CIOX Health is a medical record retrieval company that is suing the Department of Health and Human Services. The lawsuit concerns the restriction placed by HIPAA laws on the amount that providers can charge patients for requesting copies of their medical records.
According to the 2013 HIPAA Omnibus Rule updates, there is a limit to the fees that providers and business associates can charge for providing copies of stored health information to patients. Aside from the limit on fees, there’s also a limit to the types of information that can be provided to patients on request. Accessing information is costly especially if it is not stored in the electronic medical records. Despite the cost, HIPAA limits the cost of copies to $6.50.
CIOX Health argued that the flat rate is an unjustified amount. It does not consider the actual cost of providing the request of patients for copies of their health information. Charging a low fee is not good for their business. CIOX Health hopes that HHS would reverse the 2013 and 2016 changes in the HIPAA ruling with respect to the fees charged for providing copies of any kind of medical information.
In answering questions asked on the HHS web portal, HHS confirmed in May 2016 that the maximum flat fee of $6.50 charged to patients should apply only if the healthcare provider or medical records firm chooses to offer that option. HIPAA should not restrict healthcare organizations from charging a higher fee or the “actual or average allowable costs for requests for electronic copies of PHI maintained electronically.”
CIOX Health mentioned in the lawsuit that applying and enforcing these HIPAA rules put heavy financial and regulatory burdens on medical records providers that could upend this industry. It was also mentioned that the new HIPAA rules threaten to bankrupt the medical records providers by deliberately mandating them to fulfill the growing need for copies of patients’ PHI at a net loss. The rule expanded the type of health information that patients can request now, which could include electronic medical records, paper records and films. Electronic records stored in different virtual locations can be easily retrieved. But retrieving paper records and films in different physical locations require sending staff to those places consuming more time and money. Verification and compilation of records also take time and money.
There are more than 16,000 physicians using the services of CIOX Health. Every year, CIOX Health processes tens of millions of medical records copies requested by patients. By putting a cap on the cost medical records firms can charge hurts the business.
CIOX Health is also associated with another lawsuit in November 2017 as co-defendant. The lawsuit claimed that over 60 hospitals in Indiana are not providing the request of patients who already paid for their copies of medical records in 3 days. This violates the requirement set by the HITECH Act. The defendants are also alleged to have charged way more for the medical records copies.