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Friday, October 7, 2022

New Fee Rules for Obtaining Medical Records

A new law has been enacted that amends the current law concerning the fees that may be charged for copies of medical and billing records by hospitals and by health care professionals licensed by the Board of Medical Examiners. Obtaining medical records in Workers’ Compensation actions is a standard claim and litigation procedure.

Hospital Records

With regard to hospitals, the bill provides that a current prohibition against a hospital charging a fee to provide an electronic or paper reproduction of a billing record to certain parties will apply to requests for the record by a patient or the patient’s legally authorized representative, but will not apply to requests by authorized third parties, which are entities that are authorized to access the record but are not actually representing the patient.

$50.00 CAP

Current law provides that the fee for reproducing medical and billing records that are not stored on microfilm or microfiche is to be no more than $1 per page, and the fee for reproducing records stored on microfilm or microfiche is to be $1.50 per image. 

Under the bill, the total amount that can be charged to patients and legally authorized representatives in per-page fees is capped at $50. For authorized third parties, there is no cap on the total amount that can be charged in per-page fees.

Health Care Professionals

The bill removes references to “health care professionals” from section 1 of P.L.2019, c.217 (C.26:2H-5n), as the fee requirements for billing and treatment records for health care professionals are outlined in section 2 of P.L.2019, c.217 (C.45:9-22.27). 

The bill further revises the health care professional billing law for patients and their legally authorized representatives to reduce the current $200 cap on per-page fees to $50, and provides that the revised cap applies regardless of the method used to store the record. 

Authorized Third Parties

For authorized third parties, the current law provides no cap on the total amount that can be charged in per-page fees.

Search Fee Limit Increased to $20

For both hospitals and health care professionals, the bill revises the authorized search fee for patient records from no more than $10 per request to no more than $20 per request. As is provided under current law, no search fee may be charged to a patient who is requesting the patient's own record.

Definition of Authorized Third Party

For both hospitals and health care professionals, the bill clarifies that the current definition of "authorized third party" means a third party who is not a legally authorized representative of the patient. 

Definition of Legally Authorized Representative

The bill additionally revises the definition of "legally authorized representative" to clarify that the term “insurer” under the definition means an automobile insurer.

Senate Bill No. 2253--L.2022, c. 114, effective September 22, 2022

C.26:2H-5n and C.26:2H-5n

Recommended Citation: Gelman, Jon L.,  New Fee Rules for Obtaining Medical Records , Workers' Compensation Blog, Oct. 7, 2022), 

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Jon L. Gelman of Wayne, NJ, is the author of NJ Workers’ Compensation Law (Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (Thomson-Reuters). For over five decades, the Law Offices of Jon L Gelman  1.973.696.7900  have represented injured workers and their families who have suffered occupational accidents and illnesses.


Blog: Workers ' Compensation

Twitter: jongelman

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LinkedIn Group: Injured Workers Law & Advocacy Group

Author: "Workers' Compensation Law" Thomson-Reuters