Increase in Costs for Copies – But Don’t Forget HIPAA

Effective July 1, 2009, medical providers in Washington may increase their charges for searching and duplicating medical records.  The Department of Health (“DOH”) recently released the updated fee schedule for providers.[1]  The revised charges are as follows: 

 Providers who personally edit confidential information from the record are allowed to charge their usual fee for a basic office visit.  Pursuant to HIPAA, this fee may be charged when the medical record is validly requested by someone other than the individual.

 HIPAA Limitations Relating to Medical Record Requests by Patients

 Though the WAC allows certain charges, HIPAA limits these charges when a patient requests duplication of his/her medical record.  Fees charged by providers may only include:

 Charges related to copying, including the cost of supplies and the labor for copying;

1. Postage fees; and
2. If, agreed to in advance by the patient, the cost of preparing an explanation or summary of the protected health information.[2]

 Applying both the WAC and HIPAA in combination, the clerical fee of $23.00 cannot be charged to a patient requesting a copy of his/her medical record; but a reasonable clerical fee for the labor of copying the medical record may be assessed.  Providers may not charge a fee equal to a basic office visit to the patient, but may charge a reasonable fee if a summary is provided.  Copying fees up to the maximum allowed by the WAC are permissible.  In addition, the HITECH Act amends HIPAA to allow a provider to impose a fee for the labor costs associated with copying an electronic medical record.

 [1] WAC 246-08-400

[2] 45 CFR § 164.524(c)(4).