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Tallahassee Democrat: Chris Nuland: Medical records fee change is sensible

Monday, September 29, 2014

Next month, the Florida Board of Medicine will consider a rule change that would simplify the fees charged by physicians for the reproduction of medical records, by allowing hospitals and physicians to charge the same amount for medical records.

It’s a sensible step that would eliminate the confusing tiered and differential pricing system currently in place. Unfortunately, many special interests are trying to thwart this change in an attempt to limit their own business expenses.

The existing rule allows physicians to charge patients up to $1 per page for the first 25 pages, and 25 cents per page thereafter, a fee that has not been raised in more than a generation. Meanwhile, hospitals are allowed to charge a flat $1 per page, regardless of the number of pages. Not only is this differential pricing confusing, but also the lower physician rate fails to recognize the increased costs of complying with records requests in today’s world.

Before any records can be released, the federal Health Insurance Portability and Accountability Act (HIPAA) requires that all requestors, other than the patient, submit an authorization that has been signed by the patient. After an authorization is submitted, the record must be cleared to ensure HIPAA compliance, adding more time and labor to the medical records transmission process.

Moreover, when an attorney requests records, the physician runs the risk of a lawsuit if a single item is unintentionally omitted; these legal risks require a heightened degree of review, often by the physician’s own lawyers, and adds extra expense to the disclosure.

Finally, claims that the proposed rule change will increase fees patients pay for records are overstated. Even if the BOM proposal passes, the fees charged to patients are already limited by both the federal HIPAA and Health Information Technology for Economic and Clinical Health (HITECH) Act. In no event will a physician be allowed to charge the full $1 per page if that amount exceeds the physician’s actual costs.

It’s time to move past the legal challenges and adopt the proposed rule, which clarifies that anyone other than the patient may be billed $1 per page for a medical record, regardless of whether the records are requested from a hospital or physician.

Chris Nuland represents more than eight physician organizations, including the Florida Chapters of the American College of Physicians and the American College of Surgeons.

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