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Medical Records Update

In order to help standardize forms to authorize the release of medical records, the Ohio Legislature directed the Ohio Medicaid Department to develop a standardized form to be used by healthcare providers which would authorize the release of medical information in compliance with provisions of HIPAA, state law and the substance abuse and other disorder regulations.  Ohio Medicaid has issued a standardized form which use will be effective February 1, 2019.  A copy of the form is available at the Ohio Department of Medicaid website and is form number 10221

The statute provides that if presented with a signed copy of this specific form, the healthcare provider is required to honor the request to produce records described on the form and by implication, cannot require the patient to sign the provider’s version of the form.  Providers are permitted to continue to use their own version of forms for other purposes, but again by statute, must honor a request made on the standardized form.

One of the challenges faced by this new requirement is that while the statute says the form has to be honored, there does not appear to be any consequences under the statute for failing to comply with the request.  We would recommend that you review your compliance manual and make certain that this new form is included in your material as an acceptable form and advise your key staff members. 

This form also presents a good opportunity to review your office policies concerning charges for copies of medical records.  You are not required to charge for copies of medical records, but if you do, be mindful that in Ohio there are three different statutory sections that are applicable to charges and each of them are different depending upon who is asking for the records.  If a request is made by a patient or their representative, there is a charge schedule published by the Ohio Department of Health which provides for the first 10 page charge of $3.18 per page plus additional charges for a larger number of pages.  There is also a charge permitted for diagnostic tests on a higher per page basis and any postage cost incurred.  The rules also provide that the charges can include a per page equivalent charge if the records are maintained electronically.  So, for example, if an electronic record, if printed, would be 10 pages, you can charge the per page charge for the 10 pages. 

If the request is made from someone other than the patient or the patient’s representative, such as an attorney defending a personal injury case for example, you can charge an initial search fee of $19.58 plus a per page fee which is lower, which is only a $1.29 each for the first 10 pages and thereafter the page charge is the same as if for a patient.  If the medical records are requested to be submitted to the Bureau of Workers’ Compensation or the Industrial Commission or to support a claim for disability under the Social Security Act, then those requesting parties receive one copy of the records without charge.

The Ohio Department of Health updates the allowed cost rates on an annual basis due to changes in the consumer price index and we expect the changes for calendar year 2019 will be published in early February.

These changes in fees and form usage presents a good opportunity for you to review your compliance policies in general to make sure that they are current both under the privacy rules as well as the security standards.  Your policies should have been updated at least in 2014 to include changes that occurred in federal regulations.  If you adopted an early version of a HIPAA compliance plan and have not updated it since it was adopted, having an outdated plan according to the enforcement officials at the Federal Office of Civil Rights, is the same as not having a compliance plan at all and sanctions could be imposed simply for being out-of-date.  We would suggest you review your plan and if not updated recently, have it reviewed by experienced healthcare counsel. 

If you would like copies of the ODM Forms, the ODH Fee Chart or have any questions concerning these matters, please contact Scott P. Sandrock, Brennan Manna Diamond, LLC, at spsandrock@bmdllc.com or (330) 253-4367

Stark County Medical Society News, Winter 2018/2019