GAO: Medical records are still too challenging to obtain — 7 things to know

Despite a HIPAA-granted right to their own medical records, patients still struggle to easily access their data, according to a May Government Accountability Office audit.

The fees patients are charged to access their records vary across states and by the type of request, according to the government watchdog, which reviewed the laws of four states — Ohio, Kentucky, Rhode Island and Wisconsin —  and interviewed various stakeholders including provider associations, vendors that work for providers, patient advocates, state officials and HHS officials for its audit.

Here are seven things to know.

1. HIPAA allows providers to charge patients a reasonable cost-based fee when they request copies of their medical records or ask their data be sent to another provider. However, fees associated with third-party requests — which occur when a patient gives permission to another entity to request copies of their records —  are not subject to the reasonable cost-based standard and are generally controlled by state law.

2. Three of the states — Ohio, Rhode Island and Wisconsin — charge different per-page fees, and the total amount charged varies depending on the number of pages requested. These states also charge specific fee rates for imaging requests such as X-rays or MRIs.  

3. Under Kentucky's state law, patients are entitled to one free copy of their medical record, but for any additional requests, the statute allows providers to charge up to $1 per page.

4. Ohio is the only state GAO found to charge third parties different rates than patients. Third parties are subject to an initial $16.54 fee, and the per-page fees range from $1.11 to 23 cents depending on the number of pages requested.

5. Rhode Island is the only state GAO reviewed to set a maximum allowable fee ($100) if the provider uses an EHR for patient and third party requests.

6. Stakeholders said patients perceive these fees as high, and not all patients are aware of their right to challenge providers who deny them access to their medical records.

7. Providers said the costs associated with processing patient requests, including staff time and other resources, are a key challenge. Stakeholders told GAO fulfilling requests has become more complex because of EHRs — some of the information may be stored on multiple, disparate EHRs or stored on both paper and the EHR, requiring "providers or their vendors [to]carefully go through each page of the record to ensure only the correct patient's medical records are being released."

Click here to read the GAO's full report.

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