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Sun Sentinel: Get the story straight about protecting patient records

Friday, December 05, 2014

The Florida Board of Medicine rule-making committee recently considered a change that would simplify the fees charged by physicians for the reproduction of medical records. This practical step would reduce the confusing tiered pricing system currently in place.

Unfortunately, many Florida personal injury attorneys are trying to confuse the issue in an attempt to limit their own business expenses related to personal injury claims they are handling.

Patients are seldom charged a fee. The majority of patient record requests are for continued care and therefore provided for free. In the event a patient may have a unique request for records, the existing rule allows physicians to charge patients $1 per page for the first 25 pages, and 25 cents per page thereafter. Attorneys, among other groups, can be charged $1 per page regardless of the number of pages.

Many attorneys have been attempting to work around this fee structure arguing they are acting on behalf of the patient and, therefore, should be subject to the patient rate.

It is interesting that attorneys would make this case since the procedure that must be followed to grant attorneys access to client medical records actually adds additional layers and steps to an already extensive process designed to protect the safety and security of patient records.

If a patient record request is made by an attorney, the federal Health Insurance Portability and Accountability Act requires the patient submit a signed authorization. Once the authorization is submitted, the record must be cleared to ensure HIPAA compliance, adding a 32-step process — more time and labor to the medical records transmission.

The process for a patient to obtain his or her own records is less arduous. Patients do not need to submit an authorization and only need to consent to the disclosure to get copies of their records.

The intent of HIPAA is to protect patient records. When someone other than the patient requests medical records, that request and record must be carefully reviewed to ensure the medical provider is complying with HIPAA and preserving patient privacy.

Further, attorneys confuse the issue by saying the proposed rule change will increase fees for patients, which is not accurate. If the proposed rule passes, the fees charged to patients will not change because those fees are set by both the federal HIPAA and Health Information Technology for Economic and Clinical Health Act.

Attorneys already pay $1 per page rate for any medical records received from hospitals, so this proposed change will bring fees charged by physicians into alignment with the hospital fee structure outlined in state law.

Instead of focusing on the security of their clients’ highly personal medical records, attorneys are fixated on their bottom lines. A wave of class-action lawsuits have been filed across the state costing medical providers and their contractors hundreds of thousands of dollars in attorneys’ fees and further confusing what should be a simple rule change.

We need to stop these legal challenges and clear up confusion. We encourage physicians and the public to urge the Board of Medicine to adopt the draft rule during their next board meeting in December.

Dr. Jason M. Goldman of Coral Springs is treasurer of the American College of Surgeons Florida Chapter.

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