Physician Practice

OCR clarifies flat fee for electronic copies of PHI

Physician Practice Insider, June 14, 2016

The Office for Civil Rights (OCR) released a new FAQ in May clarifying the fees an organization may charge for copies of an individual’s PHI.

Earlier this year, OCR released a series of documents providing guidance and clarification on 45 CFR § 164.524, Individuals’ Right Under HIPAA to Access Their Health Information. This information included guidance on how to calculate actual and average costs for requests for electronic copies of PHI, and stated that organizations may choose to charge a flat rate of $6.50 for this service. The wording in the documents caused confusion and some organizations may have been led to believe that $6.50 was the maximum amount they were allowed to charge for copies of PHI.

The new FAQ clarifies that OCR intends the flat fee of $6.50 as an alternative option for organizations who do not want or are not able to follow the process for calculating actual or average costs for requests for electronic copies of PHI. Only the flat fee is capped at $6.50 and this is not a cap on actual or average costs as calculated following OCR’s guidance.
Covered entities (CE) or business associates (BA) are advised to follow OCR’s guidance on charging for requests for PHI. OCR notes that individual states may have fee schedules for charging for requests for PHI. However, costs authorized by states can only include those permitted by HIPAA and must be reasonable.
Fees for requests for copies of PHI may only cover certain limited labor, supply, and postage costs. Fee calculations cannot include costs for certain types of labor, such as search and retrieval, or other costs not permitted by HIPAA even if authorized by state law. CEs and BAs must be aware that reasonable fees for this service are defined solely by HIPAA and state-authorized fees may not be considered reasonable.

This article originally appeared in the Revenue Cycle Daily Advisor.

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