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January 23, 2008

Annual Adjustment of Record Copy Fees

TO: Medical Records Directors, Member Institutions

State law limits the amount of fees a health care facility can charge the patient or any person with the patient’s authorization for handling and copying the patient’s records (735 ILCS 5/8-2001). These limits apply to the amounts that may be charged "any person, entity, or organization presenting a valid authorization signed by the patient or the patient’s legally authorized representative." Please be aware that this law does not apply to subpoenas issued pursuant to a Worker’s Compensation case because a subpoenaing party is not required to pay per-page copy fees under the Workers’ Compensation Act.

The Illinois Comptroller has announced the annual inflation adjustment to the maximum fees which may be charged for paper copies of patient medical records. The following are the new maximum amounts for paper record copies, effective January 20, 2008:

Recent legislation provides a different rate for records produced in an electronic format. When available and requested by the patient, records produced in an electronic format must be provided at 50% of the paper copy rate. For more information on electronic medical record copying fees, click here.

Hospitals may continue to charge for the reasonable cost of all duplication of record material on information that cannot routinely be copied or duplicated on a standard commercial photocopy machine such as x-ray films or pictures.

How the HIPAA Privacy Rule Affects the Handling Charge
Illinois law provides the above schedule of maximum fees that providers may charge for copies of medical records. However, as of April 14, 2003, hospitals and other covered entities were required to comply with the HIPAA Privacy Rule, which partially preempted (overruled) the Illinois law by putting certain limits on the handling charge for processing the request for copies.

The HIPAA Privacy Rule prohibits the provider (and the provider’s copy service) from charging a handling fee to patients or their personal representatives as defined in the HIPAA rule. Under HIPAA, a patient’s personal representative includes those persons who have legal authority to make health care decisions on behalf of the patient: the patient’s agent under a health care power of attorney; a surrogate decision maker for a patient who lacks decisional capacity; and, in most cases, the parents or guardians of a minor.

The prohibition on handling charges applies only to records requested by a patient or the patient’s personal representative. It does not apply to requests by the patient’s attorney, or other permissible disclosures, including disclosures based on an individual’s authorization.

The HIPAA Privacy Rule pertains only to the handling charge (fee). It does not affect the maximum per-page fees, as listed in this memo.

Staff Contact: Suzanne McGary at 630/276-5464 or smcgary@ihastaff.org.