Friday, January 23, 2015

New Rules Regarding Allowable Fees Issued by Medical Providers for Copying Medical Records

I received the below information by email from MCS (www.themcsgroup.com), a subpoena/records acquisition/deposition vendor that I utilize in my practice.  As the info may impact many in terms of costs of securing copies of medical files from medical providers, I thought I would pass it along verbatim:


Effective January 1, 2015, the Commonwealth of Pennsylvania has adjusted the fees for copying medical records at all health care institutions within the state. The new rules are as follows:
 
1. Flat fees apply to amounts that may be charged by a health care facility or health care provider when copying medical charts or records either:
 
(a)  for the purpose of supporting any claim or appeal under the Social Security Act or any Federal or State financial needs based program
 
(b)  for a district attorney.
 
2. An insurer shall not be required to pay for copies of medical records required to validate medical services for which reimbursement is sought under an insurance contract, except as provided in:
 
(a)  the Workers' Compensation Act and the regulations promulgated thereunder
 
(b)  75 Pa.C.S. Chapter 17 (relating to Motor Vehicle Financial Responsibility Law) and the regulations promulgated thereunder
 
(c)  a contract between an insurer and any other party.
    
The charges listed in this advisory do not apply to an X-ray film or any other portion of a medical record which is not susceptible to photostatic reproduction.
   
The Secretary of Health is also directed to make a similar adjustment to the flat fee which may be charged by a health care facility or health care provider for the expense of reproducing medical charts or records where the request is:

(a)  for the purpose of supporting a claim or appeal under the Social Security Act or any Federal or State financial needs based benefit program
 
(b)  made by a district attorney.
    
The Secretary of Health bases these adjustments on the most recent changes in the Consumer Price Index reported annually by the Bureau of Labor Statistics of the United States Department of Labor.
   
For 2015, the following fees may be charged by a health care facility or health care provider for production of records in response to subpoena or request:

Search & Retrieval of Records Flat Fee
$21.69
Amount charged per page for pages 1-20
$1.46
Amount charged per page for pages 21-60
$1.08
Amount charged per page for pages 61-end
$0.36
Amount charged per page for microfilm copies
$2.16
     
These fees will apply for paper copies or reproductions on electronic media whether the records are stored on paper or in electronic format.

Note: In addition to the amounts listed above, charges may also be assessed for the actual cost of postage, shipping and delivery of the requested records.



For more information please contact

Alyson Gabel

1.800.473.5003 ext. 8135

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