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This short piece examines the interaction between the Health Insurance Portability and Accountability Act (HIPAA), a federal law designed to protect the privacy of individuals’ health information, and state Freedom of Information (FOI) laws, which are designed to ensure public access to government documents. It describes three recent cases from different states that addressed difficult issues about where and how to draw the line between the public’s right to know and individuals’ rights to keep their medical information secret. It concludes that questions about the interaction of state FOI laws and HIPAA should be guided by the framework suggested in HIPAA regulations for understanding the interaction between HIPAA and the federal Freedom of Information Act. State courts and agencies should therefore use the provisions in state FOI laws that regard medical privacy to inform decisions about information requests from citizens and the media.