Read the full stored bill text
HB248
HOUSE OF REPRESENTATIVES
H.B. NO.
248
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII
A BILL FOR AN ACT
RELATING
TO MEDICAL RECORDS
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
����
SECTION 1.
�
The
legislature finds that over thirty thousand disabled adults and children
currently receive social security benefits in Hawai
ʻ
i
with hundreds more applying each year, ranging from children with congenital
birth defects to people who are suddenly afflicted by a disabling back
condition, Parkinson's disease, cancer, severe mental illness, or another
career-ending condition.
����
Many
applicants for social security benefits are unable to work and earn an income
because of their disability.
�
Consequently, many applicants are indigent, homeless, or near homeless
and may receive general assistance benefits from the State.
�
����
To
apply for and receive social security benefits, an applicant is required to
provide medical records to the Social Security Administration, not only at the
outset of the application, but also for each continuing disability review that
is conducted every few years.
�
These
medical records for disabled applicants can often amount to hundreds of pages,
if not more.
����
For
requests of medical records made by an individual patient on their own behalf,
while some medical providers in the State are willing to accept either a flat
fee of $15.60 or offer copies for free, many more medical providers will charge
fees for processing, retrieving, or reviewing the medical records or a per-page
charge for copying the medical records under rules promulgated pursuant to The
Health Insurance Portability and Accountability Act of 1996 (HIPAA). However,
according to the federal General Accountability Office, if the medical records
are requested by a representative at the request of the patient, the medical
providers are not limited by HIPAA's reasonable, cost-based standard for access
requests and are instead governed by state laws, regulations, and other
requirements.
����
As
these charges to obtain medical records can be exorbitant for a disabled,
indigent applicant, the applicant is either without representation or cannot
afford to send the medical records to the Social Security Administration for a
determination of disability benefits.
�
Without the medical records to support the claim for disability benefits
under title 20 Code of Federal Regulations sections 404.1516 and 416.916, the
Social Security Administration will make a decision based on the information
available.
�
Therefore, many applicants
for disability benefits have their claims dismissed because of the cost
associated with obtaining and sending medical records.
����
If
the claim for disability benefits is dismissed, not only may applicants
struggle to obtain a livable income or affordable health insurance, but the
State is also unable to recoup its general assistance outlay.
����
Other
states, including Arizona, Connecticut, Illinois, Massachusetts, Nevada, New
Jersey, New York, Ohio, Oregon, Rhode Island, Texas, Utah, Vermont, and
Washington, have addressed the issue of exorbitant fees associated with
obtaining medical records by allowing applicants and those undergoing
disability reviews, or their representatives, a free copy of their medical
records to ensure that benefits are provided or continued where warranted.
����
Therefore,
to ensure those with disabilities can obtain their medical records for the
purposes of claiming social security benefits, and to ensure that the State is
able to be reimbursed for the aid Hawai
ʻ
i gives these
residents, the purpose of this Act is to establish fees that medical providers
may charge for medical records and impose penalties.
����
SECTION 2.
�
Chapter 323B, Hawaii Revised Statutes, is amended by adding a new
section to be appropriately designated and to read as follows:
����
"
�323B-
�
Fees; requests; medical records.
�
(a)
�
When a patient's family
member, caregiver, or representative requests medical records, a medical
provider may assess fees for obtaining medical records as follows:
����
(1)
�
For medical records that are
maintained electronically, the medical provider may assess a flat fee of not
more than $2.00 per request to prepare and send the records
electronically.
�
If the records are to be
provided by means other than email, the actual cost for the labor and supplies
used to provide the electronic medical records may be assessed;
����
(2)
�
For medical records that are
maintained on paper, the medical provider may assess a flat fee of not more
than two cents per ten pages per request in addition to the cost of postage to
mail the records;
����
(3)
�
A patient or a family member,
caregiver, or representative of a patient who is picking up paper copies of medical
records in person shall not be charged a postage fee; and
����
(4)
�
Fees including per page fees, fees
for reviewing, assessing, or searching for records, or other fees not listed in
this subsection are prohibited.
����
(b)
�
Medical providers shall
complete all requests for medical records from a patient or a family member,
caregiver, or representative of a patient in a timely manner pursuant to title 45
Code of Federal Regulations section 164.524(b).
����
(c)
�
Any medical provider found to
have violated subsection (a) shall be fined not more than:
����
(1)
�
$500 for a first violation; and
����
(2)
�
$1000 for a second violation.
����
(d)
�
For the purposes of this section:
����
"Family member" has the same meaning as defined in title 45
Code of Federal Regulations section 160.103, as may be amended.
����
"Representative" means any person or entity appointed by an
individual to represent the individual's interest in obtaining medical records.
"
����
SECTION 3.
�
New statutory material is underscored.
����
SECTION 4.
�
This Act shall take effect upon its approval.
INTRODUCED BY:
_____________________________
Report Title:
Medical
Providers; Social Security Disability Benefits; Medical Records; Requests;
Reasonable Fees; Timely Response; Penalties
Description:
Establishes
fees that medical providers may charge for requests for a patient's medical
records from the patient's family member, caregiver, or representative.
�
Requires medical providers to respond to
requests in a timely manner.
�
Establishes
penalties.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.