MD Code, Health-General § 4-304 - Medical records; copy fees

A health care provider must comply with a patient’s written request to either receive a copy of his or her medical record or see a copy of the medical record.  If a medical record relates to a psychological or psychiatric problem and the health care provider, with input from a mental health care provider, feels that disclosure would be harmful to the patient, the health care provider may refuse to disclose that portion of the medical record deemed harmful to the patient.  However, upon written request, a provider must make a summary of the undisclosed portion of the medical record available to the patient, include the summary in the patient’s medical record, allow another treating provider (treating for the same condition) to copy or inspect the medical record, and inform the patient of his or her right to select another health  care provider.

A health care provider must establish procedures to allow a patient to request a correction or addition to his or her medical record.  Information may not be deleted from a medical record.  The provider must either make the requested change or provide written notice of refusal to make the change within a reasonable time from the request.  A notice of refusal must include the reason for refusal and procedures that the provider has for reviewing the refusal.  If the final determination is that the provider has refused to allow the correction or addition to the medical record, the provider must allow the patient to insert a brief statement into the medical record stating the reason for his or her disagreement, and the provider may include a reason for refusal in the medical record. 

The provider must provide a notice of a change in the medical record or statement of refusal to all persons who the patient has designated to receive such information and any person to whom the provider has submitted an inaccurate, incomplete or disputed medical record within the last 6 months. 

For purposes of copying fees, the definition of medical record includes copies of medical bills as well, but does not includes x-rays.  A provider may require a patient to pay the reasonable costs associated with copying the medical record for all state facilities regulated by the Department of Health and Mental Hygiene and for all other health care providers.  A health care provider may charge a fee not to exceed $.50 per page to copy the medical record, and a preparation fee not to exceed $15 and the actual costs of postage and shipping.  These fees may be adjusted for inflation annually.    These fees may also be charged for mandatory disclosures of medical records that a provider is required to make.  However, the health care provider is not allowed to charge such fees if the government requests medical records.  Unless the request is an emergency request from the government or protective services, a health care provider is allowed to withhold copies of the medical record until the copying fee is paid.