caps apply to paper records; non-paper records: reasonable reproduction costO.C.G.A. § 31-33-3(a)
Hawaii
No numeric cap; requester bears the provider's reasonable costs of making copies of medical records.

Reasonable-cost standard only; no separate cap for electronic copies. Covers patients and attorneys with authorization.

—Haw. Rev. Stat. § 622-57(g)
Idaho
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—S.B. 1395, 67th Leg., 2d Reg. Sess. (Idaho 2024) (proposed 39-7301)
Illinois
Handling fee up to $36.68 + postage; per page $1.38 (1–25), $0.92 (26–50), $0.46 (51+); microfilm $2.29/page (2026)

2026 adjusted (base $20; $.75/$.50/$.25; $1.25 film). No handling fee under §8-2001.5; free copy for veterans/SSA/SSI/AABD claims

Electronic records: 50% of paper per-page rate (media included); handling fee, postage still apply735 ILCS 5/8-2001(d), (d-5), (h); 5/8-2006
Indiana
$1.00/page for pp. 1–10, $0.50 for pp. 11–50, $0.25 for 51+; or labor fee up to $20 (then no charge first 10 pp.); plus mailing

Extra $10 if copies needed within 2 working days; up to $20 to certify a record (760 IAC 1-71-3(e)). Rule readopted 2023.

No fee for a digital copy or interoperability-platform access to an electronic health recordIC 16-39-9-2, -4; 760 IAC 1-71-3
Iowa
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Iowa Code § 622.10(6)
Kansas
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—K.S.A. 65-6836(b)
Kentucky
First copy free on written request; second copy capped at $1.00/page (patient, attorney or authorized representative)

Workers' comp (KRS ch. 342): max $0.50/page; initial copy to injured worker or attorney is free. Statute excludes Dept. of Corrections and does not address electronic records. Workers' comp fees are separate.

—KRS 422.317(1); KRS 342.035(7)
Louisiana
Paper: $1.00/page for pp. 1–25, $0.50 for pp. 26–350, $0.25 after; handling fee max $25; plus actual postage

One handling fee per request. $100 digital cap covers only the digital portion of mixed records. $500 civil penalty if uncorrected after notice.

Digital: same per-page rates, total capped at $100 (digital imaging media $200), plus postageLa. R.S. 40:1165.1(A)(2)(b)
Maine
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—22 M.R.S. § 1711-A (health care practitioners)
Maryland
Up to $0.76/page + prep fee up to $22.88 + actual postage/handling; per-page fee CPI-adjusted annually

Per-page CPI-adjusted yearly, prep fee not. Free to patient/rep; Medicaid enrollee records max $20 (CPI-adj.)/100 pages.

Electronic: prep fee max $22.88; per-page 75% of paper fee (max $80); actual postage/handlingMd. Code, Health-Gen. § 4-304(c)(3)-(5)
Massachusetts
Base charge ≤$15/request, plus $0.50/page for pages 1–100 and $0.25/page after 100; CPI-adjustable

No fee if requested for a Social Security Act claim/appeal or a federal/state needs-based benefit program. Statutory base amounts; the fee may be adjusted by the medical-care CPI, so the current cap may be higher. Also see c. 112, § 12CC; 243 CMR 2.07(13).

—M.G.L. c. 111, § 70
Michigan
Paper copies: $1.00/page for pages 1–20, $0.50/page for pages 21–50, $0.20/page for pages 51+; no initial fee charged to a patient.

Base amounts; adjusted annually by Detroit CPI (from 2 yrs after 2004), so current caps may be higher. Postage and actual retrieval cost (records 7+ yrs old, off-site) extra; waived for indigent (1 set).

Non-paper formats: actual cost of preparing the duplicate (no numeric cap).MCL 333.26269 (2004 PA 47, § 9)
Minnesota
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Minn. Stat. § 144.292, subd. 6
Mississippi
$20.00 for pages 1–20; $1.00/page for next 80 pages; $0.50/page thereafter; up to 10% of total charge for postage/handling

Also $15.00 for retrieving records from off-premises archives; $25.00 for a medical record affidavit requested by patient or representative.

—Miss. Code Ann. § 11-1-52(1), (3)
Missouri
Max $30.32 search/retrieval + $0.70/page; up to $28.39 more if records are in contracted off-site storage

Effective 2/1/2026, CPI-adjusted. Base: $24.85 + $0.57/page; $23.26 off-site; $108.88 electronic total.

Electronic copies: $30.32 + $0.70/page, or $132.89 total, whichever is lessMo. Rev. Stat. § 191.227
Montana
Reasonable fee, max $0.50/page for paper copy or photocopy; may include up to $15 administrative search/handling fee

Fixed dollar amounts in statute; not CPI-adjusted. See also § 50-16-541.

—Mont. Code Ann. § 50-16-540
Nebraska
Max $20 handling fee + $0.50/page copying; reasonable cost if not routinely photocopied; labor/materials for X-rays

Fixed amounts, no CPI adjustment. No fee for certain disability/benefit applications (§ 71-8405); workers' comp exempt (§ 71-8407).

—Neb. Rev. Stat. § 71-8404
Nevada
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Nev. Rev. Stat. §§ 629.061, 629.062
New Hampshire
Paper: $5 first page; $0.41/page pp. 2–50; $0.30/page 51+, incl. related services; free if not provided in 30 days

Requestor = rep, provider, POA, attorney; patient's own request: HIPAA. Redaction ≤$25/hr; provider transfers free in 14 days.

Electronic copies and related services: reasonable rate, not to exceed $50.00N.H. Rev. Stat. § 332-I:1, I(a)-(b)
New Jersey
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—N.J. Stat. § 45:9-22.27 (health care professionals)
New Mexico
Reasonable cost-based fee: not more than $30 for first 15 pages, $0.25/page after (paper); mailing may be charged

Applies to physician-held records only, not hospitals. Amended 1/1/2009; fixed amounts, no CPI adjustment.

Electronic and non-paper formats (e.g., x-rays): actual cost of reproduction; no numeric capN.M. Admin. Code 16.10.17.8(B) (16.10.17.8 NMAC)
New York
Paper copies: max $0.75/page, and charges may not exceed documented costs; no charge for government-benefit records

Records cannot be withheld because the patient cannot pay. Benefit exemption covers applications, claims and appeals.

—N.Y. Pub. Health Law §§ 17, 18
North Carolina
75¢/page for pages 1–25; 50¢/page for 26–100; 25¢/page over 100; minimum fee up to $10.00 incl. copying

Not CPI-adjusted. Workers' comp: Industrial Commission schedule (G.S. 97-26.1); excludes DHHS DDS requests. Narrative summary fee uncapped.

No separate electronic-copy cap in statuteN.C. Gen. Stat. § 90-411
North Dakota
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—N.D. Cent. Code § 23-12-14
Ohio
Patient/rep: reasonable cost-based fee; ≤$1.11/pg 1–10, $0.57/pg 11–50, $0.23/pg 51+; $1.87/pg x-ray/MRI/CT

Others: $16.84 search fee + per-page + postage. Amounts adjusted under § 3701.742. Effective Oct 3, 2023.

Electronic copy to patient/rep/POA: total cost for access or transmission and related services ≤ $50Ohio Rev. Code § 3701.741(B); § 3701.742
Oklahoma
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Okla. Stat. tit. 76, § 19
Oregon
≤$30 for 10 or fewer pages; ≤$0.50/page for pages 11–50; ≤$0.25/page after; optional $5 if mailed in 7 business days

Applies to requests by anyone other than the patient/representative, or when the patient already got one copy. $5 applies if processed and mailed first class within 7 business days. Postage and actual cost of a requested summary may be added. No CPI adjustment.

—Or. Rev. Stat. § 192.563; Or. Admin. Code § 847-012-0000(6)
Pennsylvania
Patient/personal rep.: no numeric cap; reasonable cost-based fee. Others: $2/pg 1–20, $1.48 pp 21–60, $0.52 pp 61+

Effective Jan. 1, 2026 (3.0% CPI adj.). Per-page tiers plus actual postage; $2.95/microfilm copy. Patient fee excludes search/retrieval.

Electronic copies: fee limited to labor costs, excluding search/retrieval; no numeric cap55 Pa.B. 8441; 42 Pa.C.S. §§ 6152, 6152.1; 45 CFR 164.524
Rhode Island
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—R.I. Gen. Laws § 23-1-48
South Carolina
Paper: 65¢/page for first 30 pages, 50¢ after; clerical fee up to $25; $200 max per admission, plus postage and tax

CPI-U adjusted each July 1 (7/2025: $0.87/$0.66, $33.73 clerical, $269.95 max). No fee for provider continuing-care requests; X-rays at cost.

Electronic: same per-page rates and clerical fee; $150 max per request, plus postage and taxS.C. Code Ann. § 44-7-325(A)(1)(a)-(b), (d)
South Dakota
Paper: max $10 for first 10 pages + $0.33/page after; imaging $10 print/$15 CD; up to $18 search fee if sent to third party

Plus actual postage/shipping and tax. Search fee only for records sent to a designee or third party under signed authorization. SL 2023, ch. 134.

Electronic copy: max $0.25/page; imaging on CD/DVD/portable media max $15S.D. Codified Laws §§ 36-2-16.4, 36-2-16.5
Tennessee
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Tenn. Code Ann. § 63-2-102(a)(1)-(2) (2025)
Texas
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Tex. Health & Safety Code § 241.154 (hospitals)
Utah
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Utah Code § 78B-5-618 (esp. subsections (4), (5)(a)(ii), (10))
Vermont
Greater of $5.00 or $0.50/page; free if for Social Security Act or other federal/State needs-based benefit claim

Flat statutory amounts, not CPI-adjusted. Itemized bill required.

Non-paper formats (X-rays, films, disks, tapes): fee reasonably related to cost; no numeric cap18 V.S.A. § 9419
Virginia
Paper: $0.50/page up to 50 pages, $0.25/page after; $1/page microfilm; search/handling ≤$20; plus postage

Litigation requests (attorney, executor, insurer); patient's own-record fees fall under § 32.1-127.1:03. Electronic imaging: $25/study + $10.

Electronic: $0.37/page to 50, $0.18 after; ≤$20 search; $160 total cap (requests on/after 7/1/2021)Va. Code Ann. § 8.01-413(B2)–(B4), (B6), (G)
Washington
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Wash. Rev. Code § 70.02.010 (definition of "reasonable fee")
West Virginia
Patient/rep: no numeric cap (HIPAA-consistent fee). Others: $20 search/handling + $0.40/page + postage + tax

Per-page base fee CPI-adjusted each Oct. 1 since 2017; figures are base amounts. Also applies to subpoenaed records (§16-29-1(b)).

Electronic copy (third parties): $0.20/page max; $150 total cap incl. all fees, excl. taxesW. Va. Code § 16-29-2
Wisconsin
Paper: $1.48/pg pp.1–25, $1.10 pp.26–50, $0.72 pp.51–100, $0.42 pp.101+; microfilm $2.17/pg; X-ray $14.56/image

Through 6/30/27; CPI-adjusted each July 1. Certification $11.68, retrieval $29.20, shipping, tax only if requestor not patient/authorized.

—Wis. Stat. § 146.83(3f); DHS fee schedule 7/1/26–6/30/27
Wyoming
No numeric cap; physicians may charge reasonable actual costs (copying, clerical time, review/summary time)

Physician rule; hospital fee statute W.S. 35-2-611 repealed 2019 (ch. 78). Copy/summary can't be denied for inability to pay.

—052-3 Wyo. Code R. § 3-4(e)

Unverified rows could not be confirmed against statute text or two independent sources by the access date. They show the candidate citation for follow-up and no value. Federal limits apply on top of state caps for a patient’s own request.

Hospital-record retention periods by state

The minimum time a hospital must keep an adult patient’s record, and the rule for minors where the state sets one.

StateHospitalsMinorsCitationSource
Alabama
At least 5 years (original or legally reproduced form)

Hospital licensure rule (ch. 420-5-7), authorized by Ala. Code §§ 22-21-20 et seq. Physician retention rules are separate.

Minors: at least 5 years after reaching age of majorityAla. Admin. Code r. 420-5-7-.13(3)(a)
Alaska
7 years after discharge (unless department specifies otherwise); X-ray film 5 years.

Department may set longer periods by regulation (AS 18.20.085(b)); statute text current as of Jan. 1, 2025.

Minors (under 19): until 2 years after age 19 or 7 years after discharge, whichever is longer.AS 18.20.085(a)
Arizona
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—A.R.S. § 12-2297(A)(1)-(2)
Arkansas
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—20 CAR § 41-113(a)(19) (also 20 CAR § 43-113(a)(19))
California
General acute care hospitals: keep patient records, incl. X-ray films, at least 7 years after discharge.
Unemancipated minors: until at least 1 year after age 18, and never less than 7 years.Cal. Code Regs. tit. 22, § 70751(c)
Colorado
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—6 CCR 1011-1, Chapter 04 (Hospital Licensure), Part 10, §§ 10.6(A)-(B)
Connecticut
Minimum 10 years after discharge (short-term general and special hospitals); records must be filed accessibly

Originals may be destroyed sooner if preserved by industry-standard process; list filed with DPH. Short-term general/special hospitals only; no separate minors rule. Chronic disease hospitals governed by separate regulation.

—Regs. Conn. State Agencies § 19-13-D3(d)(6)
Delaware
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—16 Del. Admin. Code § 3340-11.6
Florida
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Fla. Admin. Code r. 64B8-10.002 (physicians, general provider rule)
Georgia
Hospitals must retain records at least 5 years after the patient's discharge.

Hospital rule under Dept. of Community Health regulations; see O.C.G.A. § 31-33-2(a)(1)(B)(ii). Other providers are governed separately.

Minors: records retained at least 5 years past the age of majority.Ga. Comp. R. & Regs. 111-8-40-.18(1)(h)
Hawaii
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Haw. Rev. Stat. § 622-58(a)
Idaho
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Idaho Code § 39-1394(1)(b)-(d)
Illinois
At least 10 years; if timely attorney notice of litigation, until case-conclusion notice or 12 years, whichever first

Format and duration set by hospital policy, subject to the 10-year floor. Litigation hold: plaintiff's attorney's written notice, with defense counsel's approval.

No separate minors rule for hospitals; the 10-year minimum applies210 ILCS 85/6.17(c); 77 Ill. Adm. Code 250.1510
Indiana
At least 7 years (original health records or microfilms); statute does not specify when the 7 years begin

7-year statutory minimum with no stated start date. State archives schedule suggests 10 years after discharge for hospitals, but it is not the statutory minimum.

—Ind. Code § 16-39-7-1(b)
Iowa
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Iowa Admin. Code r. 653—13.7(8)
Kansas
Hospitals must keep each medical record 10 years after the patient's last discharge.

Hospitals only; a summary of destroyed records must be kept at least 25 years (d)(3). Age of majority is not defined in the regulation.

Minors: until 1 year after reaching age of majority, or 10 years after last discharge, whichever is longer.K.A.R. 28-34-9a(d)(1)
Kentucky
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—902 KAR 20:016
Louisiana
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—La. R.S. 40:2144(F)
Maine
Hospital records must be retained for 7 years.

Must also comply with other applicable federal and state retention laws. Formerly cited as § XII.B.

Minors: at least 6 years after reaching the age of majority.10-144 C.M.R. ch. 112, § 3.5.5
Maryland
7 years after the record is made, unless the patient is notified before destruction

General rule for all health care providers, including hospitals; not hospital-specific. For minor-consent care (§§20-102(c), 20-103(c)), notice goes to the minor.

Minors: retain until age 18 + 7 years (age 25), unless parent or guardian is notifiedMd. Code, Health-Gen. §4-403(a)(1), (b), (c)
Massachusetts
20 years after discharge or final treatment of the patient

Applies to hospitals; the same 20-year period appears in the clinic rule, 105 CMR 140.302(C). Physician records are covered by a separate 7-year rule.

—M.G.L. c. 111, § 70; 105 CMR 130.370
Michigan
7 years from date of service; 15 years if penetration services or sexual misconduct complaint

15-year tier from 2023 PA 62 (eff. Oct. 10, 2023); applies to all health facilities/agencies; penetration tier has four exceptions

No separate minors rule; 7 years runs from date of serviceMCL 333.20175(2)(a)-(b); see MCL 333.16213
Minnesota
7 years; portions forming the permanent medical record must be retained as authorized in Minn. Stat. § 145.30

Permanent record defined in Minn. R. 4642.1000. Destruction requires hospital governing body approval. Minors provision amended 2021.

Minors: all portions kept 7 years or until age of majority, whichever is laterMinn. Stat. § 145.32, subd. 1
Mississippi
10 years from patient discharge; images/X-ray films 3 years from discharge, longer if patient requests in writing

Current text as amended by SB 2873, effective 5/13/2024.

No separate minors retention period; parent/guardian may obtain unemancipated minor's (<18) records without minor's consentMiss. Code Ann. § 41-9-69 (Laws 2024, ch. 533)
Missouri
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—19 CSR 30-20(17)
Montana
Minimum 10 years after discharge or death (entire record); imaging film and electrodiagnostic tracings 5 years

After the 10-year period, the core medical record may be abridged but must be kept at least 10 further years.

Minors: minimum 10 years after reaching age of majority or death, if earlierMont. Admin. R. 37.106.402; §§ 50-5-103, 50-5-404, MCA
Nebraska
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—175 Neb. Admin. Code ch. 1, § 008.03
Nevada
At least 5 years (original or legally reproduced form); medical staff may designate items for at least 10 years.

General statute: 5 years after receipt/production unless federal law requires longer; exceptions include lab records (NRS 652.135) and pharmacists.

Records of patients under age 23 may not be destroyed; retain until age 23 and at least 5 years.Nev. Admin. Code § 449.379(4); Nev. Rev. Stat. § 629.051
New Hampshire
7 years after patient discharge

Hospital rules may have been renumbered eff. 9/25/2024 (retention possibly He-P 802.21); confirm current section.

Minors: until at least 1 year after age 18, but never less than 7 years after dischargeN.H. Code Admin. R. He-P 802.20(g)
New Jersey
Retain 10 yrs after most recent discharge or until age 23, whichever is longer; discharge summary 20 yrs; X-rays 5 yrs

Regulation defers to the statute and sets no separate period. Statute covers institutions generally, not only hospitals.

Minors: until age 23 or 10 yrs after most recent discharge, whichever is longerN.J.S.A. 26:8-5; N.J.A.C. 8:43G-15.2(h)
New Mexico
10 years after the patient's last discharge (hospital licensing rule: 10 years after last treatment date)

Hospital rule adopted 6/25/2024, effective 7/1/2024. Separate physician rule (16.10.17.10 NMAC) requires retention until age 21.

Minors: records kept until age of majority plus 1 year (hospital licensing rule)NMSA 1978 § 14-6-2(A); 8.370.12.30(B)(2) NMAC
New York
At least 6 years from discharge, or at least 6 years after the patient's death

Regulation text sets no separate obstetrical-record period; the age-21 figure is 18 + 3 years.

Minors: 6 years from discharge or 3 years after reaching age 18 (age 21), whichever is longer10 NYCRR § 405.10(a)(4)
North Carolina
11 years following discharge of an adult patient

Rule readopted effective Aug. 1, 2023. Separate provision in (c) governs records upon hospital closure.

Minors: until 30th birthday; if readmitted as an adult, the adult 11-year rule applies10A N.C. Admin. Code 13B .3903
North Dakota
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—N.D. Cent. Code § 43-17-27.2(1)
Ohio
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Ohio Admin. Code 3701-83-11(F)
Oklahoma
7 years minimum (statute); Dept. of Health rule: 5 years after last seen, or 3 years after death

Statute has no separate minors rule. Regulation also says to dispose of records consistent with the statute of limitations.

Newborns/minors: 3 years past age of majority (OAC 310:667-19-14(a))Okla. Stat. tit. 63, § 1-739; OAC 310:667-19-14(a)
Oregon
Hospital records must be retained at least 10 years after discharge

Oregon Administrative Rules, Oregon Health Authority hospital licensing rules.

—OAR 333-505-0050(14)
Pennsylvania
7 years following patient discharge (original, reproduction or microfilm form)

Hospital rule, last amended 1980. Subsection (c) adds closure/storage duties: 5 years of retrieval services and public notice before destruction.

Minors: until majority, then 7 more years or as long as adult records are maintained28 Pa. Code § 115.23
Rhode Island
Hospital medical records: retain 5 years

Hospital licensing regulation, refiled effective 01/04/2022 with no text changes.

Minors: retain until 5 years after the patient reaches age 18216-RICR-40-10-4 § 4.6.10; R.I. Gen. Laws § 23-3-26
South Carolina
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—S.C. Code Ann. § 44-115-120 (Physicians' Patient Records Act)
South Dakota
10 years from the actual visit date of service or patient care; later visits do not extend the period

Amended eff. Nov. 27, 2023 (50 SDR 62); now says 'age of eighteen,' previously 'age of majority.'

Minors: until age 18 plus 2 years, but no less than 10 years from date of service or patient careARSD 44:75:09:06; SDCL 34-12-13(10)
Tennessee
10 years after patient's discharge or death during treatment, unless the board specifies otherwise

Board rules may modify the 10-year period. X-ray film may be retired after 4 years if signed findings are kept for the full period.

Minors/mentally disabled: minority or disability period +1 yr, or 10 yrs after discharge if longerTenn. Code Ann. § 68-11-305(a)(1)-(2)
Texas
Hospitals may dispose of records on/after the 10th anniversary of last treatment; not while litigation is unresolved.

Permissive, not mandatory. Physician rule 22 TAC § 163.2(c) (7 yrs; minors to 21 or 7 yrs, longer) does not apply to hospitals.

Minors: disposal allowed at 20th birthday or 10 years after last treatment, whichever is laterTex. Health & Safety Code § 241.103
Utah
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Utah Admin. Code R432-100-34 (Medical Records), General Hospital Standards
Vermont
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—18 V.S.A. § 1905(8)
Virginia
At least 5 years after patient discharge (original or accurate reproduction); birth and death information 10 years

Separate practitioner rule (Va. Code § 54.1-2910.4): 12-yr cap; minors to 18 or emancipation, min. 6 yrs from last encounter.

Minors: at least 5 years after reaching age 1812VAC5-410-370(F); 12VAC5-410-1260(C)
Washington
26 years from date record created; applies to records held as of July 27, 2025, whenever created

Eff. 7/27/2025; replaced 10 yrs after discharge. WAC 246-322-200(7) still states old rule. Records already lawfully destroyed excluded.

Minors: no separate rule; 26-year period applies to all recordsRCW 70.41.190(1)
West Virginia
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—W. Va. Code R. § 64-12-7.2.6
Wisconsin
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—Wis. Admin. Code Med 21.03(1)
Wyoming
UnverifiedNot confirmed

Candidate citation shown; not confirmed against statute text or two independent sources.

—048-12 Wyo. Code R. § 12-23(c)

Where a state has no hospital-specific rule in statute or regulation that we could confirm, the row is marked Unverified. Retention floors are minimums; federal programs, litigation holds and accreditation can require longer.

OCR Right-of-Access enforcement actions

Every Right-of-Access action OCR announced from 2019-09-09 to 2026-10-08, by calendar year of announcement.

A settlement is a resolution agreement with a payment and a corrective action plan. A civil money penalty is imposed by OCR after the entity does not resolve the matter. Amounts are as stated in each HHS announcement; batch announcements are split into one row per entity.

OCR Right-of-Access enforcement actions by calendar year2019: 2 actions; 2020: 11 actions; 2021: 12 actions; 2022: 17 actions; 2023: 4 actions; 2024: 5 actions; 2025: 3 actions; 2026: 2 actions2201911202012202117202242023520243202522026
OCR Right-of-Access actions by calendar year; 56 actions totaling $3,677,850.
Annual enforcement action counts and amounts
YearActionsAmount
20192$170,000
202011$537,500
202112$857,150
202217$859,000
20234$271,500
20245$420,200
20253$372,500
20262$190,000
Total56$3,677,850

Enforcement actions by date

DateEntityAmountKindSource
2019-09-09Bayfront Health St. Petersburg$85,000settlementSource
2019-12-12Korunda Medical, LLC$85,000settlementSource
2020-09-15All Inclusive Medical Services, Inc.$15,000settlementSource
2020-09-15Beth Israel Lahey Health Behavioral Services$70,000settlementSource
2020-09-15Housing Works, Inc.$38,000settlementSource
2020-09-15King MD$3,500settlementSource
2020-09-15Wise Psychiatry, PC$10,000settlementSource
2020-10-07Dignity Health d/b/a St. Joseph's Hospital and Medical Center$160,000settlementSource
2020-10-09NY Spine Medicine$100,000settlementSource
2020-11-06Riverside Psychiatric Medical Group$25,000settlementSource
2020-11-12Dr. Rajendra Bhayani$15,000settlementSource
2020-11-19University of Cincinnati Medical Center, LLC$65,000settlementSource
2020-12-22Peter Wrobel, M.D., P.C. d/b/a Elite Primary Care$36,000settlementSource
2021-01-12Banner Health$200,000settlementSource
2021-02-10Renown Health, P.C.$75,000settlementSource
2021-02-12Sharp HealthCare d/b/a Sharp Rees-Stealy Medical Centers$70,000settlementSource
2021-03-24The Arbour, Inc. d/b/a Arbour Hospital$65,000settlementSource
2021-03-26Village Plastic Surgery$30,000settlementSource
2021-06-02Diabetes, Endocrinology & Lipidology Center, Inc.$5,000settlementSource
2021-09-10Children's Hospital & Medical Center$80,000settlementSource
2021-11-30Advanced Spine & Pain Management$32,150settlementSource
2021-11-30Denver Retina Center$30,000settlementSource
2021-11-30Dr. Robert Glaser$100,000civil money penaltySource
2021-11-30Rainrock Treatment Center, LLC d/b/a Monte Nido Rainrock$160,000settlementSource
2021-11-30Wake Health Medical Group$10,000settlementSource
2022-03-28Donald B. Brockley, D.M.D.$30,000settlementSource
2022-03-28Jacob & Associates$28,000settlementSource
2022-07-15ACPM Podiatry$100,000civil money penaltySource
2022-07-15Associated Retina Specialists$22,500settlementSource
2022-07-15Coastal Ear, Nose, and Throat$20,000settlementSource
2022-07-15Danbury Psychiatric Consultants$3,500settlementSource
2022-07-15Erie County Medical Center Corporation$50,000settlementSource
2022-07-15Fallbrook Family Health Center$30,000settlementSource
2022-07-15Hillcrest Nursing and Rehabilitation$55,000settlementSource
2022-07-15Lawrence Bell, Jr., D.D.S.$5,000settlementSource
2022-07-15MelroseWakefield Healthcare$55,000settlementSource
2022-07-15Memorial Hermann Health System$240,000settlementSource
2022-07-15Southwest Surgical Associates$65,000settlementSource
2022-09-20B. Steven L. Hardy, D.D.S., LTD (Paradise Family Dental)$25,000settlementSource
2022-09-20Family Dental Care, P.C.$30,000settlementSource
2022-09-20Great Expressions Dental Center of Georgia, P.C.$80,000settlementSource
2022-12-15Health Specialists of Central Florida, Inc.$20,000settlementSource
2023-01-03Life Hope Labs, LLC$16,500settlementSource
2023-05-08David Mente, MA, LPC$15,000settlementSource
2023-08-24UnitedHealthcare Insurance Company$80,000settlementSource
2023-12-15Optum Medical Care of New Jersey, P.C.$160,000settlementSource
2024-03-29Phoenix Healthcare, LLC d/b/a Green Country Care Center$35,000settlementSource
2024-04-01Essex Residential Care, LLC d/b/a Hackensack Meridian Health West Caldwell Care Center$100,000civil money penaltySource
2024-08-01American Medical Response$115,200civil money penaltySource
2024-10-17Gums Dental Care$70,000civil money penaltySource
2024-11-19Rio Hondo Community Mental Health Center$100,000civil money penaltySource
2025-01-14South Broward Hospital District d/b/a Memorial Healthcare System$60,000settlementSource
2025-03-06Oregon Health & Science University$200,000civil money penaltySource
2025-12-16Concentra, Inc.$112,500settlementSource
2026-08-27Azul Vision, Inc.$50,000settlementSource
2026-10-08Linda L. Shen d/b/a Shen Smiles, P.C.$140,000settlementSource

Each row links to its HHS announcement or resolution agreement.

Methodology

Public sources only. No Tavrn operating data is used anywhere in this index.

Federal rules come from the eCFR and HHS guidance. Studies are cited from the published papers and the GAO report. Enforcement actions come from the HHS OCR resolution-agreements index and each announcement page; every row links to its HHS page.

For each state, we searched public statute and regulation text with the Parallel Search API, extracted the rule, then checked it again in a separate pass against official code text (state legislature or agency sites, or code reproductions on Cornell LII, Justia, FindLaw or Casetext). A row is Verified when the statute text confirms it or two independent checks agree with a verbatim quote. Anything else is Unverified, and no value is shown.

This index is published yearly. Corrections and new enforcement actions are added with a dated change-log entry. Nothing here is legal advice; confirm the current statute before relying on a figure.

Change log

  1. First edition: federal rules, two studies, OCR Right-of-Access actions through October 2026, 50-state fee-cap and hospital retention tables.

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Every public source used in this index, with the date it was accessed.

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