The Office for Civil Rights (OCR) recently came up with an explanation about the charges an HIPAA Covered Entity includes in a patient’s medical bill for having access to their medical records. The ‘additional information’ was posted on the agency’s website, which is meant to clear the doubts on the matter.
As per the post, a healthcare provider is allowed to add a reasonable fee to the patient’s medical bill, in order to compensate for providing the personal health information (PHI) copies to the patient. The additional charge should also cover providing copies of the electronic versions of the medical records. OCR experts said that this fee intends to cover the labor and supply costs incurred by the healthcare unit in providing copies of the medical records.
There are three ways of deciding the fee charged to a patient for the same: Actual Costs, Average Costs, and Flat Fee (providing copies of electronic medical records). In the Actual Costs model, a healthcare provider is required to calculate the actual labor costs involved in the process, if it includes only copying the medical records and/or providing a summary or explanation of the same. The provider is also allowed to add the supply costs incurred, such as paper or USB device, as well as the postage costs, if any.
In the Average Costs model, the healthcare provider can prepare a price plan based on the average costs associated with fulfilling the medical records access request of patients. It should include the labor and supply costs involved in the process, but only those that is permitted by HIPAA. Under the Flat Fee model, the entity can have a pre-set charge for providing access to the patient’s PHI that is maintained electronically. This should include all the labor and supply expenses related to the access request, and should not exceed $6.50.
Most healthcare units do not favor the Flat Fee model putting a $6.50 limit on the chargeable amount, as the actual costs incurred in fulfilling a patient’s access request can sometimes go beyond that. However, many of the entities also do not want to go through all the hassle of calculating the amount or putting up an average cost plan. All this is putting a lot pressure on the HHS to revise the rules on charging a patient for access to their medical records.
The post on the OCR website, however, only states that the charged amount should be reasonable, and does not share any information whether the agency is planning to revise the current amount cap for Flat Fee model or not.