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F I S C A L I M P A C T R E P O R T

SPONSOR Powdrell-Culbert

ORIGINAL DATE

LAST UPDATED

02/19/07

03/16/07 HB 937/aHHGAC

SHORT TITLE Medical Record Copying Fee Limits

SB

ANALYST Hanika Ortiz

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY07

FY08

$.1 see narrative

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Attorney General’s Office (AGO)

Health Policy Commission (HPC)

SUMMARY

Synopsis of HHGAC Amendment

The House Health & Government Affairs Committee Amendment clarifies the retrieval of

records to include electronic retrieval; provides fees for such retrieval and search of records older

than five years to not exceed $25.00; and, removes the emergency clause from the bill thereby

making the effective date of the Act July 1, 2007.

Synopsis of Original Bill

House Bill 937 amends Section 14-6-3 NMSA 1978 of the Records Act by removing references

to applicants for disability benefits to make the statute apply to all patients and former patients

and/or their representatives; and, implements a new statutory fee structure for the cost of copies

which can only be changed by the DOH every three years in accordance with the percent

increase or decrease in the medical component of the consumer price index.

Current law provides that within thirty days of receiving written request from a patient or former

patient or authorized representative of such patient or former patient, a health care provider shall

furnish the requestor a copy of that patient’s medical record.

House Bill 937/a HHGAC – Page

2

The bill provides a new fee schedule for copying medical records not to exceed:

•

For search and retrieval, twenty dollars ($20.00);

•

For the first fifteen copies, one dollar ($1.00) per page;

•

For sixteen to forty copies, forty cents ($.40) per page;

•

For forty-one copies or more, thirty cents ($.30) per page;

•

For copies from microfilm, twenty dollars ($20.00) for search and retrieval and one dollar

fifty cents ($1.50) per page;

•

For mail delivery of the copy or copies, actual postage cost; and

•

For records such as radiology films, models, photographs or fetal monitoring strips, the

full cost of reproduction.

HB937 declares an emergency, making the provisions effective April 1, 2007.

FISCAL IMPLICATIONS

The bill establishes a fixed fee scale for health care providers and patients or former patients

requesting copies of medical records such as radiology films, models, photographs or fetal

monitoring strips, or microfilm. The scope of which will include an initial administrative fee of

$20.00 for search and retrieval plus a subsequent fee scale based upon quantity or type of

medical records requested.

DOH comments that because the bill enacts a new fee schedule that can only be modified by

statute once every three years, it will be more difficult for DOH to modify the fees charged. If

DOH wanted to modify copying fees for persons other than those seeking disability benefits, it

could also dictate those fees by regulation, rather than by statute. Establishment of these fees

may not ensure that they cover a provider’s actual costs.

SIGNIFICANT ISSUES

The AGO states that current law only requires a health care provider to furnish records to

patients or former patients who are applying for benefits based on social security disability or

who are appealing a denial of such benefits. This bill will expand that requirement to apply to

records requests from all patients and former patients.

Current state law also allows the DOH to establish fees for copies or for service in obtaining

records. This bill will enact those fees into state law, and allow the Department to adjust them in

accordance with increases or decreases in the medical component of the consumer price index.

PERFORMANCE IMPLICATIONS

HIPPA permits a covered entity to impose reasonable, cost-based fees. The fee may include only

the cost of copying (including supplies and labor) and postage, if the patient requests that the

copy be mailed. If the patient has agreed to receive a summary or explanation of his or her

protected health information, the covered entity may also charge a fee for preparation of the

summary or explanation. The fee may not include costs associated with searching for and

retrieving the requested information. See 45 CFR 164.524. HIPAA preempts state laws that

are contrary to it.

House Bill 937/a HHGAC – Page

3

ADMINISTRATIVE IMPLICATIONS

DOH will be administratively responsible to ensure the provisions of the bill are enacted.

TECHNICAL ISSUES

DOH notes that neither the bill nor current State statute identifies how indigent persons who

cannot afford these fees may obtain copies of their medical records from health care providers.

Under applicable Federal regulations, individuals generally have a right to inspect and obtain a

copy of protected health information about themselves, although there doesn’t appear to be a

guideline for how indigent requests should be handled. (45 CFR 164.524)

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

Section 14-6-3 NMSA 1978 of the Records Act will not be amended to remove references to

applicants for disability benefits to make the statute apply to all; and, will fail to implement a

new statutory fee structure in accordance with the consumer price index.

AMENDMENTS

Page 2, line 4, insert “as established by the department of health" between “A fee…" and the

word “…charged" on line 4; deleting language within line 1 beginning with “A fee…" until line

4 “…records."

Page 2, line 21, replace the word “full" with the word “actual".

Page 2, delete lines 6, 7 and 8 within (1); and, renumber accordingly.

AHO/mt