Health Records Management
Electronic Health Records: Guidance on Accepting Health Information Technology Donations
Most physicians who are considering the purchase of health information technology must ask whether the product will be cost effective. Stark law exceptions and anti-kickback safe harbors have allowed physicians to accept donations for electronic prescribing and electronic medical technology from a variety of sources. While the donations ease the financial pain of the transition to electronic medical records physicians must still consider whether the donated systems are appropriate for their practices.
The American Medical Association (AMA) has developed resources to help physicians and their practice managers determine whether accepting donated technology is in the best interest of the practice. AMA’s guide “Health information technology: A guide for physicians”, and flier, “Health Information Technology Donations: What Physicians Should Know", are downloadable and free of charge. The documents will help physicians to determine the readiness of the practice for successful implementation as well as what to look for in the donor’s contract. Go to: http://www.ama-assn.org/ama/pub/category/18255.html to view these resources.
In addition, AMA is hosting a webinar on May 14 at 2:00 p.m. EST to explore the ins and outs of donation agreements. To find out if your practice should consider accepting a technology donation, go to http://eo2.commpartners.com/users/ama/series.php?id=606 to register for this seminar.
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Electronic Health Records Demonstration Project
To assist in the development of the strongest possible applications, MSNJ will provide a section of its website so potential applicants can download information, access links to CMS and review FAQ’s on the demonstration project. MSNJ will also make its facilities available as a centrally located neutral site if physician groups need meeting space. To arrange for meeting space please contact Caroline Ferraro at 609.896.1766 x258.
EHR DEMONSTRATION Project Timeline
May 13, 2008
Community partner applications due.
Mid-June 2008
Announcement of 12 sites selected for participation in the EHR Demonstration.
Summer 2008
CMS works with applicable community partners in 4 sites identified for Phase I implementation to develop and implement a strategy for conducting outreach, education and recruitment of eligible physician practices in each site.
Late Summer/Fall 2008
Conduct recruitment activities in conjunction with identified community partners, targeting eligible physician practices. Practices submit applications during this time. Final practice application submission date to be determined.
First Quarter, Calendar Year 2009
Final selection and notification of participating practices in Phase I sites.
May 2009
Kick-off meetings conducted in the Phase I sites.
June 1, 2009
Start of first year of demonstration in Phase I sites.
there is a detailed FAQ section on the EHR Demonstration website that may be helpful in answering questions you have.
If you are interested in receiving email updates as new information is posted on the demonstration website, please sign up at the following link: Email Updates.
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Medical Records: Releasing and Copying for Patients
Most of our members work in small or medium-sized medical practices. Often, office staff is stretched with the myriad of practice-management questions that can be asked on any given day. Some are about mixed medical-legal issues; some raise ethical or regulatory concerns. This column will answer some of the most frequently asked of these questions each month.
Question
What are the rules and obligations governing the release and copying of records for patients? What if the patient has an outstanding balance?
Answer
A physician may charge a reasonable fee for copying records. However, it is considered inappropriate for a physician to make a profit from the fee charged for the records, and there is a limitation on the fee amount.
Physicians may charge no more than $1 per page or $100 for the entire record, whichever is less. If the record is less than ten pages, the physician may charge up to $10 to cover the costs of postage and incidental expenses associated with the retrieval of the record. Physicians may charge a fee for the copying of records off-site. This is limited to x-rays or other documents that are not easily copied on an office copy machine. Physicians may charge the actual cost of off-site copying plus $10 or 10% of the actual cost, whichever is less, to cover staff time.
A physician may require that the records request be in writing.
A physician must provide the copied records to the patient within thirty days of the request.
If a physician elects to provide a summary of the record, in lieu of the actual record, the charge may not exceed the cost that would have been charged for the actual record.
It is important to note that physicians may not charge a fee for the copying of records in these instances:
- when the physician has affirmatively terminated a patient, or
- when the physician leaves a practice and a patient requests that his/her medical care be continued by the physician at the new practice. ÿ(N.J.A.C. 13:35-6.5 [amendments effective April 18, 2005])
If the patient’s record request is for the purpose of continuing medical treatment, then you may not refuse the request because of an unpaid balance. However, if the request is for a reason other than medical treatment (for example, a lawsuit) you may refuse. This is a narrow exception to the general obligation to provide patient records. Members are encouraged to err on the side of providing records if appropriately requested.
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