FMA Backs $1/Page Copy Fee

Oct 3, 2013

The Florida Medical Association and other physician groups said Thursday that doctors' offices should be allowed to charge patients up to $1 a page for medical records –  even if the records are electronic. 

They said it would make the fee consistent with the amount that hospitals are allowed to charge. They also pointed out that the current rule allows doctors to charge anyone other than patients $1 a page, while the patient can be charged that much only for the first 25 pages. After that, the charge is limited to a quarter.

But lawyers and patients who testified at the hearing, held in Orlando, called the charge “outrageous” and “absurd.” At a time when records are going digital, the fee should be going down, not up, they said.

“A patient record typically exceeds 100 pages. It can be hundreds of pages, even 1,000,” said attorney David Caldevilla of Tampa. “You’re tripling, quadrupling the price without any evidence that it’s justified.”

Zachary Smith of the Jeeves Law Group in St. Petersburg said that if Florida increases the fee as proposed, the state would have the second-highest charges in the nation. He said the trend in other states was to decrease the fee because of the move to electronic medical records.

But a representative of HealthPort Technologies, the company that handles information-release and audit management for medical groups, said he knew of no state that has decreased the fee. The company says the higher charge is justified because of the cost of digitizing records and reviewing them for compliance with laws.

Some doctors who were on the panel holding the hearing – the Rules Committee of the Florida Board of Medicine – asserted that it’s necessary for physicians to review records before releasing them to make sure they don’t violate the federal privacy law.

Dr. Onelia Lage of Miami, who chairs the Rules Committee, said she called other physicians to find out what it really costs them to handle requests for copies.  What they said led her to conclude that the costs are higher than they may appear.

Another committee member, Dr. Steven Rosenberg of West Palm Beach, said he has to review records before okaying them to be copied, and that takes away from his time with patients.  He said the copying fee was set up more than two decades ago, and that everything has gone up since then.  

The Committee had planned to present the $1-per-page rule change  to the full Board of Medicine when it meets on Friday. But the panel decided to postpone it until the board’s December meeting in hopes of getting some questions answered.

For one thing, they want to know what other states are doing about the fees. For another, they are required to study whether the rule change would have an “adverse impact” on small businesses in the state. The Legislature told agencies they had to do such studies to deter them from enacting new regulations that might be costly to employers.