- A survey of healthcare providers has revealed that as much as 25% of those who charge patients for EHRs may be violating HIPAA rules by doing so, according to a report released by the American Health Information Management Association.
- While it is permitted to charge patients a "reasonable, cost-based fee" to access their electronic medical records, the survey revealed that many providers simply mimic their individual state's photocopy policy for public records requests, charging around $1 per page. Because the fee being charged to the patient is not related to the cost of providing the record, it constitutes a violation of HIPAA policy, the report stated.
- "Regarding charges for electronic and paper copies of records, more than half (52.6%) of respondents indicated that they charge patients for electronic copies of their medical records, and nearly two-thirds (64.7%) reported that they charge patients for paper copies of their medical records," the report stated. "Charges for electronic copies varied from a flat fee for a device to per-page fees or some combination of the two, and charges for paper copies were generally by page, with 65% reporting that they charged less than $1.00 per page. Nearly one in four respondents (23.6%) commented that they follow their state's rates for copies. Following the state rates would suggest that the fees are not uniquely based on the cost to the facility. This finding would appear to be inconsistent with HIPAA and HITECH requirements that patients may only be charged a 'reasonable cost-based fee' for copies of their medical records."
There is no doubt that the implementation of EHRs is one of the most expensive projects to hit the healthcare industry since its inception, and it's obvious that the cost of implementation is going to eventually be picked up by the consumer. Taxpayers are already footing the bill for the $28 billion already appropriated by Congress to facilitate EHR implementation through its meaningful use program, but that still doesn't cover all of their EHR expenses.
All that being said, what's at issue here is a patient's right to obtain his or her medical records. The whole point of the paperless revolution is to streamline health information and reduce costs associated with paper-only records. By that logic, HIPAA requirements are reasonable. They simply state that providers don't have the right to charge patients unreasonably to get electronic copies of their records.
Now, $1 a page (or even less) may not sound unreasonable on the surface, but with medical advances transforming many fatal conditions into chronic conditions, patients are living longer with proper treatment. It's not uncommon for a cancer patient in remission to have hundreds of pages in their medical records. And in the age of the ACA, many patients are changing doctors and plans, necessitating transfer of the EHRs. Is it fair to charge several hundred dollars for a process that is equivalent in many cases to pointing, clicking and sending an email?