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HIPAA Q&A: Medical record requests

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questionSubmit your HIPAA questions to Editor Jaclyn Fitzgerald at jfitzgerald@hcpro.com and we will work with our experts to provide the information you need.

Q: I work in long-term care and I am familiar with the language in HIPAA regulations regarding requests for electronic copies of medical records for a reasonable fee according to community standards. However, my company does not maintain its medical records in electronic form, nor do we presently have the capability of converting our paper records into electronic format. Our state legislature addressed the issue of “reasonable charges and community standards” by state statute in 2006 by providing a formula for every medical provider to follow state-wide for copy charges regarding paper copies.

When someone requests copies of our medical records in electronic form, we first have to make a paper copy of the records, then pay an outside service to scan the records and convert them into electronic form. When we billed the person using the state statute for making paper copies, the person objected to paying for the paper copies because he didn’t believe that we didn’t create the electronic record ourselves. He then threatened to file a complaint with HIPAA.

Are we correct in charging for paper copies according to state statute that provides the same formula for all communities in this state if we cannot produce electronic copies?


A: Not surprisingly, state and federal statutes have been slow to comment about charges for electronic copies of PHI. It sounds like the law in your state pertains to paper copies only.

HIPAA allows a covered entity to impose a “reasonable, cost-based fee” for a copy of PHI. However, the fee permitted under HIPAA (45 CFR 164.524(c)(4)) can only include the cost of:

  • Labor for copying the PHI, whether in paper or electronic form
  • Supplies for creating the paper copy or electronic media (if electronic media is requested)
  • Postage

As long as the fee you are charging actually represents the cost of creating the copy (including labor and postage) and does not exceed the costs permitted by your state statute, your charging practices sound acceptable.

I suggest you network with your state AHIMA group or hospital association to develop a charging policy for electronic copies.

Editor’s note: Chris Simons, MS, RHIA, director of health information and privacy officer at Cheshire Medical Center/Dartmouth-Hitchcock in Keene, N.H., answered this question for HCPro’s Medical Records Briefing. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions.


Categories : HIPAA Q&A

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