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Patients Gouged on Copies of Medical Records: Lawsuit

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Barry Gutierrez/NPR
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Patients across Florida have been overcharged more than $1 million for their medical records over the last five years by out-of-state companies that handle copying for Florida doctors, according to a class-action suit pending in Hillsborough  County.

Those two companies stand to profit from a rule change coming before the Florida Board of Medicine on Friday. Meeting in Tampa, the board will consider raising the allowable charge for medical record copies to $1 a page -- even if the records are digital. (Update: The Board of Medicine on Thursday tabled the copying fee issue until October.)

State rules now say the maximum charge for medical records is $1 a page for the first 25 pages and 25 cents a page after that.  The rules make no distinction between paper and electronic records.

The maximum charge for hospital records is $1 a page, without limit. Doctors argue that they should be able to charge the same for their records.

The Board of Medicine voted unanimously in favor of allowing fees for doctors' records to rise to $1 a page in December, as Health News Florida reported. But the rule-changing process stalled because legal questions popped up.

Law firms that have sent in complaints say they suspect the impetus for the push is lobbying by the companies that stand to benefit:  HealthPort Technologies of Atlanta and Bactes Imaging Solutions of San Diego.

Among those protesting the increase is Alice Vicker of the Florida Consumer Action Network.

In an op-ed, Vickers said the proposed fee increase would make Florida's rates the second-highest in the
nation. "HealthPort has yet to show why there is a need to increase this cost to the consumer. Indeed, it appears these industry representatives are simply trying to increase the cost because they think they can
get away with it," Vickers wrote.

HealthPort did not return phone calls and e-mails from Health News Florida this week.

One issue that stalled the rule change involves the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). It says patients must not be charged more than a "reasonable" fee for their records.

That fee may not include costs associated with searching for and retrieving the requested information, according to the US. Department of Health and Human Services web site.

Another issue that has bogged the board down is a state law intended to protect small businesses from onerous regulation. It says that if an agency wants to enact a rule that would cost such companies a total of more than $200,000, it must do an economic study that explains why it's needed and persuade the legislature to go along.

One analysis conducted earlier this year estimated that the rule change would cost law firms, many of which meet the definition of small businesses, well over $1 million.

Lawyers say they are usually the ones requesting medical records for their clients when the time comes to file a claim for insurance after an accident, file for disability benefits and the like.

The law firms usually require reimbursement from their clients later, says one of the lawyers who brought the class-action case against HealthPort, Scott Jeeves of St. Petersburg.

He thinks the Board of Medicine misunderstands the situation. Most of the time, medical record copies aren't for malpractice suits, he said, but for other needs. And raising the copy charges doesn't hurt lawyers, he said, it hurts patients and doctors.

"It's taking money that disadvantaged patients would have to pay their co-pays," he said.

The lawsuit, Allen v HealthPort, was filed in 2012 and granted class-action status in July 2013.  Tampa resident Barbara Allen is the named plaintiff.

Allen, who needed copies of her medical records for a slip-and-fall injury case, signed a written request and gave it to Jeeves' law firm. The firm delivered Allen's request to her doctors, who used HealthPort to handle such requests. 

There were 217 pages, which by Florida law should have been copied for $73 plus postage. HealthPort charged the firm $242.72, which included shipping, sales tax and $1-a-page copy fee. Allen later paid the firm back.

HealthPort said it was entitled to $1 a page because it was not Allen herself who made the request, but the law firm acting on her behalf. The company argued that the law says "other entities" requesting the patient records may be charged more.

But the law firms that seek records for their clients have signed statements from the patients authorizing release of the records, Hillsborough Circuit Judge William P. Levens ruled last month. He granted the plaintiffs partial summary judgment.

The company must treat the request for copies as a request from the patient herself, he said. To do otherwise, Levens ruled, "would achieve unreasonable, harsh, or absurd results."

HealthPort is expected to appeal the decision. The case will go forward, to determine how many patients may be affected and how much money they lost.

Jeeves is working with J. Daniel Clark of the Tampa firm Clark & Martino on that case as well as another: Patricia Webber vs. Bactes Imaging Solutions Inc.

The San Diego company is accused of similarly overcharging for records requested through a law firm.

--Health News Florida is part of WUSF Public Media. Contact Editor Carol Gentry at 813-974-8629 (desk) or e-mail at cgentry@wusf.org. For more health news, visit HealthNewsFlorida.org.