Law Times

PAGE 12 FOCUS January 9, 2012 • Law Times Lawyer slams costs for medical records Even pharmacies charge varying amounts for prescription summaries BY JUDY VAN RHIJN For Law Times Canada to A Mississauga, Ont., law- yer is challenging the Insurance Bureau of take action over the escalating cost of patients' medical records. Despite guidelines from the governing professional bodies, he believes these charges are going beyond the actual costs of production and becoming a source of rev- enue for various parts of the health industry. Personal injury lawyer Roger Foisy recalls that at the begin- ning of his legal career, copies of patient records were provid- ed for free or occasionally for a small administration fee of up to $15. Now he finds that he's expected to pay substantial fees for clinical reports from health service providers. "At times, we are paying $50 for two pieces of paper from doctors or up to $500 for 100 pieces of paper and now phar- macists are getting in on the act. I kid you not, we are paying $75 to $150 for a prescription summary that may be one piece of paper." Foisy believes the provid- ers are aware that lawyers seek reimbursement of the fee from the clients' insurers. "They say it's not really the patient's mon- ey, but I see it as my clients' money even if at the end of the day it is reimbursed. Insurance companies end up charging higher premiums because the cost of litigation is more expen- sive. It must cost them hundreds of thousands of dollars a year in pharmacy records alone and it is the victims that pay at the end of the day." The trend annoys Foisy all paid to write on them. There should be a small administra- tive fee to produce it." The Ontario Medical Asso- 'Why are they allowing a free market on record production?' asks Roger Foisy. the more because he believes the clinical notes and records are re- ally the patient's property. "The professionals have already been with ciation provides guidelines that state that physicians are prohib- ited from charging a fee for pro- viding copies of their medical records unless they first give the individual an estimate of the fee they'll be charging. They go on to state that there are two ele- ments to the charge for provid- ing a copy of medical records. First is the cost of the provi- sion of the copy, for which the OMA recommends a charge of $30 plus 25 cents per page for each one over 20 pages. The second element deals out-of-pocket disburse- ments incurred by the physi- cian such as charges for the re- trieval of the medical record from storage, postage, courier fees, long-distance fax costs, and other expenses of a similar nature. Only where the physician must look over the records before providing copies is it proper to charge a pro- fessional fee for the review. The OMA recommends doing this at the usual hourly rate. Foisy is very familiar with the OMA guidelines but says that in his experience, following them isn't the norm. "While there are a number of doctors' offices which do follow the guidelines, there are far more that do not." He also notes that the OMA guidelines don't cover medical clinics that employ chiropractors, physio- therapists, and other regulated and non-regulated professionals. "This is where the vast majority of requests are going to," says Foisy. "There does not appear to be any consistency in record production costs from those sources." According to Foisy, what has been most interesting and prob- lematic for his clients are the re- cords charges from pharmacies. "Over the course of the last three years, we have paid between $30 and $175 per request for phar- macy prescription summaries, which on average include one to five pages at most. You can't tell me that a one-page pharmacy prescription history with 10 pre- scriptions costs $150. I'm tired of paying that on behalf of the cli- ent. It doesn't make any sense." These high fees are at odds with the position taken by the Ontario Pharmacists' Associa- What do your clients need? The means to move on. Guaranteed. Baxter Structures customizes personal injury settlements into tax-free annuities that can help your clients be secure for life. » Pre- and post- settlement consultation and support » Caring professionalism for over 30 years » No fee to you or your clients ™ tion, which covers the matter in its suggested fee guide for unin- sured clinical and professional pharmacy services under the category of consultant and ad- visory services. That section rec- ommends an hourly rate of $135 per hour. A spokesperson for the association notes that a report of this type would take about 10 to 15 minutes. This would not only include copying but reviewing and collating the information to ensure that it's free of internal administrative transactions that aren't relevant to the patient file. The association recommends that pharmacists charge in 15-minute increments and therefore con- siders the appropriate fee to be around $33.50 plus HST. In response, Foisy is chal- FREE BAXTER APP! FREE BAXTER APP! DOWNLOAD OUR HANDY PRESENT VALUE/LIFE EXPECTANCY APP FOR YOUR MOBILE DEVICE AT BAXTERSTRUCTURES.COM DOWNLOAD OUR HANDY PRESENT VALUE/LIFE EXPECTANCY APP FOR YOUR MOBILE DEVICE AT BAXTERSTRUCTURES.COM Need more information? Contact us at 1 800 387 1686 or baxterstructures.com lenging the insurance bureau to lobby the government to restrict or regulate the cost of production of medical records. "If they are so interested in trying to save costs, why are they so easily paying these amounts?" he asks. "It's not that they shouldn't reimburse the client but that they should seek legislation on this." Foisy suggests a cap of $30 for the first 20 pages and 25 cents for each additional page. This is the rate recently adopted by the larger hospitals. "At present, it's a free-for-all out there. You never know what to expect." Foisy notes that the insur- ance bureau has actively lobbied to contain costs in other areas. See Document, page 13 Baxter_LT_Jan9_12.indd 1 www.lawtimesnews.com 12-01-05 4:13 PM

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