Christine Jordan Sexton
A fierce battle over the costs of medical record reproduction has been waged at the Florida Board of Medicine for two years. Now the Florida Legislature is being asked to weigh in on the issue.
The Board of Medicine agreed at a Wednesday teleconference meeting to send the proposed rule to the Legislature for ratification because the changes — which would allow doctors to charge $1 a page for medical records regardless of who is asking and how many pages are in the record — would have more than a $1 million impact on businesses.
The decision negates a February decision by the board to approve the proposed rule along with a SERC — statement of estimated regulatory costs — that showed the changes wouldn’t increase costs by $1 million.
The estimated fiscal impact is significant because under a law passed in 201o any rule that increases costs to the public by more than $1 million needs to be signed off on by the Legislature.
The Joint Administrative Procedures Committee (JPAC) on Feb. 17 sent a letter to the Board of Medicine flagging the SERC’s findings. Florida Board of Medicine Counsel Ed Tellechea told board members that the letter arrived at his office before he had submitted to the state any of the transactional paperwork associated with rule publication.
The timing, Tellechea said, indicates that “this this was instigated by somebody else.” Additionally, when he queried JAPC about the timing of the letter, Tellechia said, he didn’t get “too much information about what is going on.”
Current rules allow a physician to charge patients seeking their records $1 a page for the first 25 pages and 25 cents a page for each additional page. The same rates apply for government agencies. Doctors are allowed to charge all others $1 a page. In 2010 a circuit court judge ruled that attorneys, acting on behalf of their patients, should be charged the patient rate.
The Board of Medicine began reviewing the rules in 2013 and held a series of public meetings taking testimony. The changes were pushed by Florida doctors who said they were overwhelmed with request for records but also by “release-of-information” companies that specialize in reproducing medical charts for doctors.
The board in February agreed to approve the proposed rule allowing the increases, the first increases in 26 years.
Lobbyist Cynthia Henderson represents the release-of-information company, Healthport. She tried to dissuade board members from sending the rule to the Legislature for ratification. Henderson said she lobbied the Legislature last year unsuccessfully to pass a law that increased the costs to $1 per page. She said she was “shot down” by one member of the Legislature.
“It will be nearly impossible to pass it through the Legislature with the amount of pressure,” she said.
Henderson told the board it should move ahead with the rule it approved at the February meeting and that if its challenged, the Board of Medicine could defend it in administrative court, which she said would give extreme deference to the board.
Tellechea disagreed with Henderson, though, telling board members that administrative court does not give agencies “extreme deference.”
In addition to agreeing to send the rule to the Legislature to ratify the proposed rule, the board also voted at the March 4 meeting to amend the SERC to show that the proposed rule does trigger the $1 million impact and that it requires legislative ratification.
Henderson then interjected saying changing the SERC “is completely inappropriate, by the way.”
Tellechea immediately chided Henderson for interrupting a board meeting telling her: “Ms. Henderson, I think it would be appropriate to speak when you’re recognized by the chair and request to speak before you blurt out at this committee meeting. Thank you.”
