Fees and regulations associated with healthcare records can make it difficult for patients to access their own records, according to a report released by the U.S. Government Accountability Office (GAO).
The report studied laws in four states, while interviewing patient advocates, health plan administrators, and other stakeholders about the regulations surrounding patient access to healthcare records.
Though HIPAA laws have required healthcare organizations to allow patients to access their own healthcare records in a timely, affordable way, the report shows that those costs and regulations surrounding access can vary in each state.
The report released in June 2018 studied Kentucky, Ohio, Rhode Island, and Wisconsin, and found that access and fees vary depending on the type of request made and who is making it.
“We selected these states based on input from stakeholders, a review of state laws, and because these states have a range of different types of fees,” says Carolyn Yocom, director of the healthcare team for GAO.
For example, in Ohio, Rhode Island, and Wisconsin, patients are charged a per-page for records requests. There were also additional rates for X-ray and MRI image requests.
In Ohio, there are additional fees for third-party record requests (ex., from a patient’s lawyer). In Rhode Island, the state has a maximum allowable fee if the provider uses and EHR system for patient-directed requests. In Kentucky, patients are allowed one free copy of their healthcare records by law, and charges $1 per page for additional copies.
Patient advocates interviewed for the report say that some patients face high fees when experienced a healthcare emergency. They also note that patients don’t understand their rights when requesting their own records. The report found that two patients were charged more than $500 for a single record request, and two other patients were directed to pay an annual subscription fee to access healthcare records.
“According to patient advocates we interviewed, high fees can adversely affect patients’ access to their medical records. For example, one patient advocate told us that some patients simply cancel their requests after learning about the potential costs associated with their request. Another patient advocate told us that patients are often unable to afford the fees charged for accessing their medical records, even in cases when the fees are allowed under HIPAA or applicable state law,” the report states.