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Ciox Health Faces Lawsuit Over Excessive Health Record Copying Fees

The class action lawsuit regarding patient data access alleged that Ciox Health unlawfully charged patients higher health record copying fees than permitted under Texas law.

Ciox Health, a Georgia-based health record management vendor, has reached a $1.85 million settlement to resolve allegations that claimed the company charged excessive health record copying fees during patient data access attempts.

The class action lawsuit filed in the United States District Court for the Eastern District of Texas Sherman Division alleged state and federal laws violations.

According to the lawsuit filed, one of the plaintiffs stated they were requested to pay $77.50 to get access to their electronic medical records from a non-hospital urgent care clinic. However, under Texas state law, the health record copying fee should have been $25.

The second plaintiff claimed they were charged more than $150 to receive their health records from a hospital. Yet, the fees were only supposed to amount to no more than $83, according to the lawsuit.

“Prices that exceed the legal maximums in the contracts between Ciox and patients (entered into on behalf of the patients by their attorneys) are illegal and void, as unauthorized charges, and the statutory maximums are deemed incorporated into the contracts in their place,” the Ciox Health medical records fee class action lawsuit contends.

Additionally, the class action lawsuit claimed Ciox Health illegally imposed additional fees. Despite being prohibited by Texas state laws, Ciox Health charged patient fees such as an “Electronic Data Archive Fee” or “Electronic Delivery Fee” of $2 per request.

The plaintiffs seek to recoup all fees that were over the threshold permitted by Texas laws. By settling this lawsuit, Ciox is not admitting to any wrongdoing the lawsuit mentioned. As part of the settlement health, the record management vendor will reimburse all or a portion of disputed fees paid concerning the health record request.

HIPAA legally requires patient access to health information, but organizations may charge a “reasonable, cost-based fee.”

Under HIPAA, covered entities may charge “a flat fee for all requests for electronic copies of personal health information (PHI) maintained electronically, provided the fee does not exceed $6.50.”

However, the $6.50 is only the maximum for HIPPA-covered practices that do not want to calculate a reasonable fee.

In some cases where an entity chooses to use the average cost method, it is calculated by actual allowable costs to fulfill each request or the allowable labor costs to fulfill standard requests, according to HHS.

Charging high record copying fees may dissuade patient data access, a 2018 report from the Government Accountability Office (GAO) found.

The GAO report noted cost for health data access varied from state to state, but the number of patients who declined access to their own medical records due to cost wasn’t identified.

In interviews with various healthcare officials, GAO learned that patients with chronic illnesses often face cost-prohibitive copying fees because of the length of their medical records.

“Multiple stakeholders we interviewed told us that responding to patient requests for medical records can be challenging because it requires the allocation of staff and other resources, and as a result, responding to such requests can be costly,” the GAO report explained.

Additionally, limited information and education about patient rights to health data serve as patient data access obstacles.

Through the use of patient portals, access to health data is continuously increasing, reducing the number of health record requests. That said, the patient portal also poses barriers to data access.

Overall, patient data access improves patient engagement and empowerment in care. When patients have full health data access, they can review and understand their personal health information and will be more involved in their care.

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