Back to Tennessee

HB0495 • 2026

Hospitals and Health Care Facilities

AN ACT to amend Tennessee Code Annotated, Title 63 and Title 68, relative to medical records.

Healthcare Technology
Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor
Baum, Bailey
Last action
2025-05-08
Official status
Effective date(s) 07/01/2025
Effective date
Not listed

Plain English Breakdown

The candidate explanation included a statement about allowing providers to require payment before releasing records, which is not supported by the official source material.

Medical Record Fees for Patients and Others

This bill sets new limits on how much hospitals can charge patients and others for medical records in both paper and electronic formats.

What This Bill Does

  • Sets a maximum fee of $25 for paper copies of medical records up to five pages long.
  • Limits the cost per page to 50 cents after the first five pages for paper copies, with additional fees for radiology images.
  • Requires hospitals to provide electronic copies unless they are not usually kept in that format.
  • Caps the fee at $90 for all electronic medical records requested by anyone other than the patient or their representative.
  • Prohibits charging a fee when the Department of Health requests certification or notarization.

Who It Names or Affects

  • Patients requesting copies of their own medical records
  • Third-party release of information providers handling record requests
  • Healthcare facilities providing medical records

Terms To Know

HIPAA
The Health Insurance Portability and Accountability Act, which sets rules for protecting health information.
HITECH Act
The Health Information Technology for Economic and Clinical Health Act, which supports the use of electronic health records.

Limits and Unknowns

  • Does not specify how hospitals should handle requests from the Department of Health.
  • Effective date is July 1, 2025.
  • The bill does not address fees for workers' compensation cases.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Amendment 1-0 to HB0495

Plain English: The amendment changes how much hospitals and health care facilities can charge for copying and sending medical records in both paper and electronic formats.

  • Sets a maximum fee of $25 for paper copies of medical records up to five pages, and 50 cents per page for each additional page beyond the first five.
  • Establishes a flat fee of $90 for providing all electronic medical records via portable media or email, with lower fees for specific types of requests like radiology images.
  • Requires hospitals to provide records in electronic form if available, unless otherwise specified.
  • The amendment text does not specify how the changes will be enforced or monitored.
Amendment 1-0 to SB0606

Plain English: The amendment changes how much hospitals and health care providers can charge for copying and sending medical records in both paper and electronic formats.

  • Sets a maximum fee of $25 for paper copies of medical records up to five pages, and 50 cents per page after that.
  • Establishes a flat fee of $90 for providing all electronic medical records via portable media or email.
  • Limits the cost of producing radiology images in hard copy to $20 per printed film and $25-$15 for digital copies on CD, DVD, USB, or emailed.
  • The amendment text does not specify all details about how fees are calculated for electronic records under HIPAA and HITECH Act, which may require further clarification.

Bill History

  1. 2025-05-08 Tennessee General Assembly

    Effective date(s) 07/01/2025

  2. 2025-05-08 Tennessee General Assembly

    Pub. Ch. 339

  3. 2025-05-08 Tennessee General Assembly

    Comp. became Pub. Ch. 339

  4. 2025-05-02 Tennessee General Assembly

    Signed by Governor.

  5. 2025-04-22 Tennessee General Assembly

    Transmitted to Governor for his action.

  6. 2025-04-22 Tennessee General Assembly

    Signed by Senate Speaker

  7. 2025-04-22 Tennessee General Assembly

    Signed by H. Speaker

  8. 2025-04-16 Tennessee General Assembly

    Enrolled; ready for sig. of H. Speaker.

  9. 2025-04-15 Tennessee General Assembly

    Passed Senate, Ayes 31, Nays 0

  10. 2025-04-15 Tennessee General Assembly

    Amendment withdrawn. (Amendment 1 - SA0157)

  11. 2025-04-15 Tennessee General Assembly

    Senate substituted House Bill for companion Senate Bill.

  12. 2025-04-15 Tennessee General Assembly

    Companion House Bill substituted

  13. 2025-04-14 Tennessee General Assembly

    Placed on Senate Regular Calendar for 4/15/2025

  14. 2025-04-11 Tennessee General Assembly

    Placed on Senate Regular Calendar for 4/15/2025

  15. 2025-04-03 Tennessee General Assembly

    Received from House, Passed on First Consideration

  16. 2025-04-01 Tennessee General Assembly

    Engrossed; ready for transmission to Sen.

  17. 2025-03-31 Tennessee General Assembly

    Passed H., as am., Ayes 95, Nays 0, PNV 0

  18. 2025-03-31 Tennessee General Assembly

    Sponsor(s) Added.

  19. 2025-03-31 Tennessee General Assembly

    H. adopted am. (Amendment 1 - HA0180)

  20. 2025-03-27 Tennessee General Assembly

    H. Placed on Regular Calendar for 3/31/2025

  21. 2025-03-26 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 3/27/2025

  22. 2025-03-25 Tennessee General Assembly

    Rec. for pass. if am., ref. to Calendar & Rules Committee

  23. 2025-03-19 Tennessee General Assembly

    Placed on cal. Health Committee for 3/25/2025

  24. 2025-03-19 Tennessee General Assembly

    Rec for pass if am by s/c ref. to Health Committee

  25. 2025-03-19 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0

  26. 2025-03-12 Tennessee General Assembly

    Placed on s/c cal Health Subcommittee for 3/19/2025

  27. 2025-03-12 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/19/2025

  28. 2025-02-12 Tennessee General Assembly

    Passed on Second Consideration, refer to Senate Health and Welfare Committee

  29. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  30. 2025-02-05 Tennessee General Assembly

    Assigned to s/c Health Subcommittee

  31. 2025-02-05 Tennessee General Assembly

    P2C, ref. to Health Committee

  32. 2025-02-03 Tennessee General Assembly

    Intro., P1C.

  33. 2025-01-31 Tennessee General Assembly

    Filed for introduction

  34. 2025-01-29 Tennessee General Assembly

    Filed for introduction

Official Summary Text

Present law generally requires a party requesting a patient's records to be responsible for the reasonable costs of copying and mailing the patient's records. The following charges are presumed reasonable:



A fee of $18, which includes the first five pages of the medical record and a per page charge of 85¢ a page for the sixth page, up to and including the 50th page.



60¢ a page for the 51st page up to the 250th page and 35¢ a page for all pages thereafter.



A fee for certifying medical records, not to exceed $20 for each record certified.

PAPER COPIES

This bill provides that, for records, other than those involving workers' compensation cases, the party requesting the patient's medical records in paper format is responsible to the provider or the pro
vider's third-party release of information provider for the reasonable costs of copying and mailing the patient's records. However, such reasonable costs must not exceed the following combined:



$25 for paper copies of medical records five pages or less in length.



50¢ per page for each page copied after the first five pages.



$20 per printed film for producing radiology images in hard copy.



The actual cost of mailing.

This bill provides that if a party described above requests certification or
notarization, then a certification or notary fee must be charged as a flat fee of $20.

ELECTRONIC COPIES

This bill provides that the reasonable fees for fulfilling a patient's request for the patient's own records are governed by the federal Health Insu
rance Portability and Accountability Act (HIPAA) and the federal Health Information Technology for Economic and Clinical Health (HITECH) Act, which must not exceed the cost of the following combined:



Labor for copying the protected health information requested by the individual.



Supplies for creating the paper copy, or electronic media if the individual requests that the electronic copy be provided on portable media.



Postage, when the individual has requested the copy, summary, or explanation be mailed.

For all other requesters, this bill requires the total fees for electronic medical records provided via portable media, electronic mail, or medical record portal, to comply with the following requirements:



The total charges must be no more than $5 for records 10 pages or less in length.



The total charges must be no more than 25¢ per page for each page after the first 10 pages, up to $25.



The mailing costs and applicable taxes, if any, must be the actual mailing costs and applicable taxes.



The fee for producing electronic copies of radiology images must be no more than $25 per request for CD, DVD, or USB, or $15 per request for electronic files emailed or sent via medical record portal.



If certification or notarization is requested, then a certification or notary fee must be charged as a flat fee of $20.



Charges for copying paper records or faxing paper records are subject to the limits set out above for paper copies.



The fees charged for reproducing records of patients involved in a claim or appeal of denial for social security disability benefits must be a flat fee of $20, only when the records are produced electronically.

This bill requires a person providing records to provide the records in electronic form unless the records are not kept in ele
ctronic form in the usual course of business. A third-party release of information provider of record copying and related services is subject to the fee limits contained in this bill and must not impose a charge or fee for such service in excess of such
f
ee limits.

ON MARCH 31, 2025, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 495, AS AMENDED.

AMENDMENT #1 makes the following revisions:



Provides that the
fee for all electronic medical records
for requesters and recipients, other than the patient,
must be a flat fee of $90
.



Authorizes, f
or any medical records request
,
other than a request made by the patient or the patient's personal representativ
e
for the patient's personal use, a covered entity or business associate
to
require payment prior to the release of the records. Payment may be remitted electronically
.



Prohibits a
provider
from
charg
ing
a fee for copying or notarizing a medical record when requested by the department of health pursuant to a complaint, inspection, or survey.

Current Bill Text

Read the full stored bill text
SENATE BILL 606
By Bailey

HOUSE BILL 495
By Baum

HB0495
002331
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 63
and Title 68, relative to medical records.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 68-11-304(a)(2)(A), is amended by
deleting the subdivision and substituting:
(2)
(A) For records other than those involving workers' compensation cases:
(i) The party requesting the patient's medical records in paper
format is responsible to the provider or the provider's third-party release
of information provider for the reasonable costs of copying and mailing
the patient's records. Such reasonable costs must not exceed:
(a) Twenty-five dollars ($25.00) for paper copies of
medical records five (5) pages or less in length;
(b) Fifty cents (50¢) per page for each page copied after
the first five (5) pages;
(c) Twenty dollars ($20.00) per printed film for producing
radiology images in hard copy; and
(d) The actual cost of mailing;
(ii) If a party described in subdivision (a)(2)(A)(i) requests
certification or notarization, then a certification or notary fee must be
charged as a flat fee of twenty dollars ($20.00);

- 2 - 002331

(iii) The party requesting the patient's records in electronic format
is responsible to the provider or the provider's third-party release of
information provider for the following fees:
(a) The reasonable fees for fulfilling a patient's request for
the patient's own records are governed by the Health Insurance
Portability and Accountability Act (HIPAA) of 1996 (42 U.S.C. §
1320d et seq.), and the Health Information Technology for
Economic and Clinical Health (HITECH) Act (42 U.S.C. § 201 et
seq.), and those acts implementing regulations, which must not
exceed the cost of the following:
(1) Labor for copying the protected health
information requested by the individual;
(2) Supplies for creating the paper copy, or
electronic media if the individual requests that the
electronic copy be provided on portable media; and
(3) Postage, when the individual has requested the
copy, summary, or explanation be mailed; and
(b) For all other requesters, the total fees for electronic
medical records provided via portable media, electronic mail, or
medical record portal, must comply with the following:
(1) The total charges must be no more than five
dollars ($5.00) for records ten (10) pages or less in length;
(2) The total charges must be no more than
twenty-five cents (25¢) per page for each page after the
first ten (10) pages, up to twenty-five dollars ($25.00);

- 3 - 002331

(3) The mailing costs and applicable taxes, if any,
must be the actual mailing costs and applicable taxes;
(4) The fee for producing electronic copies of
radiology images must be no more than twenty-five dollars
($25.00) per request for CD, DVD, or USB, or fifteen
dollars ($15.00) per request for electronic files emailed or
sent via medical record portal;
(5) If certification or notarization is requested, then
a certification or notary fee must be charged as a flat fee of
twenty dollars ($20.00);
(6) Charges for copying paper records or faxing
paper records are subject to the limits set in subdivisions
(a)(2)(A)(i); and
(7) The fees charged for reproducing records of
patients involved in a claim or appeal of denial for social
security disability benefits must be a flat fee of twenty
dollars ($20.00), only when the records are produced
electronically;
(iv) Upon request, a person providing records pursuant to this
section shall provide the records in electronic form unless the records are
not kept in electronic form in the usual course of business;
(v) A third-party release of information provider of record copying
and related services is subject to the fee limits contained in this section
and shall not impose a charge or fee for such service in excess of such
fee limits; and

- 4 - 002331

(vi) The fees charged for reproducing records of patients involved
in a workers' compensation claim are as specified in § 50-6-204.
SECTION 2. Tennessee Code Annotated, Section 68-11-304(d), is amended by
deleting the subsection.
SECTION 3. This act takes effect July 1, 2025, the public welfare requiring it.