Many states have laws that waive or limit the amount medical providers can charge for providing copies of medical records when the request is made in connection with a Social Security disability or SSI claim. Other states have limits that apply to all requests, regardless of purpose, while other states have no limits at all.  Below is the readily available information regarding states’ laws on this issue. Please let us know of any errors in this information.  Also, send us a copy of the applicable statutes or regulations.

Many of the state laws that limit costs were initiated by NOSSCR members who contacted their state representative and pushed for such legislation.  If you are interested in contacting your state representative to pass a similar statute, contact NOSSCR for a copy of other states’ statutes to be used as a format for your state.

LAST UPDATED: SEPTEMBER 2017.

Alabama: $1.00 per page for the first 25 pages, not more than 50¢ per page for each page in excess of 25 pages, and a search fee limited to $5.00.  The actual cost of mailing the records can also be charged.  In addition to those fees, the medical provider can charge the actual reproduction costs of x-rays and other special medical records.  Code of Alabama § 12-21-6.1

Alaska: No state law limits the costs of providing copies of medical records.

Arizona: Medical providers may charge “a reasonable fee for the production of the records.”  Arizona Revised Statutes § 12-2295.  

Arkansas: 50¢ per page for the first 25 pages, and 25¢ per page for each additional page.  These costs do not apply to photocopies of x-rays.  A labor charge of up to $15.00 and the actual cost of postage can also be charged.  Additional “reasonable fees” can be charged for retrieval of records stored offsite and for narrative medical reports.  Arkansas Code § 16-46-106.

California: One free copy of a patient’s medical records for any unrepresented patient or former patient or the patient’s legal aid representative if the records are needed to support an appeal regarding eligibility for a public benefit program, which includes the Medi-Cal program, Social Security Disability Insurance Benefits, and Supplemental Security Income/State Supplementary Program for the Aged, Blind and Disabled (SSI/SSP) benefits.  However, if the patient is represented by a “private attorney,” meaning any attorney not employed by a nonprofit legal services entity, who is paying for the costs related to the patient’s appeal, pending the outcome of that appeal, then the medical provider may charge 25¢ per page or 50¢ per page for records that are copied from microfilm and any additional reasonable clerical costs incurred in making the records available.  Thus, the patient and/or patient’s representative is entitled to a free copy of the patient’s records if the patient is pro se, the patient’s representative is a legal services attorney, or the patient’s representative is a private attorney who is not advancing costs.  Additionally, the medical provider may charge “all reasonable costs, not exceeding actual costs” for copies of x-rays.  If the records are requested to support a SSDI or SSI appeal, the medical provider must “ensure that the copies are transmitted within 30 days after receiving the written request.”  California Health & Safety Code, Division 106, Chapter 1, § 123110.

Colorado: A fee is determined in accordance with HIPPA.  “Reasonable fees” are defined as $18.53 per page for the first 10 pages, 85¢ per page for the next 30 pages, and 57¢ per page for each additional page.  These costs do not apply to medical records that are stored on microfilm, which cost $1.50 per page, or radiographic studies, which cost the actual cost of reproduction for each radiograph copy.  Additionally, the medical provider may charge the actual postage, electronic media costs, if applicable, and applicable taxes as well as a fee of $10 for certification of the medical records.  Colorado Revised Statutes § 25-1-801.

Connecticut: No charge for medical records requested by a patient, patient's attorney or authorized representative “for the purpose of supporting a claim or appeal under any provision of the Social Security Act.”  The request must be accompanied by documentation of the claim or appeal.  The medical provider must furnish the records within 30 days of the request.  Connecticut General Statutes § 20-7c(d).

Delaware: $2.00 per page for the first 10 pages, $1.00 per page for pages 11-20, 90¢ per page for pages 21-60, and 50¢ per page for pages 61 and above.  The actual cost of reproduction may be charged for records unsusceptible to photocopying, such as radiology films, models, photographs or fetal monitoring strips.  The medical provider may also charge the actual cost of postage or shipping if the records are mailed.   Advance payment for medical records requested to make or complete an application for a disability benefits program is not required.  Delaware Administrative Code, Title 24, Division 1700, § 16.0See also State of Delaware, Medical Records Fees.

District of Columbia: Medical providers may charge “a reasonable fee for duplicating records,” payment of which may be required prior to providing the records in non-emergency situations.  The medical provider must provide copies of the records within 30 days of the request.  D.C. Municipal Regulations § 17-4612.2.  

Florida: Hospitals: $1.00 per page, plus sales tax and actual postage.  Non-paper records (such as microfiche) are subject to a charge not to exceed $2.00.  A fee of up to $1 may be charged for each year of records requested.  However, this does not apply to records maintained at any licensed facility that primarily provides psychiatric care, or to records of treatment for any mental or emotional condition, or records of substance abuse.  Florida Statutes, Title XXIX, Chapter 395, § 3025Doctors: While “the Board of Medicine urges physicians to provide their patients a copy of their medical records, upon request, without cost, especially when the patient is economically disadvantaged,” the doctor is permitted to charge $1.00 per page for the first 25 pages and 25¢ for each additional page.  But, the doctor may charge the actual cost of reproduction for x-rays and other special kinds of records.  Florida Administrative Code § 64B8-10.003.  Of note, Florida is currently in the process of revising Rule 64B8-10.003.  The rule proposed on March 15, 2015 would change the cost for supplying records to a flat $1 per page, among other things. 

Georgia: The relevant section in the Official Georgia Code, § 31-33-3, which sets forth the costs of copying and mailing patient records, specifically states that these costs “shall not apply to records requested in order to make or complete an application for a disability benefits program.”  Therefore, this Code section indicates that copies of records requested to support a SSDI or SSI claim will be provided free of charge.  However, despite this language, some representatives have reported being charged fees for copies of patient records with providers saying this section is not applicable.  Of note, this Code section does apply to a patient’s psychiatric, psychological, and other mental health records.  Official Georgia Code Annotated § 31-33-3See also Georgia Department of Community Health, Medical Records Retrieval Rates.

Hawaii: “Reasonable costs incurred by a health care provider in making copies of medical records shall be borne by the requesting person.”  Hawaii Revised Statutes § 622-57(g).

Idaho: No state law limits the costs of providing copies of medical records.

Illinois: $1.02 per page for the first 25 pages, 68¢ per page for pages 26-50, and 34¢ per page for pages in excess of 50.  Additionally, a handling charge of $27.33 and the actual postage or shipping charge, if any, plus copy charges must be paid.  But, the cost for copies made from microfiche or microfilm is $1.71 per page.  Also, the medical provider may “charge for the reasonable cost of all duplication of record material or information that cannot routinely be copied or duplicated on a standard commercial photocopy machine such as x-ray films or pictures.”  For electronic records, retrieved from a scanning, digital imaging, electronic information or other digital format in an electronic document, a charge of 50% of the per page charge for paper copies listed above.  This per page charge includes the cost of each CD Rom, DVD, or other storage media.  Illinois Compiled Statutes, Chapter 735, § 5/8-2001(d)See also State of Illinois Comptroller, Copying Fees Adjustments.  

Indiana: The Department of Insurance sets the rules for making and providing copies of medical records.  Indiana Code, Title 16, Article 39, Chapter 9, § 2.  The maximum copying fees are $1 per page for the first 10 pages, 50¢ per page for pages 11-50, and 25¢ per page for pages 51 and higher.  Additionally, the medical provider may charge the actual costs of mailing.   A $20 labor fee can also be charged; however, if a labor fee is charged, the first 10 pages are free.  An expedited processing fee of $10 may be charged if the records are provided within two working days.  The medical provider may also charge $20 for certified records.  Indiana Administrative Code, Title 760, Article 1, Rule 71, § 3.

Iowa: Medical providers may charge “the actual cost of production” for producing patient records or images, which cannot “exceed the rates established by the workers’ compensation commissioner for copies of records in workers’ compensation cases.”  The records and images must be provided within 30 days of receipt of the written request.  The medical provider may also charge $10 for certified records.  Iowa Code § 622.10(6).  The rates established by the workers’ compensation commissioner are $20 for pages 1-20, $20 plus $1 per page for 21-30 pages, $30 plus 50¢ per page for 31-100 pages, $65 plus 25¢ per page for 101-200 pages, $90 plus 10¢ per page for more than 200 pages, and the actual expense of postage.  Iowa Administrative Code § 876.8.9

Kansas: No state law limits the costs of providing copies of medical records since Kansas Statutes Annotated § 65-4971(b) was repealed by the 2011 Kansas Legislature.  See STATUTES REPEALED OR AMENDED BY THE 2011 LEGISLATURE (REVISED).

Kentucky: One free copy of a patient’s medical records upon the patient’s written request.  A copying fee of $1 per page may be charged “for furnishing a second copy of the patient's medical record upon request either by the patient or the patient's attorney or the patient's authorized representative.”  This does not apply to the Department of Corrections.  Kentucky Revised Statutes § 422.317.

Louisiana: 50¢ per page for the first 5 pages and 25¢ for each additional page for “any records that are necessary to support [a patient’s] filing for Social Security disability benefits or Supplemental Security Income benefits under any provision of the Social Security Act.”  However, “the amount due shall not be less than the amount paid by the Department of Children and Family Services [DCFS] for such copies.”  Unfortunately, the DCFS rate is not published online, but we have been told it is $20 as of March 2017.  Louisiana Revised Statutes § 46:18

Maine: Hospitals: For paper copies, $5 for the first page and 45¢ for each additional page, up to a maximum of $250 for the entire medical record.  For electronic copies, the hospital may charge “reasonable actual costs of staff time to create or copy the medical record and the costs of necessary supplies and postage,” not to exceed $150.  “Actual costs may not include a retrieval fee or the costs of new technology, maintenance of the electronic record system, data access or storage infrastructure.”  Maine Revised Statutes, Title 22, Subtitle 2, Part 4, Chapter 401, § 1711Doctors: For paper copies, $5 for the first page and 45¢ for each additional page, up to a maximum of $250 for the entire treatment record or medical report.  For electronic copies, the doctor may charge “reasonable actual costs of staff time to create or copy the treatment record or medical report and the costs of necessary supplies and postage,” not to exceed $150.  “Actual costs may not include a retrieval fee or the costs of new technology, maintenance of the electronic record system, data access or storage infrastructure.”  Maine Revised Statutes, Title 22, Subtitle 2, Part 4, Chapter 401, § 1711-A.

Maryland: 75¢ per page plus the actual cost for postage and handling.  Additionally, a medical provider may charge a $22.88 preparation fee (unless the records are provided directly to the patient per federal HIPPA regulations).  Code of Maryland, Health – General § 4-304(c)(3).

Massachusetts: Hospitals & Clinics: No charge for medical records requested by “any applicant, beneficiary or individual representing said applicant or beneficiary… for the purpose of supporting a claim or appeal under any provision of the Social Security Act,” upon proof that the records are being requested for this purpose.  The hospital must furnish the records within 30 days.  Massachusetts General Laws, Chapter 111, § 70Doctors: No charge for medical records requested by “any applicant, beneficiary or individual representing said applicant or beneficiary if the record is requested for the purpose of supporting a claim or appeal under any provision of the Social Security Act,” upon proof that the records are being requested for this purpose.  Code of Massachusetts Regulations, Title 243, § 2.07(13)(d).  

Michigan: One free copy of a patient’s medical records for “a medically indigent individual.”  Any additional requests are subject to an initial fee of $23.17 per request, plus $1.19 per page for the first 20 pages, 60¢ per page for pages 21-50, and 23¢ per page for pages 51+.  However, a medical provider cannot charge a patient an initial fee for his/her own medical records.  Michigan Compiled Laws § 333.26269See also State of Michigan Department of Health and Human Services, 2017 MEDICAL RECORDS ACCESS ACT FEES (In Accordance with the Consumer Price Index).  

Minnesota: $10 retrieval fee only for “copies of records requested by a patient or the patient's authorized representative if the request for copies of records is for purposes of appealing a denial of Social Security disability income or Social Security disability benefits under title II or title XVI of the Social Security Act.”  But, a medical provider cannot even charge the retrieval fee “to a person who is receiving public assistance, who is represented by an attorney on behalf of a civil legal services program or a volunteer attorney program based on indigency.”  For further appeals, “a patient may receive no more than two medical record updates without charge, but only for medical record information previously not provided.”  Minnesota Statutes § 144.292, subdivision 6, paragraph (d).

Mississippi: $20 total for pages 1-20, $1 per page for the next 80 pages, and 50¢ per page for any additional pages.  A medical provider may add 10% of the total charges for postage and handling.  Also, an extra $15 can be charged for retrieval of records stored offsite.  Mississippi Code Annotated § 11-1-52(1).  

Missouri: For paper copies, a $24.85 search and retrieval fee, plus 57¢ per page.  An extra $23.26 can be charged for retrieval of records stored offsite.  For electronic copies, a $24.85 search and retrieval fee, plus 57¢ per page, or $108.88 total, whichever is less.  Additionally, a medical provider may charge postage, to include packaging and delivery cost, and a $2 notary fee, if requested.  Missouri Revised Statutes § 191.227.1See also Missouri Department of Health and Senior Services, Fees for Medical Records (Effective 2/1/17).

Montana: $15 administrative fee for searching and handling, plus 50¢ per page for paper copies.  Montana Code Annotated § 50-16-540.

Nebraska: No charge for medical records requested by a patient for use in supporting an application for disability benefits or an appeal relating to the denial of such benefits under Title II, Title XVI, or Title XVIII of the Social Security Act.  The request must also include a statement or document from the Social Security Administration that confirms the application or appeal.  Nebraska Revised Statute § 71-8405.

Nevada: One free copy of a patient’s medical records “necessary to support a claim or appeal under any provision of the Social Security Act… if the request is accompanied by documentation of the claim or appeal.”  A copying fee of 60¢ per page plus “a reasonable cost for copies of x-ray photographs and other health care records produced by similar processes” may be charged for furnishing a second copy of the patient’s records to support the same claim or appeal.  “No administrative fee or additional service fee of any kind may be charged for furnishing such a copy.”  However, a medical provider cannot deny furnishing a copy of the records “solely because the patient is unable to pay the [applicable] fees.”  The records must be provided within 30 days of receipt of the request.  Nevada Revised Statutes § 629.061(5)

New Hampshire: $15 total for the first 30 pages or 50¢ per page, whichever is greater.  However, a medical provider may charge a “reasonable cost” for providing copies of “filmed records,” including radiograms, x-rays, and sonograms.  New Hampshire Revised Statutes, Title XXX, § 332-I:1.  

New Jersey: Hospitals: $10 search fee per request, plus $1 per page or $100 per record for the first 100 pages.  For records containing more than 100 pages, a copying fee of 25¢ per page may be charged for each page over the first 100 pages, up to a maximum of $200 for the entire record.  Additionally, the hospital may charge a postage charge of actual costs of mailing.  New Jersey Administrative Code § 8:43G-15.3(d)Doctors: $1 per page or $100 for the entire record, whichever is less.  If the record requested is less than 10 pages, the doctor may charge up to $10 to cover postage and miscellaneous retrieval costs.  For copies of x-rays or “any other material within a patient record which cannot be routinely copied or duplicated on a commercial photocopy machine,” the doctor may charge the actual cost of duplication, or the fee charged to the provider for duplication plus an administrative fee of the lesser of $10 or 10% of the cost of reproduction.  New Jersey Administrative Code § 13:35-6.5(c)4.

New Mexico: $2 per page for the first 10 (one-sided) pages, 20¢ per page for each additional page. New Mexico Administrative Code § 7.1.10.10.  All requests for medical records needed to support a Social Security disability application or appeal must be accompanied by a written verification of the application or appeal.  New Mexico Administrative Code § 7.1.10.8B.  Regardless of whether the applicable fees have been paid, the medical provider must produce the records within 30 days of receipt of the written request.  New Mexico Administrative Code § 7.1.10.9.

New York: No charge for medical records if requested “for the purpose of supporting an application, claim or appeal for any government benefit or program…”  If the medical provider maintains records in electronic format, it will provide copies “in either electronic or paper form, as required by the government benefit or program, or at the patient’s request.”  New York Public Health Law § 17.  

North Carolina: 75¢ per page for the first 25 pages, 50¢ per page for pages 26-100, and 25¢ per page for each page over 100, with a minimum fee of $10.  North Carolina General Statutes § 90-411.

North Dakota: For paper copies, $20 total for the first 25 pages, plus 75¢ per page for each additional page.  For electronic copies, $30 total for the first 25 pages, plus 25¢ per page for each additional page.  North Dakota Century Code § 23-12-14.2.

Ohio: One free copy of a patient’s medical records, plus one free copy of any updated records (excluding copies of records already provided), to a patient or his/her representative “if the medical record is necessary to support a claim under Title II or Title XVI of the Social Security Act.”  The request must be accompanied by documentation that a disability claim has been filed.  Ohio Revised Code § 3701.741(C)(1)(e).

Oklahoma: For paper copies, 50¢ per page, except for x-rays or other photographs, images or pathology slides, which cost $5 each.  If an attorney requests the records, the medical provider may charge an additional $10 base fee, plus postage or delivery fees.   For electronic copies, 30¢ per page plus delivery fees, not to exceed $200.  However, a medical provider cannot charge a patient requesting his/her own records any fees for “searching, retrieving, reviewing, and preparing medical records…”  Oklahoma Statutes § 76-19(A)(2).

Oregon: Effective July 3, 2017, one free copy of a patient’s medical records for the period from the date of the alleged onset of disability to the date of the administrative hearing to support an appeal of the denial of Social Security disability benefits to the claimant or his/her representative in either paper or electronic format.  Oregon Revised Statutes § 192.576 as amended by Senate Bill 275.   

Pennsylvania: $27.92 flat fee for production of records “requested for the purpose of supporting a claim or appeal under any provision of the Social Security Act.”  The medical provider must be given “clear and convincing documentation” that the records are necessary to support a Social Security claim or appeal.  Pennsylvania Consolidated Statutes, Title 42, Chapter 1, § 6152.1See also Pennsylvania Bulletin, Amendments to Charges for Medical Records, Doc. No. 16-2082.

Puerto Rico: Although Laws of Puerto Rico Annotated, Title 24, Chapter 132, § 3049(e) specifies that all “patients are entitled to receive a copy of their medical record,” no state law limits the costs of providing copies of medical records.

Rhode Island: No charge for medical records furnished to a patient or his/her attorney or representative if “necessary for the purposes of supporting an appeal under any provision of the Social Security Act,” and the request is accompanied by documentation of the appeal.  The medical provider must furnish the records within 30 days of receipt of the request.  Rhode Island General Laws § 23-17-19.1(16).

South Carolina: Hospitals & Clinics: For paper copies, 65¢ per page for the first 30 pages, 50¢ per page for each additional page, plus a $25 clerical fee, altogether not to exceed $200 per admission.  But, actual postage and applicable sales tax may be charged.  For electronic copies, 65¢ per page for the first 30 pages, 50¢ per page for each additional page, plus a $25 clerical fee, altogether not to exceed $150 per request (regardless of the number of records or number of admissions).  But, actual postage and applicable sales tax may be charged.  For copies of x-rays, the hospital may charge the actual cost of reproduction, including the cost of materials and supplies used to duplicate the x-ray and the labor and overhead costs associated with the duplication.   The hospital must furnish the records within 45 days after the patient’s discharge or after the request is received, whichever is later.  The clerical fee for searching and handling may be charged even when no medical records are found, unless the request is made by the actual patient.  South Carolina Code of Laws § 44-7-325Doctors: For paper copies, 65¢ per page for the first 30 pages, 50¢ per page for each additional page, plus a $25 clerical fee, altogether not to exceed $200 per request.  But, actual postage and applicable sales tax may be charged.  For electronic copies, 65¢ per page for the first 30 pages, 50¢ per page for each additional page, plus a $25 clerical fee, altogether not to exceed $150 per request.  But, actual postage and applicable sales tax may be charged.  For copies of x-rays, the doctor may charge the actual cost of reproduction, including the cost of materials and supplies used to duplicate the x-ray and the labor and overhead costs associated with the duplication.  The clerical fee for searching and handling may be charged even when no medical records are found, unless the request is made by the actual patient.  South Carolina Code of Laws § 44-115-80For BOTH Hospitals & Doctors: The fees authorized to be charged in both statutes (§§ 44-7-325 & 44-115-80) are adjusted by a 0.8% increase for the current fiscal year (e.g. a fee of $100 is adjusted to $100.80)See S.C. Department of Health and Environmental Control, Annual Adjustment to the Fee for Search and Duplication of a Medical Record.  

South Dakota: $10 total for the first 10 pages, and 33¢ for each additional page.  South Dakota Administrative Rules § 47:03:05:09

Tennessee: Hospitals: No charge for medical records for an “indigent person” to support a claim or appeal under any provision of the Social Security Act, if the request is accompanied by a copy of a recent application for or decision denying Social Security benefits.  “Patients being represented by organizations whose purpose is to provide legal assistance to the indigent, or represented by attorneys with an affiliated pro bono program, shall be presumed indigent.”  The hospital must furnish the records within 30 days of the request.  For non-indigent patients, the hospital may charge an $18 fee, which includes the first 5 pages and a per page charge of 85¢ for pages 6-50, 60¢ per page for pages 51-250, and 35¢ per page for each page after that.  The hospital may also charge $20 for each certified record.  Tennessee Code Annotated § 68-11-304Doctors: $20 total for records 5 pages or less and 50¢ per page for each page over the first 5 pages, plus the actual cost of mailing.  The doctor may also charge $20 for certified records. Tennessee Code Annotated § 63-2-102.

Texas: One free copy of a patient’s medical records, including mental health records, requested by a patient, former patient, or his/her attorney or representative for use in supporting an application for or appeal of disability benefits under Title II, Title XVI, or Title XVIII of the Social Security Act.  The request must also include documentation from the Social Security Administration confirming the application or appeal.  Texas Health & Safety Code § 161.202

Utah: For paper copies, a $21.16 search fee per request, plus 53¢ per page for the first 40 pages, and 32¢ per page for each additional page, plus the cost of postage.  For electronic copies, for record requests made on or before June 30, 2018, the per page fee is 60% of the per page paper copy fee (31.8¢ or 19.2¢); for record requests made on or after July 1, 2018, the per page fee is 50% of the per page paper copy fee (26.5¢ or 16¢).  Utah Code § 78B-5-618.

Vermont: No charge for medical records “requested to support a claim or an appeal under any provision of the Social Security Act.”  Vermont Statutes Annotated, Title 18, § 9419(a).

Virginia: If a patient requests a copy of his/her own records, a medical provider may charge a “reasonable cost-based fee,” which can only include the cost of supplies for and labor of copying the requested information, postage, and preparation of an explanation or summary of such information as agreed to by the patient.  Code of Virginia § 32.1-127.1:03(J).  If an attorney requests a copy of the patient’s records, for paper copies, a medical provider may charge 50¢ per page up to 50 pages and 25¢ per page for each additional page, plus a $20 search and handling fee and all postage and shipping costs.  These costs do not apply to photocopies of x-rays, which cost a “reasonable fee” that may include a search and handling fee of $10 plus the actual cost of reproduction and all postage and shipping costs, or copies from microfilm or other micrographic process, which cost $1 per page.  For electronic copies, a medical provider may charge 37¢ per page up to 50 pages and 18¢ per page for each additional page, plus a $20 search and handling fee and all postage and shipping costs, not to exceed a total of $150 for requests made on or after July 1, 2017 but before July 1, 2021, or $160 for requests made on or after July 1, 2021.  These costs do not apply to electronic copies of x-rays, which cost a “reasonable fee” of $25 per x-ray, plus a search and handling fee of $10 and all postage and shipping costs.  The patient’s attorney must provide the medical provider with a written confirmation signed by the patient confirming the attorney’s authority to make the request (a photocopy, facsimile or other copy of the original signed by the patient is acceptable).  Code of Virginia § 8.01-413(B).

Washington: $1.12 per page for the first 30 pages and 84¢ per page for each additional page, plus a $25 clerical fee.  These fees are effective until June 30, 2017.  Washington Administrative Code § 246-08-400See also Revised Code of Washington § 70.02.010(37).

West Virginia: One free copy of a patient’s medical records for an “indigent person” if necessary to support a claim or appeal under any provisions of the Social Security Act.  Patients are considered indigent if he/she is “represented by an organization or affiliated pro bono program that provides legal assistance to indigents; or verifies on a medical records request and release form that the records are requested for purposes of supporting a Social Security claim or appeal and submits with the release form reasonable proof that the person is financially unable to pay full copying charges by reason of unemployment, disability, income below the federal poverty level, or receipt of state or federal income assistance.”  For non-indigent patients, the medical provider may charge $25 per hour of copying, plus cost of supplies and postage.  West Virginia Code § 16-29-2.

Wisconsin: If a patient or his/her representative requests medical records for use in appealing the denial of a Social Security disability insurance or Supplemental Security Income claim, the medical provider cannot charge “more than the amount that the federal Social Security Administration reimburses the department for copies of patient health care records.”  Wisconsin Statutes § 146.83(1f)(am)

Wyoming: A medical provider may charge “reasonable charges, and charge a patient for the actual costs incurred in responding to a patient's request” for medical records, including “the cost of copies, clerical staff time and the physician’s time in reviewing and summarizing the records and/or x-rays and diagnostic records, if necessary.”  A medical provider cannot deny a patient a summary or copy of his/her medical records because of an inability to pay.  Wyoming Administrative Rules, Board of Medicine, Chapter 3: Practice of Medicine, § 4(e).

HIPPA: The Privacy Rule permits a medical provider to impose a “reasonable, cost-based fee,” which may include only the cost of labor for copying the requested records, whether in paper or electronic form; supplies for creating the paper copy or electronic media (e.g., CD or USB drive); postage, when records are requested to be mailed; and preparation of an explanation or summary of the medical records, if agreed to by the patient.  45 CFR § 164.524(c)(4).  The fee may not include costs associated with verification, documentation, search and retrieval, maintaining systems, recouping capital for data access, storage, or infrastructure, or other costs not listed above, even if such costs are authorized by state law.  See also U.S. Department of Health & Human Services, Individuals’ Right under HIPAA to Access their Health Information 45 CFR § 164.524.

HITECH Act: Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, healthcare providers that maintain electronic medical records are required to provide them to third parties, excluding psychotherapy records, for the actual cost of production within 30 days of the written request.  The request must be signed by the patient indicating that it is a patient’s request for medical records to be sent to a third party (i.e. the attorney/representative).  When applicable, HITECH preempts state law, unless the state law provides greater rights to the individual.  Recently, the Department of Health and Human Services (HHS) clarified that $6.50 is not the maximum amount that can be charged for requests for an electronic copy of protected health information (PHI) maintained electronically.  “Charging a flat fee not to exceed $6.50 per request is therefore an option available to entities that do not want to go through the process of calculating actual or average allowable costs for requests for electronic copies of PHI maintained electronically.”  See “New Clarification – $6.50 Flat Rate Option is Not a Cap on Fees for Copies of PHI,” U.S. Department of Health & Human Services, Individuals’ Right under HIPAA to Access their Health Information 45 CFR § 164.524.

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