Key Takeaways
- Washington’s S.B. 5354 proposes a $50 cap on medical records requests to improve patient access to health care information
- The bill aims to reduce financial barriers that disproportionately affect patients with complex medical histories and disabilities, who face higher costs due to extensive records
- HIPAA requires health care providers to grant patients access to their records but systems to access the information varies by state
Introduction
In January 2025, a bill was introduced in the Washington state legislature aimed at improving access to health care information for all patients in the state. The bill was titled S.B. 5354: Strengthening Patients’ Rights Regarding Their Health Care Information. It proposes a $50 price cap on medical records requests to ensure patients have better access to their records. This bill aims to remove financial barriers that prevent patients from accessing their health information and to provide a platform for better individual health literacy.
What Is HIPAA and How Does It Regulate Medical Records Access?
The system for accessing patient records varies from state-to-state. Many patients face high fees that prevent them from accessing their health care information, reports the United States Government Accountability Office (GAO). These high fees are due to state-by-state differences and interpretations of HIPAA. The only consistent national policy on health care information is the Health Insurance Portability and Accountability Act of 1996, or HIPAA. HIPAA requires that all health care providers and insurers provide patients access to their own medical records upon request. However, HIPAA does not specify a payment structure for accessing these records. Specifically, it does not specify whether the provider or insurer must cover the costs of the printing and distributing records.
Each state has a different set of rules and regulations for how much a provider or insurer can charge patients to access their records. In the state of Washington, the pay structure is set at $1.24 per page for the first 30 pages and only $0.94 per page after that. The current rate in California for accessing your health care records is $0.25 per page, which is much lower than in Washington. Patients with more complex records and longer medical histories, including people with disabilities, may be charged far more to access their medical records than people who do not have extensive medical records.
What Gaps Exist in Current Health Information Access Policies?
Though policies in recent years aim to ensure patients receive access to their health care information, gaps still exist. Electronic health records (EHR) were becoming more common in 2015. That same year, HIPAA was expanded through the American Recovery and Reinvestment Act (ARRA). The act required health care organizations to provide patients with health care information in an electronic format. This expansion once again improved access to health care information for people throughout the United States. In California in 2016, the Cures Act required health care organizations to provide patients with timely access to their electronic health information. However, this act still does not cover past records and medical information patients may need for specialists or their health care information autonomy.During the COVID-19 pandemic, EHRs became even more commonplace. Yet, with new laws and regulations to increase access disparities are still evident.
S.B. 5354 seeks to reduce these gaps that remain in the state of Washington. In Washington, the disparity lies in the cost of patients’ health records and how that impacts their health autonomy. California currently has a more straightforward cost structure that is less expensive than Washington’s. While this cap does not match California’s lower per-page rate, it would still significantly reduce the barriers to health care information for patients with extensive medical records or those who cannot afford more than $50 for their medical records.
Conclusion
S.B. 5354 would lower overall health care information costs and cap them at $50 to reduce disparities based on cost and improve patients’ health access and literacy. HIPAA provides ample space for state-level decisions to access patients’ health information, leading to disparities in access to health care information between states.
FAQ
- What would S.B. 5354 change? The bill would establish a $50 cap on medical records requests regardless of the number of pages, which would remove the per-page fee structure and make access more affordable for patients with complex or lengthy medical records.
- What is HIPAA? The Health Insurance Portability and Accountability Act of 1996 requires all health care providers and insurers to provide patients access to their own medical records upon request. However, HIPAA does not specify a payment structure, allowing states to set their own fees for printing and distributing records.