Medical Records Cost: Hollabaugh v. MRO
The Baltimore Medical Malpractice Lawyer Blog delves into Maryland appellate opinions in medical malpractice cases and other relevant legal matters. Here it features a significant case from June 6, 2024. The Appellate Court of Maryland issued an unreported opinion in Hollabaugh v. MRO Corp., No. 1049, a class action complaint that raised important questions about medical records cost.
Factual Background of Medical Records Cost
The plaintiff brought in a class action case brought before the Circuit Court for Baltimore County. She had submitted a medical record request to the defendant. However, the defendant failed to find responsive records. The defendant then charged the plaintiff a $22.88 fee in a ‘Cancellation Invoice.’ The plaintiff argued that this fee was prohibited by Maryland’s Confidentiality of Medical Records Act (‘CMRA’) at HG 4-301 et seq. That law permits charges up to $22.88 for ‘retrieval and preparation’ of medical records. The circuit court’s disagreement and subsequent dismissal of the case raised important questions about the legal interpretation of the CMRA.
Appellate Court Analysis of Medical Records Cost
The Law
The Appellate Court summarized the relevant provisions in HG 4-304:
Subparagraph (c)(3)(i) provides that “for a copy of a medical record requested by a person in interest or any other authorized person . . . , a health care provider may charge a fee for copying and mailing not exceeding 76 cents for each page of the medical record.” Then Subparagraph (ii) adds, “In addition to the fee charged under subparagraph (i) of this paragraph, a hospital or a health care provider may charge,” in addition to a postage fee, “a preparation fee not to exceed $22.88 for medical record retrieval and preparation.” Subparagraph (iii) provides that a hospital or health care provider may also charge a fee not to exceed $22.88 for records provided in electronic form. In addition, paragraph (c)(4) states that the statute does not allow a “preparation fee” for either physical or electronic records to adjust for inflation.
(Id. at 10).
Analysis
Standing
The defendant contended that the plaintiff did not have standing to bring the class action. HG 4-304 refers to the “person in interest” who requests copies of a medical record may be required to pay a fee. The plaintiff was not the person required to pay the fee, so the defense argued that she was not aggrieved and lacked standing to seek judicial relief.
The Appellate Court saw nothing in the statute to indicate that the “person” could not make the request through an agent. All indications were that the plaintiff’s lawyer had requested the records in a representative capacity as her lawyer. So, the Appellate Court proceeded to the merits of the appeal. (Id. at 5-6).
Merits
The plaintiff argued that “retrieval” cannot be read to include the word “search.” She also contended that the CMRA is pro-consumer and intends to disallow fees not expressly provided for. (Id. at 7).
The defendant argued that it is equally likely that the legislature viewed search as part of preparation and retrieval, and it is naturally part of it. Further, the statute was both for consumer protection and to allow medical records providers to charge a reasonable fee for retrieving records, even when unsuccessful. (Id. at 8).
The Appellate Court found the medical records cost language of the statute to be ambiguous. They then turned to statutory construction rules to interpret the legislature’s intent. The court agreed with the circuit court that it would be an absurd result to require retrieval and preparation to be a completed act to allow a fee. They also stated that finding no fee would need some indication that the legislature intended that health care providers were required to conduct searches for records without demanding payment. They did not see anything that convinced them of such an intent. As a result, the Appellate Court upheld the circuit court’s dismissal, concluding the case.
Commentary by the Baltimore Medical Malpractice Lawyer
Medical records are part of every medical malpractice case. However, they can be costly to obtain. Consequently, the law governing the cost of medical record retrieval is of significant interest to plaintiffs and medical malpractice lawyers.
In Hollabaugh, the circuit court and the Appellate Court found that the plaintiff’s argument would lead to an absurd result. I don’t see it this way.
Apply the Plain Language
The law’s plain language allows for charges for medical record “retrieval and preparation.” There were no records responsive to the plaintiff’s request, so there was no retrieval or preparation. (In fact, the defendant’s invoice said it was a “cancellation invoice.”) In this circumstance, giving the ordinary and expected meaning to the statute’s terms indicates that the charge allowed for retrieval and preparation did not apply here.
This result is not absurd; it is a result that most consumers likely would expect. If one contracts for a service of retrieval and preparation for an agreed-upon price, the consumer will not expect a charge for failure to provide the service of retrieval and preparation.
The courts objected that this result would require healthcare providers to perform searches that do not reveal records for free. However, various businesses charge only based on successfully performing the service requested. In these circumstances, the businesses absorb the costs of unsuccessful efforts.
That could be the legislature’s intention here. Contrary to the courts’ conclusions, that would not be absurd but is a relatively common business practice. Therefore, the courts had to choose between two plausible intentions. They chose the one that contradicted the plain wording of the law.
The Legislature Can Clarify Its Intention on Medical Records Cost If Necessary
Alternatively, the courts could have refrained from guessing the legislature’s intention on medical records cost. They then could have applied the plain meaning of the words to disallow a charge for unsuccessful searches. The statute’s language and its failure to specifically address the situation of a search that revealed no records could be improved. If the legislature intended to allow a charge in such an instance, it could then make that clear by amending the law.
You can read more about the role of medical records in medical malpractice cases in the litigation process webpages on this website.
Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.