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RRS Medical, a leader in Secure PHI Transfer Technology and Services, is an official exhibitor at the AHIMA20 Virtual Conference. To learn more about RRS Medical or arrange a meeting with representatives during AHIMA20, please contact Andrew Friday, regional vice president; Rob Turner, regional vice president; or Cat Valyi, senior vice president, marketing.

By Sue Chamberlain, MSCTE, RHIA, CDIP, CCS-P


Anyone responsible for Release of Information (ROI) over the past few years has been dealing with pressure from attorneys and their record retrieval companies (RRCs) to abide by their interpretation of the HITECH Act.

Seminars and published articles were specifically designed to show attorneys how to get complete medical records for ‘$6.50 patient rate’ or free, including how to threaten and submit complaints to the OCR to counter any provider pushback.

Experienced HIM professionals argued the guidance was misinterpreted, but additional ‘costs’ to push back was often not supported. Unfortunately, several offices of the Office for Civil Rights (OCR) also treated the guidance as law and enforced the rates, adding more confusion.

In January, a federal court found in favor of Ciox in Ciox Health v. Azar, ruling that the Department of Health and Human Services had overstepped when it issued the guidance in 2016, and the guidance was never binding or lawful.

In addition, the fee limitation of ‘cost’ only applies to an individual’s request to access their personal records and not to an individual’s request to provide records to a third party such as an attorney or insurance company.

For these requests, State guidelines for charges would apply, thus shifting the costs back to the requester rather than being absorbed by the healthcare provider.

Note: Ciox also argued that the ‘$6.50 flat-fee’ for patient access was not based upon actual costs associated with such requests. Read this article for additional information regarding the ruling and how to respond to future requests claiming ‘HITECH fees.’

As the HITECH door closes, attorneys are now starting to send out new requests claiming they are entitled to free or limited fees under the 21st Century CURES Act. The wording has been cherry-picked to support their argument. To prepare against this new attack on healthcare provider resources, AHIOS has provided the following tips regarding The CURES Act:

  • The rule only applies to electronic records being accessed through an EMR portal or via API access by patients
  • The rules are deferential to the rules and fees permitted under the existing HIPAA requirements
  • The act does not restrict allowable fees charged for copies of ePHI under the HIPAA Privacy Rule or the Ciox ruling
  • Charging cost-based fees to patients (45 CFR 164.524(c)(4)) and allowable costs per State laws to third parties would not be excluded from collection
  • Charging of cost-based fees and state statute fees to third parties would not be a practice that implicated the information-blocking provision as long as the fees charged comply with HIPAA access provisions
  • The information-blocking provisions do not impact the timeline requirements for release of information, which continue to be determined by HIPAA (45 CFR 164.524(b)(2)) or state law, whichever is shorter
Register for AHIMA20

The AHIMA20 Virtual Conference is the premier educational, exhibition, and networking event for health information professionals. Whether you are seeking cutting-edge education, evaluating the latest market innovations, or are seeking new professional connections, the AHIMA20 Virtual Conference is the place to be. Register today.


Sue Chamberlain, MSCTE, RHIA, CDIP, CCS-P, ( is vice president of compliance and education for RRS Medical, a leader in Secure PHI Transfer Technology and Services. She has over 30 years of health information management experience and is highly credentialed. She continues to educate healthcare students, provide compliance consultation, conduct educational webinars, and participates in a variety of speaking engagements.

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