If a patient is behind on payments, can I withhold records or stop treatment ?

No. This would be a violation of state and federal laws governing patient access to records. Both HIPAA and state laws require health care providers to make requested health records available to a patient (within 15 days of the request, according to California law). This right to receive records upon request is not conditional on whether the patient is current in paying bills for past treatment. If a patient is behind in payments, you have alternative options, such as submitting unpaid bills to collection. Stopping treatment that has already been initiated would be improper if doing so would cause injury to the patient; in that case, discontinuation of treatment would violate the standard of care. You must complete the pending treatment but may refuse to provide further treatment and you may undertake proper actions to discontinue your relationship with that patient. You should ensure that discontinuation of treatment cannot be construed as abandonment of the patient.