bulletin - Allegheny County Medical Society

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○SPECIAL REPORTMedical Records Reproduction FeesUnder 42 Pa.C.S. §§6152 and 6155 (relating tosubpoena of records and rights of patients), theSecretary of Health (secretary) is directed toadjust annually the amounts which may be charged by ahealth care facility or health care provider upon receipt ofa request or subpoena for production of medical charts orrecords. These charges apply to any request for a copy of amedical chart or record except as follows:(1) Flat fees (as listed in this notice) apply toamounts that may be charged by a health care facilityor health care provider when copying medicalcharges or records either for the purpose of supportingany claim or appeal under the Social Security Actor any federal or state financial needs based program,or for a district attorney.(2) An insurer shall not be required to pay forcopies of medical records required to validate medicalservices for which reimbursement is sought underan insurance contract, except as provided in: (a) theWorker’s Compensation Act (77 P.S. §§1—1041.1and 2501—2506) and the regulations promulgatedthereunder; (b) 75 Pa.C.S. Chapter 17 (relating tomotor vehicle financial responsibility law) and theregulations promulgated thereunder; or (c) a contractbetween an insurer and any other party.The charges listed in this notice do not apply to anX-ray film or any other portion of a medical record that isnot susceptible to photostatic reproduction.Under 42 Pa.C.S. §6152.1 (relating to limit oncharges), the secretary is directed to make a similaradjustment to the flat fee which may be charged by ahealth care facility or health care provider for the expenseof reproducing medical charts or records where therequest is: (1) for the purpose of supporting a claim orappeal under the Social Security Act or any federal or statefinancial needs based benefit program; or (2) made by adistrict attorney.The secretary is directed to base these adjustments onthe most recent changes in the Consumer Price Indexreported annually by the Bureau of Labor Statistics of theUnited States Department of Labor. For the annualMedical RecordsReproduction Fee Schedule for 20112001 HIPAARetrieval Fee ... $19.92 .............................. $0Pages 1-20 ......... $1.34/page ....... Cost to copy & mailPages 21-60 ........ $ .99/page ....... Cost to copy & mailPages 61+ .......... $ .33/page ....... Cost to copy & mailMicrofilm copies $ 1.97/page ....... Cost to copy & mail38 Bulletin : January 2011period of October 31, 2009, through October 31, 2010,the Consumer Price Index was 1.2 percent.Accordingly, the secretary provides notice that,effective January 1, 2011, the following fees may becharged by a health care facility or health care provider forproduction of records in response to subpoena or request:The Department of Health and Human Services hasstated that, under HIPAA, medical record copying feesfor patients may not include costs associated with searchingfor and retrieving the medical record. For a subpoena,attorney, or insurance company requests, you may chargethe fees, including the search and retrieval fee. To determineyour cost for copying and mailing medical recordsfor a patient request under HIPAA, you should considerthe following:• Salary and benefits of the person who does the copying.Include all steps of the process, i.e., verifying validity ofauthorization, pulling the chart, reviewing the record,removing the records, copying, preparation for mailing,re-assembling the chart, and re-filing the chart.• Cost of the supplies, i.e., paper, toner, envelopes, etc.• Cost of equipment, i.e., prorated lease or depreciationexpense.In addition to the amounts listed, charges may also beassessed for the actual cost of postage, shipping anddelivery of the requested records.Neither PA Law or HIPAA mandates that charges beassessed for copies of medical records. It merely sets themaximum fees that can be charged.