SB 305: RELATING TO MEDICAL RECORDS.

A BILL FOR AN ACT

RELATING TO MEDICAL RECORDS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that over thirty thousand disabled adults and children currently receive social security benefits in Hawaiʻi with hundreds more applying each year, ranging from children with congenital birth defects to people who are suddenly afflicted by a disabling back condition, Parkinson's disease, cancer, severe mental illness, or another career-ending condition.

     Many applicants for social security benefits are unable to work and earn an income because of their disability.  Consequently, many applicants are indigent, homeless, or near homeless and may receive general assistance benefits from the State. 

     To apply for and receive social security benefits, an applicant is required to provide medical records to the Social Security Administration, not only at the outset of the application, but also for each continuing disability review that is conducted every few years.  These medical records for disabled applicants can often amount to hundreds of pages, if not more.

     For requests of medical records made by an individual patient on their own behalf, while some medical providers in the State are willing to accept either a flat fee of $15.60 or offer copies for free, many more medical providers will charge fees for processing, retrieving, or reviewing the medical records or a per-page charge for copying the medical records under rules promulgated pursuant to The Health Insurance Portability and Accountability Act of 1996 (HIPAA). However, according to the federal General Accountability Office, if the medical records are requested by a representative at the request of the patient, the medical providers are not limited by HIPAA's reasonable, cost-based standard for access requests and are instead governed by state laws, regulations, and other requirements.

     As these charges to obtain medical records can be exorbitant for a disabled, indigent applicant, the applicant is either without representation or cannot afford to send the medical records to the Social Security Administration for a determination of disability benefits.  Without the medical records to support the claim for disability benefits under title 20 Code of Federal Regulations sections 404.1516 and 416.916, the Social Security Administration will make a decision based on the information available.  Therefore, many applicants for disability benefits have their claims dismissed because of the cost associated with obtaining and sending medical records.

     If the claim for disability benefits is dismissed, not only may applicants struggle to obtain a livable income or affordable health insurance, but the State is also unable to recoup its general assistance outlay.

     Other states, including Arizona, Connecticut, Illinois, Massachusetts, Nevada, New Jersey, New York, Ohio, Oregon, Rhode Island, Texas, Utah, Vermont, and Washington, have addressed the issue of exorbitant fees associated with obtaining medical records by allowing applicants and those undergoing disability reviews, or their representatives, a free copy of their medical records to ensure that benefits are provided or continued where warranted.

     Therefore, to ensure those with disabilities can obtain their medical records for the purposes of claiming social security benefits, and to ensure that the State is able to be reimbursed for the aid Hawaiʻi gives these residents, the purpose of this Act is to establish fees that medical providers may charge for medical records and impose penalties.

     SECTION 2.  Chapter 323B, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§323B-    Fees; requests; medical records.  (a)  When a patient's family member, caregiver, or representative requests medical records, a medical provider may assess fees for obtaining medical records as follows:

     (1)  For medical records that are maintained electronically, the medical provider may assess a flat fee of not more than $2.00 per request to prepare and send the records electronically.  If the records are to be provided by means other than email, the actual cost for the labor and supplies used to provide the electronic medical records may be assessed;

     (2)  For medical records that are maintained on paper, the medical provider may assess a flat fee of not more than two cents per ten pages per request in addition to the cost of postage to mail the records;

     (3)  A patient or a family member, caregiver, or representative of a patient who is picking up paper copies of medical records in person shall not be charged a postage fee; and

     (4)  Fees including per page fees, fees for reviewing, assessing, or searching for records, or other fees not listed in this subsection are prohibited.

     (b)  Medical providers shall complete all requests for medical records from a patient or a family member, caregiver, or representative of a patient in a timely manner pursuant to title 45 Code of Federal Regulations section 164.524(b).

     (c)  Any medical provider found to have violated subsection (a) shall be fined not more than:

     (1)  $500 for a first violation; and

     (2)  $1000 for a second violation.

     (d)  For the purposes of this section:

     "Family member" has the same meaning as defined in title 45 Code of Federal Regulations section 160.103, as may be amended.

     "Representative" means any person or entity appointed by an individual to represent the individual's interest in obtaining medical records."

     SECTION 3.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect upon its approval.

Report Title:

Medical Providers; Social Security Disability Benefits; Medical Records; Requests; Reasonable Fees; Timely Response; Penalties

Description:

Establishes fees that medical providers may charge for requests for a patient's medical records from the patient's family member, caregiver, or representative.  Requires medical providers to respond to requests in a timely manner.  Establishes penalties.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.