Short Answer

In North Carolina, a county EMS that is a HIPAA-covered provider must provide a decedent’s medical and billing records to the estate’s personal representative within 30 days of receiving a proper request. The agency may take one 30-day extension if it sends a written notice explaining the delay and giving a new date. The request should come from the court‑appointed personal representative (or their attorney) and include proof of authority (Letters).

Understanding the Problem

You want to know how quickly, in North Carolina, a county EMS must send treatment and billing records when the estate’s personal representative asks for them. The personal representative (or the attorney acting for them) is requesting these records, and the records custodian plans to email them once the request is approved.

Apply the Law

Under HIPAA, a covered health care provider must give an individual, or that person’s personal representative after death, timely access to protected health information. A personal representative is the court‑appointed fiduciary for the estate (executor or administrator). In North Carolina, that authority begins when the Clerk of Superior Court issues Letters, and it relates back to protect acts that benefit the estate. The main “forum” here is the EMS agency’s HIPAA privacy office, not a court. The core deadline is 30 days from receipt of a valid request, with one possible 30‑day written extension. If an electronic copy is requested and readily producible, the provider should send it electronically (e.g., email).

Key Requirements

• Authorized requester: The estate’s personal representative (executor/administrator) or an attorney acting for the personal representative with proof of authority (Letters).
• Proper scope: Records must relate to the decedent’s EMS treatment and billing; these are protected health information subject to HIPAA.
• Timing: Provide access within 30 days of receipt; one written 30‑day extension is allowed with a reason and firm date.
• Format: If requested and readily producible, provide an electronic copy (such as a secure email or PDF).
• Fees: Any fee must be reasonable and cost‑based for copies and delivery; no “search and retrieval” fees.

What the Statutes Say

• HIPAA: 45 C.F.R. § 164.524 (Access to health records) – Requires access within 30 days, allows one 30‑day written extension, and permits electronic copies if readily producible.
• N.C. Gen. Stat. § 28A-13-1 (Commencement; relation back) – A personal representative’s authority begins at appointment and relates back for beneficial acts.
• N.C. Gen. Stat. § 28A-13-3 (Powers of personal representative) – Confirms the personal representative’s authority to act for the estate in managing estate affairs.

Analysis

Apply the Rule to the Facts: Because a law firm represents the estate, the personal representative should authorize the request and provide Letters from the Clerk of Superior Court. With the decedent’s name, date of birth, and accident date, the EMS custodian can locate the record and, under HIPAA, must send access within 30 days. Since the custodian plans to email the documents, an electronic copy is appropriate if requested; if more time is needed, the EMS must send a written extension notice with a new date.

Process & Timing

1. Who files: Personal representative (or attorney for the personal representative). Where: The county EMS provider’s records/health information management or HIPAA privacy office in North Carolina. What: A written HIPAA request identifying the decedent and directing release to the attorney’s office, with copies of Letters and a photo ID; request electronic delivery. When: The EMS must provide access within 30 days of receiving a valid request; one written 30‑day extension is allowed.
2. EMS verifies authority and identity, locates the record, and prepares copies. If applicable, it may invoice a reasonable, cost‑based fee before release. Many agencies fulfill straightforward requests within a few weeks, but timelines can vary by county workload.
3. Upon completion, the records custodian emails the documents in the requested format (often password‑protected PDF) to the attorney’s office and confirms transmission.

Exceptions & Pitfalls

• Request must come from, or be authorized by, the court‑appointed personal representative. An attorney alone, without proof of the PR’s authority (Letters), can be declined.
• Public Records Act requests are not the right tool for medical records; patient medical records are confidential. Use a HIPAA request as the decedent’s personal representative.
• If you want the records emailed to counsel, include a written direction from the personal representative specifying the attorney’s email and acknowledging any security risks of unencrypted email if applicable.
• Limited denials exist (for example, information compiled for litigation or psychotherapy notes), but typical EMS treatment and billing records are disclosable to the personal representative.
• Fees must be reasonable and cost‑based. If an invoice includes “search and retrieval” charges or per‑page fees for purely electronic copies, ask the EMS to align the fee with HIPAA’s rules.

Talk to a Probate Attorney

If you’re dealing with an estate records request to a county EMS provider, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.