COST FOR ROI
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ROI RATES & FEES VARY FROM STATE TO STATE
All states for the most part have regulated rates which MMRA recommends for healthcare facilities to follow. Our fees to requesters are based on our clients direction and the fees that were determined. MMRA does not determine any fees charged to requesters. From state to state, rates are different in what can be charged. This will determine if a healthcare facility will incur any direct fees. This can be a determining factor if a healthcare facility will incur any fees from MMRA. This is not only what the healthcare facility determines by the state rates but also what the healthcare determines is a billable request or a non-billable request. Even though a state may be regulated (a fee determined structure) the laws can still be somewhat confusing and will require each individual client to determine what to charge. In most cases the fees from billable requests allow MMRA to perform Full ROI services where a healthcare facility will incur little or no costs. Below is a table with each state’s statutory rates.
Many states have laws that waive or limit the amount medical providers can charge for providing copies of medical records when the request is made in connection with a Social Security disability or SSI claim. Other states have limits that apply to all requests, regardless of purpose, while other states have no limits at all. Below is the readily available information regarding states’ laws on this issue. Please let us know of any errors in this information. Also, send us a copy of the applicable statutes or regulations.
|STATE||SOURCE WEBSITE||COST FOR ROI|
|Alabama||Code of Alabama § 12-21-6.1||$1 per page for the first 25 pages, 50¢ per page for each additional page, and a $5 search fee. The actual cost of mailing the records can also be charged. In addition to those fees, the medical provider can charge the actual reproduction costs of x-rays and other special medical records.|
|Alaska||No state law limits the costs of providing copies of medical records.|
|Arizona||Arizona Revised Statutes § 12-2295||Medical providers may charge “a reasonable fee for the production of the records.”|
|Arkansas||Arkansas Code § 16-46-106||50¢ per page for the first 25 pages, 25¢ per page for each additional page, and a $15 labor charge. The actual cost of any required postage can also be charged. However, the per page costs do not apply to photocopies of x-rays. Additional “reasonable fees” can be charged for retrieval of records stored offsite and for narrative medical reports.|
|California||California Health & Safety Code, Division 106, Chapter 1, § 123110||Effective January 1, 2018, one free copy of a patient’s medical records for any unrepresented patient or former patient or the patient’s legal aid representative if the records are needed to support a claim or appeal regarding eligibility for a public benefit program, which includes the Medi-Cal program, the In-Home Supportive Services Program, the California Work Opportunity and Responsibility to Kids (CalWORKs) program, Social Security Disability Insurance Benefits, and Supplemental Security Income/State Supplementary Program for the Aged, Blind and Disabled (SSI/SSP) benefits, federal veterans service-connected compensation and nonservice connected pension disability benefits, and CalFresh. However, if the patient’s appeal regarding eligibility for one of the public benefit programs listed above is successful, the hospital or medical provider may bill the patient 25¢ per page or 50¢ per page for records that are copied from microfilm plus the costs of labor, supplies, and postage, if applicable. Additionally, the medical provider may charge “all reasonable costs, not exceeding actual costs” for copies of x-rays. Notably, the provision granting one free copy of the patient’s medical records does not apply if the patient is represented by a “private attorney,” meaning any attorney not employed by a nonprofit legal services entity, who is paying for the costs related to the patient’s appeal, pending the outcome of that appeal. In that case, the medical provider may charge 25¢ per page or 50¢ per page for records that are copied from microfilm plus the costs of labor, supplies, and postage, if applicable. Thus, the patient and/or patient’s representative is entitled to a free copy of the patient’s records only if the patient is pro se, the patient’s representative is a legal services attorney, or the patient’s representative is a private attorney who is not advancing costs. If the records are requested to support a claim or appeal regarding eligibility for a public benefit program, the medical provider must “ensure that the copies are transmitted within 30 days after receiving the written request.”|
|Colorado||Colorado Revised Statutes § 25-1-801||A fee is determined in accordance with HIPPA. “Reasonable fees” are defined as $18.53 for the first 10 pages, 85¢ per page for the next 30 pages, and 57¢ per page for each additional page. These costs do not apply to medical records that are stored on microfilm, which cost $1.50 per page, or radiographic studies, which cost the actual cost of reproduction for each radiograph copy. Additionally, the medical provider may charge the actual postage and electronic media costs, if applicable, and any applicable taxes as well as a $10 fee for certification of the medical records, if requested.|
|Connecticut||Connecticut General Statutes § 20-7c(d)||No charge for medical records requested by a patient, patient’s attorney or authorized representative “for the purpose of supporting a claim or appeal under any provision of the Social Security Act.” The request must be accompanied by documentation of the claim or appeal. The medical provider must furnish the records within 30 days of the request.|
|Delaware||Delaware Administrative Code, Title 24, Division 1700, § 16.0||$2 per page for the first 10 pages, $1 per page for pages 11-20, 90¢ per page for pages 21-60, and 50¢ per page for pages 61 and above. The actual cost of reproduction may be charged for records unsusceptible to photocopying, such as radiology films, models, photographs or fetal monitoring strips. The medical provider may also charge the actual cost of postage or shipping if the records are mailed. Advance payment for medical records requested to make or complete an application for a disability benefits program is not required.|
|District of Columbia||D.C. Municipal Regulations § 17-4612.2||Medical providers may charge “a reasonable fee for duplicating records,” payment of which may be required prior to providing the records in non-emergency situations. The medical provider must provide copies of the records within 30 days of the request.|
|Florida Hospitals||Florida Statutes, Title XXIX, Chapter 395, § 3025||$1 per page, plus sales tax and actual postage. Non-paper records (such as microfiche) are subject to a charge not to exceed $2. A fee of up to $1 may be charged for each year of requested records. However, this does not apply to records maintained at any licensed facility that primarily provides psychiatric care, or to records of treatment for any mental or emotional condition, or records of substance abuse.|
|Florida Doctors||Florida Administrative Code § 64B8-10.003||While “the Board of Medicine urges physicians to provide their patients a copy of their medical records, upon request, without cost, especially when the patient is economically disadvantaged,” the doctor is permitted to charge $1 per page for the first 25 pages and 25¢ for each additional page. But, the doctor may charge the actual cost of reproduction for x-rays and other special kinds of records.|
|Georgia||Official Georgia Code Annotated § 31-33-3||Per § 31-33-3(a) of the Official Georgia Code Annotated (O.G.C.A.), which sets forth the costs of copying and mailing patient records, these costs “shall not apply to records requested in order to make or complete an application for a disability benefits program.” However, despite this language, some representatives have reported being charged fees for copies of patient records with providers saying this section is not applicable. Of note, this Code section does apply to a patient’s psychiatric, psychological, and other mental health records.|
|Hawaii||Hawaii Revised Statutes § 622-57(g)||“Reasonable costs incurred by a health care provider in making copies of medical records shall be borne by the requesting person.”|
|Idaho||No state law limits the costs of providing copies of medical records.|
|Illinois||Illinois Compiled Statutes, Chapter 735, § 5/8-2001(d)||In 2018, for paper copies, $1.05 per page for the first 25 pages, 70¢ per page for pages 26-50, and 35¢ per page for pages in excess of 50. Additionally, the medical provider may charge a $27.91 handling charge, the actual postage or shipping charge, if any, and copy charges. But, the cost for copies made from microfiche or microfilm is $1.74 per page. Also, the medical provider may “charge for the reasonable cost of all duplication of record material or information that cannot routinely be copied or duplicated on a standard commercial photocopy machine such as x-ray films or pictures.” For electronic copies, records “retrieved from a scanning, digital imaging, electronic information or other digital format in an electronic document,” the cost is half (50%) of the per page charge for paper copies listed above. This per page charge includes the cost of each CD Rom, DVD, or other storage media.|
|Illinois (con't)||State of Illinois Comptroller, Copying Fees Adjustments.|
|Indiana||Indiana Code, Title 16, Article 39, Chapter 9, § 2||The Department of Insurance sets the rules for making and providing copies of medical records.|
|Indiana (con't)||Indiana Administrative Code, Title 760, Article 1, Rule 71, § 3||The maximum copying fees are $1 per page for the first 10 pages, 50¢ per page for pages 11-50, and 25¢ per page for pages 51 and higher. Additionally, the medical provider may charge the actual costs of mailing. A $20 labor fee can also be charged; however, if a labor fee is charged, the first 10 pages are free. An expedited processing fee of $10 may be charged if the records are to be provided within two working days. The medical provider may also charge $20 for certified records.|
|Iowa||Iowa Code § 622.10(6)||Medical providers may charge “the actual cost of production” for producing patient records or images, which cannot “exceed the rates established by the workers’ compensation commissioner for copies of records in workers’ compensation cases.” The records and images must be provided within 30 days of receipt of the written request. The medical provider may also charge $10 for certified records.|
|Iowa (con't)||Iowa Administrative Code § 876.8.9||The rates established by the workers’ compensation commissioner are $20 for pages 1-20, $20 plus $1 per page for 21-30 pages, $30 plus 50¢ per page for 31-100 pages, $65 plus 25¢ per page for 101-200 pages, $90 plus 10¢ per page for more than 200 pages, and the actual expense of postage.|
|Kansas||STATUTES REPEALED OR AMENDED BY THE 2011 LEGISLATURE (REVISED)||No state law limits the costs of providing copies of medical records since Kansas Statutes Annotated § 65-4971(b) was repealed by the 2011 Kansas Legislature. See STATUTES REPEALED OR AMENDED BY THE 2011 LEGISLATURE (REVISED).|
|Kentucky||Kentucky Revised Statutes § 422.317||One free copy of a patient’s medical records upon the patient’s written request. A copying fee of $1 per page may be charged “for furnishing a second copy of the patient’s medical record upon request either by the patient or the patient’s attorney or the patient’s authorized representative.” This does not apply to the Department of Corrections.|
|Louisiana||Louisiana Revised Statutes § 46:18||50¢ per page for the first 5 pages and 25¢ for each additional page for “any records that are necessary to support [a patient’s] filing for Social Security disability benefits or Supplemental Security Income benefits under any provision of the Social Security Act.” However, “the amount due shall not be less than the amount paid by the Department of Children and Family Services [DCFS] for such copies.” Unfortunately, the DCFS rate is not published online, but we have been told it is $20 as of March 2017.|
|Maine Hospitals||Maine Revised Statutes, Title 22, Subtitle 2, Part 4, Chapter 401, § 1711||For paper copies, $5 for the first page and 45¢ for each additional page, up to a maximum of $250 for the entire medical record. “The hospital may require payment prior to responding to the request.” For electronic copies, the hospital may charge “reasonable actual costs of staff time to create or copy the medical record and the costs of necessary supplies and postage,” not to exceed $150. “Actual costs may not include a retrieval fee or the costs of new technology, maintenance of the electronic record system, data access or storage infrastructure.”|
|Maine Doctors||Maine Revised Statutes, Title 22, Subtitle 2, Part 4, Chapter 401, § 1711-A||For paper copies, $5 for the first page and 45¢ for each additional page, up to a maximum of $250 for the entire treatment record or medical report. For electronic copies, the doctor may charge “reasonable actual costs of staff time to create or copy the treatment record or medical report and the costs of necessary supplies and postage,” not to exceed $150. “Actual costs may not include a retrieval fee or the costs of new technology, maintenance of the electronic record system, data access or storage infrastructure.”|
|Maryland||Code of Maryland, Health – General § 4-304(c)(3)||For paper copies, 76¢ per page plus the actual cost for postage and handling. Additionally, a medical provider may charge a $22.88 retrieval and preparation fee (unless the records are provided directly to the patient per federal HIPPA regulations). For electronic copies, 57¢ per page (75% of the per page charge for paper copies) plus the actual cost for postage and handling. Additionally, a medical provider may charge a $22.88 retrieval and preparation fee (unless the records are provided directly to the patient per federal HIPPA regulations).|
|Massachusetts Hospitals & Clinics||Massachusetts General Laws, Chapter 111, § 70||No charge for medical records requested by “any applicant, beneficiary or individual representing said applicant or beneficiary… for the purpose of supporting a claim or appeal under any provision of the Social Security Act,” upon proof that the records are being requested for this purpose. The hospital or clinic must furnish the records within 30 days.|
|Massachusetts Doctors||Code of Massachusetts Regulations, Title 243, § 2.07(13)(d)||No charge for medical records requested by “any applicant, beneficiary or individual representing said applicant or beneficiary if the record is requested for the purpose of supporting a claim or appeal under any provision of the Social Security Act,” upon proof that the records are being requested for this purpose.|
|Michigan||Michigan Compiled Laws § 333.26269||One free copy of a patient’s medical records for “a medically indigent individual.” Any additional or other requests are subject to an initial fee of $24.48 per request, plus $1.22 per page for the first 20 pages, 61¢ per page for pages 21-50, and 24¢ per page for pages 51+. However, a medical provider cannot charge a patient an initial fee for his/her own medical records.|
|Michigan (con't)||State of Michigan Department of Health and Human Services, 2018 MEDICAL RECORDS ACCESS ACT FEES (In Accordance with the Consumer Price Index)|
|Minnesota||Minnesota Statutes § 144.292, subdivision 6, paragraph (d)||$10 retrieval fee only for “copies of records requested by a patient or the patient’s authorized representative if the request for copies of records is for purposes of appealing a denial of Social Security disability income or Social Security disability benefits under title II or title XVI of the Social Security Act.” But, a medical provider cannot even charge the retrieval fee “to a person who is receiving public assistance, who is represented by an attorney on behalf of a civil legal services program or a volunteer attorney program based on indigency.” For further appeals, “a patient may receive no more than two medical record updates without charge, but only for medical record information previously not provided.”|
|Mississippi||Mississippi Code Annotated § 11-1-52(1)||$20 total for pages 1-20, $1 per page for the next 80 pages, and 50¢ per page for any additional pages. A medical provider may add 10% of the total charges for postage and handling. Also, an extra $15 can be charged for retrieval of records stored offsite.|
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