The Government Accountability Office (GAO) lately performed an audit which revealed that patients continue to face many difficulties in obtaining copies of their health records. Healthcare companies and insurers are likewise unable to satisfy HIPAA requirements ending up in a breach of HIPAA rules sometimes.
The 21st Century Cures Act required the audit to find out the status of patient access to their healthcare records. Stakeholders, provider agencies, vendors, patient advocates, HHS and state officers coming from four states took part in the audit interviews. Kentucky, Rhose Island, Ohio and Wisconsin were the chosen states maybe because of the amount of fees that patients spend to obtain copies of their medical data.
The HIPAA safeguards the rights of patients to obtain copies of their healthcare data. Patients could request paper or digital healthcare data, which should be prepared in 30 days. Upon claiming of the requested copies, HIPAA-covered organizations can ask the patients to pay a reasonable amount.
Patients may need copies of their healthcare data for the following reasons:
- to have the necesary information to be more engaged in their self-care
- to pass on their medical records to new providers
- to sort out disputes on insurance claims
- to provide the patients health data to a third party such as an attorney
- to file disability claims
- so that doctors can give a copy of the patient’s health records to another doctor for second opinion
Based on the result of the GAO audit, providers from different states charged considerably varying fees various types of request. Certain providers have set fees, formulas and restrictions. Three states have per-page rates, and various prices for medical images such as X-ray duplicates.
Ohio – has a per-page rate for third party requests
Rhode Island – has a maximum charge for providers using an EHR for patient requests
Kentucky – offers patients one free copy of their healthcare records and bills $1 per page for additional copies
The HIPAA mandates providers to bill only a fair, cost-based fee for health records requested by patients. This arrangement doesn’t apply to third party requests for copies of medical records. Providers are allowed to ask for higher fees for third party requests.
Regrettably, many providers fail to comply with this HIPAA Rule. There are many instances in the GAO report that excessive fees are charged to individuals getting copies of their healthcare records.
- One patient spent $148 for a PDF of his healthcare records
- Two patients spent above $500 for just one copy of their healthcare records
- There are some that paid yearly subscription fees to access their healthcare records
- One patient had to pay a retrieval fee to a release-of-information (ROI) vendor to obtain a copy of her healthcare records, even though the HIPAA prohibits it
- Some patients whose medical records comprise many pages because of many doctor visits, have to pay a big amount when requesting a copy
Because of the excessive costs linked to obtaining copies of health information, a lot of patients just cancelled their requests for a copy. The GAO report revealed that although HIPAA has very clear guidelines, numerous patients are still unable to exercise their legal rights to get their copies of health records.