HB248 would regulate the fees medical providers may charge when a patient’s family member, caregiver, or representative requests copies of medical records. The bill is aimed primarily at helping disabled applicants and recipients of Social Security disability benefits obtain the records needed to support initial claims and continuing disability reviews, which the bill says are often too costly to secure under current practices. It also seeks to reduce barriers for indigent or near-indigent applicants who may otherwise be unable to submit the documentation the Social Security Administration requires.
Under the bill, providers could charge only limited, specified fees: up to $2 per request for electronically maintained records, or a very small flat fee for paper records, plus postage where applicable. It would prohibit per-page charges, search/review fees, and other unspecified charges. The bill also requires timely completion of requests under federal HIPAA timing rules and authorizes fines of up to $500 for a first violation and $1,000 for a second violation. The measure would be added to chapter 323B, Hawaii Revised Statutes, and would take effect upon approval.
Impact
HB248 would create a new state-law fee schedule governing medical-records requests made by a patient’s family member, caregiver, or representative, and would limit what medical providers may charge for producing those records. It would also impose a timeliness requirement tied to federal HIPAA regulations and establish civil penalties for noncompliance. The practical effect would be to lower the cost of obtaining records for disability-benefit claims and to constrain provider billing practices for these requests, while giving the state an enforcement mechanism through fines.
Sentiment
The bill’s stated purpose and framing are strongly supportive of access to medical records for disabled residents, especially those seeking Social Security disability benefits. The bill text presents the measure as a way to reduce financial barriers, improve access to benefits, and help the state recover general assistance costs when residents qualify for federal disability support. No committee transcript or vote record was provided, so there is no recorded floor or committee debate to indicate opposition or amendment activity.
Contention
The main policy tension is between lowering costs for patients and representatives on one hand, and limiting medical providers’ ability to recover administrative and copying expenses on the other. The bill specifically targets fees that providers may currently charge under state law or practices that can exceed HIPAA’s cost-based standard when records are requested by a representative. Potential points of contention include the very low fee caps, the prohibition on search/review fees, and the enforcement penalties, which providers may view as restrictive or burdensome. The bill’s supporters are implicitly disabled applicants, caregivers, representatives, and the state, while affected parties on the other side are medical providers and record-processing vendors.