The cost of obtaining medical records in New Jersey workers’ compensation cases has been significantly restructured. Senate Bill 2253—signed into law by Governor Phil Murphy as P.L. 2022, c. 114, effective September 22, 2022—slashed the permissible fees that hospitals and licensed health care professionals may charge for copies of medical and billing records. Three years on, a January 5, 2026, regulatory amendment to N.J.A.C. 8:43G-15.3 has updated hospital licensing standards to bring administrative rules into full alignment with the statute, closing a gap that had persisted since 2011.
For petitioners’ attorneys, respondents’ counsel, carriers, and employers, these changes have direct operational and financial consequences in every claim that requires medical documentation.
Background: Why This Matters in Workers’ Compensation
Medical records are the evidentiary backbone of every workers’ compensation claim. They establish the nature and extent of a work-related injury, document medical causation, support or undermine permanency ratings, and underpin Medicare Set-Aside allocations. Under prior law, providers could charge up to $1.00 per page with a cap of $125.00 for copies, plus a search fee of up to $25.00 per request—fees that routinely generated invoices of several hundred dollars for voluminous records in occupational disease, orthopedic, or long-term care cases. The 2022 legislation dramatically reduces that financial barrier.
Key Provisions of P.L. 2022, c. 114
Hospital Records (C.26:2H-5n)
For patients and their legally authorized representatives, the per-page fee remains no more than $1.00 per page (paper, electronic, microfilm, or microfiche), but the total amount that may be charged per individual admission or patient record is now capped at $50.00. The prior prohibition on charging for electronic billing records has been clarified to apply to patients and their legally authorized representatives. Authorized third parties (entities with valid authorization, subpoena, legal process, or court order, but who are not representing the patient) are not subject to the $50.00 cap on per-page fees.
Health Care Professionals (C.45:9-22.27)
For licensed health care professionals (physicians, dentists, nurses, pharmacists, and others regulated under Title 45), the previous $200.00 cap on per-page fees for patients and their legally authorized representatives has been reduced to $50.00, regardless of the medium in which records are stored—electronic, paper, microfilm, or microfiche.
Search Fee: Increased to $20.00
For both hospitals and health care professionals, the authorized search fee has increased from $10.00 to $20.00 per request. No search fee may be charged to a patient requesting their own records.
Certification Fee: $10.00 Maximum
A certification fee of no more than $10.00 per certification is permitted. Delivery costs (in any medium) plus applicable sales tax may also be charged.
Critical Definitions for Workers’ Compensation Practice
Workers’ Compensation Carrier as Legally Authorized Representative
The statute expressly defines a “legally authorized representative” to include a workers’ compensation carrier, but with a critical limitation: carrier access is restricted to that portion of the treatment or billing record relevant to the specific work-related incident at issue in the claim. This restriction aligns with privacy principles under HIPAA and limits the scope of records insurers may obtain at the capped $50.00 fee. Requests that exceed this scope—for example, seeking records addressing pre-existing conditions unrelated to the claim—are not governed by the $50.00 cap for legally authorized representatives.
Authorized Third Parties: No Per-Request Cap
An “authorized third party”—any third party with a valid authorization, subpoena, legal process, or court order—is not entitled to the $50.00 cap on per-page fees. This distinction creates a two-tiered fee structure depending on a requester’s legal relationship to the patient.
Insurer Defined as Automobile Insurer
The statute clarifies that the term “insurer” in the definition of “legally authorized representative” refers to an automobile insurer, not a health insurer or a workers’ compensation carrier.
January 5, 2026 Regulatory Update: N.J.A.C. 8:43G-15.3
On November 21, 2025, Acting Commissioner Jeffrey A. Brown of the New Jersey Department of Health adopted amendments to N.J.A.C. 8:43G-15.3 (Hospital Licensing Standards—Medical Record Patient Services), effective January 5, 2026. These amendments update hospital licensing regulations—last revised in 2011—to reflect the statutory changes enacted by P.L. 2022, c. 114 and earlier amendments under P.L. 2021, c. 359.
Notably, the regulations now expressly prohibit hospitals from imposing medical record fees on a patient, or an attorney representing a patient, who has a pending application for or is currently receiving Social Security disability benefits (SSI or SSDI) under Titles II or XVI of the Social Security Act. While this provision primarily arises in the Social Security disability context, it is also relevant in workers’ compensation cases where concurrent Social Security disability claims are pending.
The 2026 regulatory update also resolves the prior conflict between the outdated administrative rule and the governing statutes, providing hospitals with clear, updated compliance benchmarks.
Impact on Workers’ Compensation Claims
The cumulative effect of P.L. 2022, c. 114, and the 2026 regulatory amendments reshapes records practice in workers’ compensation proceedings in several concrete ways:
• Cost reduction for petitioners: The $50.00 cap substantially lowers the financial burden on injured workers and their attorneys seeking comprehensive medical histories, particularly in occupational disease, toxic exposure, and traumatic injury cases with voluminous treatment records.
• Carrier record requests now circumscribed: Workers’ compensation carriers acting as legally authorized representatives are entitled to the $50.00 cap, but only for records relevant to the specific work-related incident. Requests for broader medical histories must be pursued through subpoena or authorization, subjecting those requests to third-party fee schedules.
• Compliance obligations for providers: Hospitals and physicians must apply the correct fee schedule based on the legal category of the requester. Overcharging a patient or a legally authorized representative in violation of the statute may expose providers to dispute and potential regulatory sanctions.
• Medicare Set-Aside and lien resolution: Accurate and complete medical records remain essential for Medicare Set-Aside calculations and Medicare Secondary Payer compliance. The reduced cost structure facilitates more comprehensive record collection at a lower overall cost to the claim.
• Electronic delivery mandatory: Upon request by the patient, legally authorized representative, or authorized third party, records must be delivered electronically, by mail, or by fax—providers may not limit access to paper copies only.
• 30-day response requirement: Providers must furnish records within 30 days of a written request. Delays in producing records in the current fee environment are not justified by processing costs, and practitioners should monitor compliance with this mandatory turnaround.
Fee Schedule Summary
Fee Type | Patient / Legally Auth. Rep. | Authorized Third Party |
Per-page copy fee | $1.00/page; capped at $50.00 total | $1.00/page; no total cap |
Search fee | $20.00 max (none for own records) | $20.00 max |
Certification fee | $10.00 max per certification | $10.00 max per certification |
Billing records fee | No charge (patient/rep to hospital) | Fees may apply |
Delivery costs | Actual cost + applicable sales tax | Actual cost + applicable sales tax |
Recommended Citation: Gelman, Jon L., “Medical Records Fees Reshape Claims,” Workers’ Compensation Blog (Jon L. Gelman, LLC, May 28, 2026).
Sources
• N.J. P.L. 2022, c. 114 (Senate Bill 2253)—Amending N.J.S.A. 26:2H-5n and N.J.S.A. 45:9-22.27, effective September 22, 2022: https://pub.njleg.gov/bills/2022/S2500/2253_I1.HTM
• N.J.S.A. 26:2H-5n (Hospital Records Fee Statute, 2024): https://law.justia.com/codes/new-jersey/title-26/section-26-2h-5n/
• N.J.S.A. 45:9-22.27 (Health Care Professional Records Fee Statute, 2025): https://law.justia.com/codes/new-jersey/title-45/section-45-9-22-27/
• N.J.A.C. 8:43G-15.3 Adopted Amendment, effective January 5, 2026 (57 N.J.R. 7(1), July 7, 2025; adopted November 21, 2025): https://www.nj.gov/health/legal/documents/adoption/8_43G-15.3%20NOA.pdf
• N.J. S2274 (2024–2025 Session)—Pending legislation to further limit medical records fees: https://legiscan.com/NJ/text/S2274/id/2874407
• N.J. Department of Health, Notice of Receipt of Petition for Rulemaking, N.J.A.C. 8:43G-15.3 (January 6, 2025): https://nj.gov/health/legal/documents/public-notices/8_43G-15.3%20(Receipt).pdf
*Jon L. Gelman of Wayne, NJ, is the author of NJ Workers' Compensation Law (West-Thomson-Reuters) and co-author of the national treatise Modern Workers' Compensation Law (West-Thomson-Reuters).
Blog: Workers' Compensation
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© 2026 Jon L Gelman. All rights reserved.
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