I often have discussions with clients about their medical records. Most clients are unaware that they can request copies of those records for their personal use. It’s a relatively straight-forward request under the Health Information Technology for Economic and Clinical Health Act (the HITECH Act), which gives patients the “right to obtain…a copy of [their medical records] in an electronic format.” See 42 U.S.C. Section 17935 (e)(1). Most hospitals, group practices and medical records vendors have adopted electronic medical records systems, so this is typically not a labor-intensive request.
The healthcare provider is only allowed to charge the patient who is making the request the amount of the cost of copying the records, and for the labor involved in meeting the request. See 45 C.F.R 164.524(c)(4)(i). If the request is for electronic copies, however, there shouldn’t be a cost charged to the patient for paper copies. Regardless, medical providers routinely provide paper copies instead, and charge the maximum fee possible.
The HITECH Act doesn’t govern paper copies of medical records. State statutes do. Electronic copies are typically cheaper because most records are stored electronically – there are no supplies and minimal labor costs involved in meeting a patient’s request, which is the logic behind the HITECH Act: people have a right to their records and shouldn’t be burdened with the high cost of paper copies. Paper-copy fees can be cost-prohibitive for large files. Here’s a list of all states’ fees for easy reference.
Ordinarily, if I’m talking to someone about their medical records, it’s because I need to review them, or have my firm’s doctor and/or nurse consultants review them. HITECH allows third parties (doctors, lawyers, insurance companies) to make these requests of their client’s medical providers. “If requested by an individual, a covered entity must transmit the copy of the protected health information directly to another person designated by the individual.” See Federal Register, 2013 Vol. 78 No. 17, p. 5634. If they refuse, you can file a complaint with the Health & Human Services Office for Civil Rights.
This link to the U.S. Dept. of Health & Human Services’ FQAs regarding medical records covers a wide range of issues and includes citations to the Federal code for access to the source material underlying the answers provided on www.HHS.gov.