Patient medical record fees violating HIPAA standard, advocates say

Medical records

Advocates are grilling healthcare providers over the prices they charge patients for electronic or printed medical records, claiming some fees may even go as far as to violate HIPAA rules.

The American Health Information Management Association recently said health information managers should remove or reduce the cost associated with supplying patients their electronic medical records. In addition, hospitals, physician practices and other facilities should charge no more than the actual supply and labor cost for providing paper copies of medical records, according to Katherine Downing, director of HIM Practice Excellence for AHIMA.

“If it costs only a dollar, that reasonable cost-based fee can’t be more than that,” Downing said.

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A recent survey suggests many HIM professionals may be violating the HIPAA standard, putting themselves at risk of an Office of Civil Rights audit, Downing said.

HIPAA requires healthcare providers furnish patients with a copy of their medical records within 30 days of the request. Under the HITECH Act of 2013, patients have the right to request their health information in electronic form. The fee imposed also cannot exceed the labor and supply costs of responding to the request.

The American Medical Association suggests “a reasonable fee” be charged for copying medical records.

A recent survey by the AHIMA Foundation and Texas State University shows fees charged, particularly for supplying paper medical records, vary widely by state.

Out of 313 AHIMA members who responded to the survey, about a quarter said they base their charges on state regulations. The survey findings show state fees varying from free to hundreds of dollars.

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About 65 percent of respondents said they charge less than $1 per page.

More than half, 52.6 percent, said they charge for electronic copies and 64.7 percent reported they charge patients for paper copies.

Downing said a member of her family was charged $200 to get medical records.

“It is frustrating, as far as customer service,” Downing said.

Under meaningful use criteria, healthcare organizations are encouraged to offer information via a patient portal. The portals offer patients a way to directly access their medical history.

“We really want to encourage patients to access their information,” Downing said.

However, half of the survey respondents said patient use of the portal systems was very low, at less than 5 percent.

Many healthcare professionals simply hand patients a CD of medical records, according to Downing.

“We believe that the electronic media available should drastically reduce the labor and supply costs,” Downing said. “More information is stored electronically. They must have a way to provide it in electronic form.”

Compliance in EHRs is good among hospitals and larger entities, she said.

“I think where this continues to be an issue is physician practices,” said Downing, who said she continues to hear complaints from patients who tell her they’ve gotten the run around in trying to access their medical information.

HIM professionals should evaluate practices to ensure compliance and have a procedure in place to comply within the 30-day deadline, according to Downing. Meanwhile, workers should seek to educate patients about how to access EHRs through online portals, which would eliminate the need for special charges.

For those using an EHR vendor, managers should push for tools for them to easily burn a CD of a patient’s records.

Twitter: @SusanMorseHFN