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Committee hears bill capping costs for patient access to medical records; opponents warn of operational burden
Summary
Senate Bill 5,254 would cap fees at $50 for a patient or specified parties to obtain a patient's medical records and would replace the current per‑page fee schedule with a standard tied to actual production costs; the committee heard strong testimony both for and against the measure.
The Senate Health and Long Term Care Committee heard testimony on Senate Bill 5,254, legislation that would restrict fees that health care providers, facilities and third‑party vendors may charge when providing a patient's health record to the patient, their representative, a licensed attorney representing the patient, a treating provider, or a community‑based advocate.
Under the bill as described to the committee, providers and third parties would be prohibited from charging more than $50 for furnishing a patient's health information to covered requesters; the existing per‑page statutory schedule would be removed and the Department of Health would be directed to adopt rules establishing a reasonable fee standard based on actual cost rather than a per‑page calculation. Committee staff summarized statutory background, noting current per‑page caps and indexing tied to the Consumer Price Index.
Supporters — including plaintiffs' attorneys, victim‑rights advocates, Northwest Health Law Advocates, the Washington State Association for Justice and other legal and survivors' groups — told the committee that excessive fees for records block access to courts and services and impose barriers that fall hardest on low‑income and vulnerable patients. "Patients are paying, in my experience, up to tens of thousands of dollars in order to be able to access their medical records and assess their legal rights," testified Holly Brauchley, an attorney representing injured clients. Survivors' advocates described cases in which record fees impeded civil protection orders and other legal remedies.
Opponents included DataVant (formerly Ciox) and the Association of Health Information Outsourcing Services, hospitals and health systems, and associations representing smaller providers. Data management vendors warned that many requests are operationally complex — requiring validation, redaction of sensitive information (HIV, substance‑use, mental health and reproductive health records), and coordination across multiple electronic systems — and argued that a flat $50 cap would not cover costs for voluminous or highly sensitive record productions. "This labor is intensive, and it's extremely important to get it right," testified Kyle Probst representing DataVant, noting examples of very large paper requests and the costs of processing and delivery.
Hospitals and health systems also urged caution, saying patient requests are typically provided at low cost but third‑party attorney requests can have higher costs; some providers reported patient request averages under $2 in 2024 while attorney requests averaged higher charges. Several attorneys described invoices they received from record vendors showing fees in the thousands for electronic medical record exports.
The committee recorded robust public interest in the measure: staff reported 151 pro‑testifiers and 33 con‑testifiers during the hearing. No committee action was recorded at the close of testimony; sponsors said they would continue discussions and seek refinements.
Ending: Supporters urged statutory change to ensure patients and survivors can access records without financial barriers; opponents urged targeted fixes and cautioned against an overly broad flat cap that might shift costs to small providers or threaten privacy protections during complex redaction processes.
