HIPAA compliance for physical therapy practices in Ohio

Ohio's general breach-notification statute excludes HIPAA covered entities outright, so for covered physical therapy practices the federal rules govern and the state statute adds no separate notification duty. Beyond that, Ohio has 2 recorded rules that apply to physical therapy practices differently from other businesses in the state — set out below with their conditions and sources.

Ohio jurisdiction record verified against primary state authority August 2026. General reference, not legal advice.

Does this reach your practice?

Two questions have to be settled before any state rule matters: whether HIPAA reaches a practice like yours, and whether Ohio's own law reaches a practice that HIPAA already covers.

Federal — is this practice a covered entity

Physical therapy practices that electronically submit claims, check benefits, request authorization, or have those transactions conducted on their behalf are HIPAA covered entities. Once covered, the duties below are required across every location and workflow handling PHI.

State — how Ohio law interacts with HIPAA

Ohio's general breach-notification statute expressly excludes HIPAA covered entities from its scope. For physical therapy practices that qualify as covered entities under 45 CFR §160.103, the federal rules govern and the state statute below adds no separate notification duty.

Covered-entity exclusion. Ohio Rev. Code § 1349.19(F)(2) provides that '[t]his section does not apply to any person or entity that is a covered entity as defined in 45 C.F.R. 160.103.' HIPAA covered entities operating in Ohio are excluded from § 1349.19 — no residual state-law breach-notification obligation runs alongside HIPAA for CEs. Business associates are NOT expressly included in the (F)(2) exclusion and require separate analysis — a BA should independently evaluate whether it qualifies as a covered entity under 45 C.F.R. 160.103 (which enumerates health plans, healthcare clearinghouses, and qualifying healthcare providers as covered entities and separately defines business associate) or whether some other Ohio provision applies to it. Financial institutions, trust companies, and credit unions subject to and complying with their functional federal regulator's requirements are also excluded from § 1349.19 under (F)(1).

What Ohio adds for physical therapy practices specifically

Rules that exist because of the combination — not federal HIPAA, which applies the same way everywhere, and not Ohio's general breach law, which applies the same way to every business in the state.

How long records must be kept

Duty to keep an accurate record

A REFERRAL TO ANOTHER DISCIPLINE, INCLUDING A PHYSICIAN, SHALL BE DOCUMENTED IN THE MEDICAL RECORD. REPORTS WRITTEN BY THE PHYSICAL THERAPIST ASSISTANT for inclusion in the patient's record SHALL BE COSIGNED BY THE SUPERVISING PHYSICAL THERAPIST. A physical therapist shall obtain AN ORIGINAL WRITTEN REFERRAL FROM THE REFERRING PRACTITIONER WITH A SIGNATURE FOR INCLUSION IN THE PATIENT'S OFFICIAL RECORD.

Provider class: Ohio physical therapists and physical therapist assistants

What this means operationally

Three documentation duties, all about what must physically end up in the file. The cosignature rule allocates responsibility upward — an assistant's report is not a record entry until the supervising therapist signs it, so an unsigned assistant note is an incomplete record rather than a pending one. The referral rule cuts both ways: outbound referrals to another discipline must be documented, and inbound ones require the ORIGINAL signed written referral in the official record, which a scanned copy or a verbal authorization does not satisfy on the face of the rule.

Applies when

An Ohio physical therapist makes or receives a referral, or a physical therapist assistant writes a report for the patient record

State regulationOhio Admin. Code 4755:2-2-04, 4755:2-2-06, 4755:2-2-08Patients of the practiceVerified 2026-08-30

Amendment or correction of a record

Duty to keep an accurate record

A LICENSE HOLDER SHALL NOT FALSIFY, ALTER, OR DESTROY PATIENT/CLIENT RECORDS, MEDICAL RECORDS, OR BILLING RECORDS WITHOUT AUTHORIZATION.

Provider class: Ohio physical therapists and physical therapist assistants

What this means operationally

This is the whole of Ohio's physical-therapy records-integrity regime and it is worth seeing what it is and is not. It prohibits three acts — falsifying, altering and destroying — and qualifies all three with WITHOUT AUTHORIZATION, so a legitimate correction is not caught. What it does not do is state how an authorized amendment must be made: there is no requirement that the original remain legible, no author or timestamp requirement, and no retention period anywhere in the physical-therapy rules. A practice therefore has integrity obligations without the procedural scaffolding that Texas or Ohio optometry supply, and should not infer a destruction schedule from the prohibition.

Applies when

An Ohio physical therapy license holder handles patient, medical or billing records

Exceptions

Alteration or destruction with authorization is outside the prohibition

State regulationOhio Admin. Code 4755:2-2-01(9)Patients of the practiceVerified 2026-08-30

Each rule above was read against the cited source on the date shown. General reference for compliance planning, not legal advice — confirm current text before relying on it.

Ohio breach obligations

These apply to businesses generally rather than to physical therapy practices in particular, and they are shown after applicability because whether they reach you depends on the answer above.

Ohiobreach data →

Individual notice deadline

In the most expedient time possible but not later than forty-five days following discovery or notification of the breach, subject to law-enforcement delay and any measures reasonably necessary to determine the scope of the breach, ascertain the identity of affected residents, and restore the reasonable integrity of the data system.

The statute sets a 45-day outer bound. It is shown for context: a HIPAA covered entity is outside this section, so HIPAA's own 60-day individual-notice window is the operative deadline.

State regulator notice

Not required

None for HIPAA-covered entities (they are excluded from the section entirely — see the HIPAA-interaction note below). For entities subject to § 1349.19, the section does not impose an Attorney General notice obligation.

Source: Ohio Rev. Code § 1349.19(B)(2)

Statewide rules that also reach physical therapy practices

Parental right of access

A patient, a patient's personal representative, or an authorized person who wishes to examine or obtain a copy of part or all of a medical record SHALL SUBMIT TO THE HEALTH CARE PROVIDER A WRITTEN REQUEST SIGNED by the requester and DATED NOT MORE THAN ONE YEAR BEFORE THE DATE ON WHICH IT IS SUBMITTED. The request SHALL INDICATE WHETHER THE COPY IS TO BE SENT to the requester, sent to a physician, advanced practice registered nurse or chiropractor, or HELD FOR THE REQUESTER at the office of the health care provider. WITHIN A REASONABLE TIME after receiving a request that meets those requirements and includes sufficient information to identify the record, a health care provider that has the patient's medical records SHALL PERMIT THE PATIENT TO EXAMINE THE RECORD DURING REGULAR BUSINESS HOURS WITHOUT CHARGE or, on request, shall provide a copy in accordance with § 3701.741. If a health care provider FAILS TO FURNISH a medical record as required, the requester MAY BRING A CIVIL ACTION to enforce the patient's right of access.

What this means operationally

Two conditions sit on the REQUEST rather than the practice, and both are enforceable gatekeeping. The request must be signed, and it must be DATED NOT MORE THAN ONE YEAR before submission — a staleness rule that lets a practice decline an old authorization without inventing a policy. It must also state the destination, which is why a bare 'send me my records' note is incomplete under Ohio law. On the practice's side, in-person EXAMINATION is free and must be available in regular business hours; only copying attracts a fee. Note what Ohio does not give: no day count. The standard is a reasonable time, and the sanction is a private civil action rather than board discipline.

Applies when

A patient, personal representative or authorized person submits a signed written request dated within the past year, identifying the record and stating where the copy should go

Exceptions

Does not apply to records covered by Ohio Rev. Code §§ 173.20 or 3721.13, chapters 1347, 5119 or 5122, 42 C.F.R. part 2 (alcohol and drug abuse patient records), or 42 C.F.R. § 483.10
Does not supersede the peer-review confidentiality provisions at §§ 2305.24, 2305.25, 2305.251 and 2305.252

StatewideOhio Rev. Code § 3701.74(B), (C), (D)Patients, personal representatives and authorized personsVerified 2026-08-30

Limit on copy fees, format or delivery

Where the request is made by the PATIENT, the patient's personal representative, or an individual authorized through a valid power of attorney, TOTAL COSTS for copies and all related services SHALL BE REASONABLE, COST-BASED AMOUNTS PERMITTED TO BE CHARGED TO THE PATIENT UNDER FEDERAL LAWS AND REGULATIONS, and any per-page charges SHALL NOT EXCEED the sums authorized for third-party requests. If the request by such a person is for ACCESS TO DIGITAL RECORDS OR ELECTRONICALLY TRANSMITTED RECORDS, the TOTAL COST for that access or transmission, AND ALL RELATED SERVICES, SHALL NOT EXCEED FIFTY DOLLARS.

What this means operationally

The fifty-dollar cap is the number to build the workflow around: it is a TOTAL, covering access, transmission and every related service, and it applies regardless of how large the record is. For any substantial chart electronic delivery is therefore dramatically cheaper for the requester than paper, and a practice that defaults to printing is charging more than it needs to defend. For non-digital patient requests Ohio does not write its own figure at all — it adopts the federal cost-based limit by reference and then caps per-page charges at the third-party schedule, so the federal rules are the operative constraint and the state schedule is only a ceiling.

Applies when

A patient, personal representative or power-of-attorney holder requests copies of a medical record

StatewideOhio Rev. Code § 3701.741(B)(1)Patients, personal representatives and authorized personsVerified 2026-08-30

Limit on copy fees, format or delivery

Where the request is made by ANYONE OTHER THAN the patient, personal representative or power-of-attorney holder, total costs for copies and all related services SHALL NOT EXCEED the sum of: AN INITIAL FEE OF SIXTEEN DOLLARS AND EIGHTY-FOUR CENTS, adjusted in accordance with § 3701.742, WHICH SHALL COMPENSATE FOR THE RECORDS SEARCH; for data recorded on paper or electronically, ONE DOLLAR AND ELEVEN CENTS PER PAGE FOR THE FIRST TEN PAGES, FIFTY-SEVEN CENTS PER PAGE FOR PAGES ELEVEN THROUGH FIFTY, and TWENTY-THREE CENTS PER PAGE FOR PAGES FIFTY-ONE AND HIGHER, each adjusted under § 3701.742; for data resulting from an X-RAY, MRI OR CAT SCAN recorded on paper or film, ONE DOLLAR AND EIGHTY-SEVEN CENTS PER PAGE; and THE ACTUAL COST OF ANY RELATED POSTAGE. Every charge in this schedule applies to MEDICAL RECORDS COMPANIES as well as to health care providers.

What this means operationally

Ohio is unusual in letting the practice recover a SEARCH fee at all — most cost-based regimes exclude retrieval time — and it is a flat initial charge rather than an hourly one. The per-page rate is steeply degressive, so the marginal cost of a long record is low and the fixed component dominates a short one. Two structural points matter more than the figures. All of them are INFLATION-ADJUSTED under § 3701.742, so any quoted amount needs a date beside it. And the schedule expressly binds MEDICAL RECORDS COMPANIES, the third-party firms practices outsource copying to, which prevents a practice from routing around the cap through a vendor.

Applies when

A third party such as an attorney or insurer requests copies of a medical record from a provider or a medical records company

Exceptions

One free copy, and one copy of subsequently created records, must be provided without charge to the Bureau of Workers’ Compensation and the other recipients § 3701.741(C) names

StatewideOhio Rev. Code § 3701.741(A), (B)(2)Patients, personal representatives and authorized personsVerified 2026-08-30

What applies to physical therapy practices everywhere

Physical therapy moves treatment beyond the exam room. Home visits, mobile documentation, progress photography, exercise platforms, temporary staffing, workers' compensation, and frequent communication all expand the practice's ePHI surface.

The EHR, scheduling, billing, claims, and patient-portal systems

Home-exercise and patient-engagement platforms that receive identifiable treatment information

Progress photos and videos — including how they are captured, uploaded, stored, accessed, retained, and removed from devices

Laptops, tablets, and phones used in the clinic, during home visits, or while staff work remotely

Telehealth, secure messaging, email, text, e-fax, referral, and care-coordination workflows

Workers' compensation, employer, insurer, case-manager, and attorney disclosure processes

Full physical therapistscompliance guide →

Knowing the Ohio rule is not the same as meeting it.

The risk assessment asks what your practice actually does — which systems hold records, who reaches them, which vendors touch them — and reports against the obligations that apply to you, including the Ohio rules on this page.

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