Missouri law requires that physicians maintain adequate records on each patient for at least seven years from the date of last service performed.  Any corrections, modifications or deletions made in the patient record must be clearly outlined in the patient record.  The patient record must contain information that identifies the patient as well as clinical information.  Missouri law differs from other states in that the medical board cannot pursue disciplinary action against a physician solely based on violation of failure to maintain adequate records.  If other violations are alleged, violation of failure to keep medical records may be included.  In conducting an investigation, the medical board must obtain the written authorization of the patient to receive the patient’s record.1

        Under Missouri’s Hospital Licensing Law, hospitals must maintain adequate medical records for each patient in order to be licensed for operation for a minimum of ten years, with the exception of minor patient’s records, which must be retained until the minor’s 23^rd birthday, or for a period of ten years, whichever occurs later.  The medical records must specifically contain information that identifies the patient and clinical information.  According to the regulation, medical records are considered the property of the hospital and must be preserved in a permanent file in a format that may include electronic media.  Written consent of a patient is required in order to access or release a patient’s medical record to individuals who are not otherwise authorized to view it.2

        The law provides a separate provision for the maintenance of medical records by abortion facilities, which are considered ambulatory surgery centers.  Abortion facilities must maintain medical records for each patient.  The medical record must contain a unique identification number, patient identifying information, diagnosis and treatment information, patient consent form, and physician’s orders.  Medical records must be retained for seven years for adults.  For minors, the medical record must be retained for seven years or two years past the time when the minor reaches the age of majority, whichever is longer.  All medical records are the facility’s property, and may be removed from the facility under very limited circumstances.3

        Missouri law dictates that the Division of Family Assistance must retain Medicaid records for five years from payment of public assistance or rejection of an application, after which they can be destroyed.4  However, because all Medicaid claims must be submitted electronically, the state requires that Medicaid providers maintain the paper records for five years.5

        The law grants patients access to their medical records upon written request to the provider.  Health care providers are permitted to charge a small fee to cover copying and posting costs.6  Notably, Missouri has a separate provision that gives mental health patients the right to access their medical records as well.7