Here is a little scam to cheat physicians out of the pittance that they can charge for providing medical records. Don’t allow a lawyer’s letter to intimidate you into jumping to action.

A lawyer sends a letter requesting medical records. Not unusual. He includes a HIPPA compliant release form – good, this guy apparently knows what is needed.

But wait, he also includes in his letter a rather pompous representation that his obligation to pay for medical records is only $0.12 per page for copying. Of course, he says nothing, and offers nothing for sending him the records. But to bolster his claim, he cites the applicability of a 2002 HHS (Federal Health and Human Services Department) rule that limits the charge to $0.12.

But wait, here’s the deal – even though he claims his oblivion to be just $0.12 per page, he’ll pay $0.75 page “if” the records are sent within 10 days, because “we can find no provisions…preventing us from offering a greater fee……. for expedited service”.

To the unaware, and easily intimidated, the practice has just gotten had and will likely hustle to get him what he wants in 10 days.

Of course, he has no legal leg to stand on. The rule limiting charges to $0.12 page cited is not applicable to request from physicians> Not only is it is outdated, it applies only in the context of hospitals providing medical records to Quality Improvement Organizations. Have you ever known lawyers to be Quality Improvement Organizations?

Under NYS regulation, (check state regulations if not in NY) physicians may charge a cost-based fee, up $0.75page, for paper copies of a patient’s medical records. 2014 HIPAA guidance explicitly states that fees permitted under state law are reasonable as long as they do not include amounts associated with a cost of search/retrieval or other costs not permitted under HIPAA.

And remember the allowable fee is the cost to copy on paper. How you send the records, and the cost of alternative media, CD or flash drive if used, is not mentioned in these regulations, which pre-date such technology.

What to do? Before doing anything, figure out how many pages the records are, and then add to it the cost of mailing, in a secure manner (FedExpress, etc., so there is proof of receipt). Then advise the requestor the total cost and indicate that you will provide after receipt of payment. There is no reason to be nice, send, and wait for money, money that you will likely not get paid. Feral, why should they pay you once they have what they want, the cost to collect makes collection efforts not worth the trouble.

As to the cost of other media, if they request such, then the guidance is to charge a reasonable amount, the cost of the material, plus the per page charge. There is no regulatory guidance in this regard, so advise the requestor beforehand what the cost is, and if there is any pushback, tell them it is $0.75 per page and they can pick the papers up at your office.