Bill Summary – FastDemocracy

HB 849
                       Department of Legislative Services
                               Maryland General Assembly
                                     2021 Session
                             FISCAL AND POLICY NOTE
                                  Enrolled - Revised
House Bill 849              (Delegate Rosenberg)
Health and Government Operations                                                        Finance
                          Public Health - Medical Records - Fees
This bill prohibits a health care provider or a representative of the health care provider from
charging a fee for providing copies of a medical record (1) requested by the patient, the
patient’s personal representative, or an employee or other representative of a nonprofit
legal services entity or other volunteer or nonprofit program and (2) that will be used to
support a claim or appeal for Social Security Disability Income (SSDI) or Social Security
benefits.
                                      Fiscal Summary
State Effect: State finances are not likely materially affected.
Local Effect: To the extent that a local health department charges a fee for providing
copies of medical records, local revenues may decrease. Expenditures are not likely
affected.
Small Business Effect: Meaningful.
                                           Analysis
Current Law: “Medical record” means any oral, written, or other transmission that is
(1) entered in the record of a patient or recipient, (2) identifies or can be readily associated
with the identify of a patient or recipient, and (3) relates to the health care of the patient or
recipient. “Medical record” includes a copy of a medical bill that has been requested by an
individual. Provisions related to fees for medical records do not apply to x-rays. “Health
care provider” means (1) a person who is licensed, certified, or otherwise authorized under
the Health Occupations Article or the Education Article to provide health care in the
ordinary course of business or practice of a profession or in an approved education or
training program or (2) a facility where health care is provided to patients or recipients,
including a hospital, a related institution, a health maintenance organization, an outpatient
clinic, a medical laboratory, a comprehensive crisis response center, a crisis stabilization
center, and a crisis treatment center.
With specified exceptions, a health care provider may charge a fee for copying and mailing
requested medical records of up to 76 cents per page. In addition, a health care provider
may charge a preparation fee of up to $22.88 for medical record retrieval and preparation
and the cost for postage and handling of the medical record. The fee for a copy of medical
records may be adjusted annually for inflation, with the exception of the $22.88 preparation
fee, which may not be adjusted for inflation.
The fee that may be charged for an electronic copy of a medical record includes a maximum
preparation fee of $22.88, a per-page fee of 75% of the per-page fee charged for a
nonelectronic copy, and the actual cost for postage and handling of the electronic copy.
A health care provider may not charge a fee exceeding $20.00 per 100 pages (or portion of
100 pages) for a copy of a medical record associated with an individual enrolled in
Medicaid, unless the request is made by a lawfully appointed attorney.
Any person or entity who is not subject to the provisions regarding medical record fees and
obtains a medical record from a health care provider or the provider’s agent may not charge
a fee for any subsequent copies of that medical record that exceeds the maximum per page
fee of 76 cents for copying and mailing.
Small Business Effect: Small business health care providers will be unable to charge a
fee for providing medical records when requested by specified individuals, including the
patient, for SSDI and Social Security claims.
                                Additional Information
Prior Introductions: None.
Designated Cross File: None.
Information Source(s): Maryland Association of County Health Officers; Maryland
Department of Health; Department of Legislative Services
HB 849/ Page 2
Fiscal Note History:   First Reader - February 24, 2021
rh/jc                  Third Reader - March 22, 2021
                              Revised - Amendment(s) - March 22, 2021
                       Enrolled - April 7, 2021
                              Revised - Amendment(s) - April 7, 2021
Analysis by: Amber R. Gundlach                   Direct Inquiries to:
                                                 (410) 946-5510
                                                 (301) 970-5510
HB 849/ Page 3
Statutes affected: 
Text - First - Public Health - Medical Records - Fees: 4-304 Health General
Text - Third - Public Health - Medical Records - Fees: 4-304 Health General
Text - Enrolled - Public Health - Medical Records - Fees: 4-304 Health General