Releasing Medical Records
Health care providers are required to disclose medical records within a reasonable time, but no more than 21 working days after the date a person in interest requests the disclosure. A health care provider that knowingly and willfully refuses to disclose medical records in violation of Health-General Article § 4-309 (a)(d) is liable for actual damages, is guilty of a misdemeanor, and on conviction is subject to a fine not exceeding $1,000 for the first offense and not exceeding $5,000 for each subsequent conviction for a violation of any provision of this subtitle.
The fees that may be charged for preparation and production of medical records may be adjusted annually for inflation using the Consumer Price Index on July 1 of each year. Beginning January 1, 2014, adjusted rates for medical record copying are as follows: a preparation fee of no more than $22.88 (Please note that preparation fees can be charged to hospitals and insurance companies, but NOT patients.), plus a fee of no more than 76 cents per page copied, plus the actual cost of shipping and handling. Reasonable fees may be charged for duplicate x-rays.
More information on the Consumer Price Index can be found at: http://www.bls.gov/bls/proghome.htm
Health care providers may not refuse to disclose a medical record on the request of a person in interest because of the failure of the person in interest to pay for health care rendered by the provider. Health care providers may require payment of the preparation, copying, shipping and handling fees and charges before turning the records over to a patient or other authorized individual. Health care providers are required to comply with subpoenas, and no fee may be charged to transfer the records of Medicaid recipients to another provider.
However, physicians using electronic medical records systems should take note of an important change in HIPAA medical records privacy rules. As of February I7, 20 I 0, if a medical practice is using an electronic medical records system, they must provide a patient requesting their medical record with a copy in electronic format if the patient so requests. The charge for the copy provided can be no more than the actual labor costs incurred by the practice in responding to that request.
A health care provider or any other person, including an officer or employee of a governmental unit, who knowingly and willfully requests or obtains a medical record under false pretenses or through deception or knowingly and willfully discloses a medical record in violation of this subtitle is guilty of a misdemeanor and on conviction is subject to the following penalties: A fine not exceeding $50,000, imprisonment for not more than 1 year , or both; If the offense is committed under false pretenses, a fine not exceeding $100,000, imprisonment for not more than 5 years, or both; and if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, a fine not exceeding $250,000, imprisonment for not more than 10 years, or both. This subsection does not apply to an officer or employee of a governmental unit that is conducting a criminal investigation.
Being cooperative and timely when a patient requests their medical records avoids complaints to the Board.
Retaining of Medical Records
HIPAA regulations require that patient documents must be kept a minimum of six (6) years. The Medical Records Act states that unless a patient is a minor, medical records, laboratory and X-ray reports must be kept at least five years (see §4-403 below).
Annotated Code of Maryland
Title 4. Statistics and Records
(b) Except for a minor patient, unless a patient is notified, a health care provider may not destroy a medical record or laboratory or X-ray report about a patient for 5 years after the record or report is made.
(c) In the case of a minor patient, a medical record or laboratory or X-ray report about a minor patient may not be destroyed until the patient attains the age of majority plus 3 years or for 5 years after the record or report is made, whichever is later, unless:
(d) The notice under subsections (b) and (c) of this section shall:
- The parent or guardian of the minor patient is notified; or
- If the medical care documented in the record was provided under § 20-102(c) or § 20-103(c) of this article, the minor patient is notified.
(e) After the death, retirement, surrender of the license, or discontinuance of the practice or business of a health care provider, the health care provider, the administrator of the estate, or a designee who agrees to provide for the maintenance of the medical records of the practice or business and who states, in writing to the appropriate health occupation board within a reasonable time, that the records will be maintained in compliance with this section, shall:
- Be made by first-class mail to the last known address of the patient;
- Include the date on which the record of the patient shall be destroyed; and
- Include a statement that the record or synopsis of the record, if wanted, must be retrieved at a designated location within 30 days of the proposed date of destruction.
(f) (1) After consulting with the Association of Maryland Hospitals and Health Systems, the Maryland State Medical Society, and other interested parties, including consumers and payors, the Secretary shall adopt regulations governing the destruction of medical records.
- Forward the notice required in this section before the destruction or transfer of medical records; or
- Publish a notice in a daily newspaper that is circulated locally for 2 consecutive weeks:
(i) Stating the date that the medical records will be destroyed or transferred; and
(ii) Designating a location, date, and time where the medical records may be retrieved, if wanted.
(2) The regulations adopted under this subsection shall:
(i) Specify the manner in which a health care provider shall maintain and store medical records to:
(3) The regulations adopted under this subsection may not:
1. Ensure confidentiality; and
(ii) Ensure that the method of destruction renders the medical records unreadable.
2. Provide limited access to the medical records until the records are destroyed; and
(i) Require or encourage the destruction of medical records; or
(g) (1) A health care provider or any other person who knowingly violates any provision of this subtitle is liable for actual damages.
(ii) Be inconsistent with any provision of law applicable to the maintenance or destruction of medical records.
(2) (i) In addition to any other penalties provided under this article, a health care facility that knowingly violates this section is subject to an administrative fine not exceeding $10,000 for all violations cited in a single day.
(ii) 1. In addition to any other penalties provided under this article, an individual who knowingly violates this section is subject to the fines provided in sub-subparagraph 2 of this subparagraph if the individual is:
A. A health care provider, as defined under subsection (a)(1)(i) through (vi) or (viii) through (xx) of this section; or
2. The administrative fines applicable to an individual covered under sub-subparagraph 1 of this subparagraph shall be assessed as follows:
B. An agent, employee, officer, or director of a health care provider.
A. The first fine assessed or first set of fines assessed concurrently for all violations cited in a single day may not exceed $1,000;
B. The second fine assessed or second set of fines assessed concurrently for all violations cited in a single day may not exceed $2,500; and
C. The third or subsequent fine assessed or third or subsequent set of fines assessed concurrently for all violations cited in a single day may not exceed $5,000.
The Board recommends that a practitioner consult his/her health care attorney regarding retirement from practice and retaining of medical records.