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New S.C. law limits medical record fees; statutes vary nationwide


By Bob Herman
Posted: July 1, 2014 - 1:15 pm ET
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In yet another change to a medical policy that has little consistency across the country, South Carolina now limits how much healthcare providers can charge patients for their medical records.

The issue gained steam after the (Charleston, S.C.) Post and Courier reported a hospital charged one of its patients more than $3,800 to burn a copy of her father's medical records onto a CD.

Under the federal HIPAA statute, providers can charge patients for the “reasonable costs for copying and mailing the records.” Those rates vary from state to state. A South Carolina law implemented in June amends a 1992 state law and places adjusted caps on medical record fees—and brings digital versions into the fold.

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For electronic copies, South Carolina hospitals and physicians can charge no more than $150, regardless of the number of times a patient has been admitted. For paper duplicates, fees cannot exceed $200 per admission. A spokeswoman for the South Carolina Hospital Association said the group supported the bill. Representatives with the South Carolina Medical Association weren't immediately available to comment.

High fees for medical records are not uncommon, said Tom Lamb, a personal injury attorney in Wilmington, N.C., whose firm maintains a state-by-state list of policies. Providers say the fees are justified because of labor and retrieval costs, but patients often don't know the policy for their state. And there already is great variance among states for what providers can charge.

Texas has one of the more convoluted medical record fee structures. Hospitals in Texas can charge patients up to $45.02 for the first 10 pages of their records. After that, they can charge $1.51 for pages 11-60, $0.75 for pages 61-400 and $0.40 for any additional pages thereafter. The initial costs of a 100-page medical record would be more than $150. Hospitals can also bill for the cost of mailing and shipping, and further costs apply if the records are stored on a microform.

Comparatively, in North Carolina, providers can collect $0.75 per page for the first 25 pages, $0.50 for pages 26-100 and $0.25 for pages beyond 100. A minimum fee of $10 also applies.

“It's all over the board,” Lamb said.

Follow Bob Herman on Twitter: @MHbherman


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