Even though Texas law for years has clearly stated that medical providers cannot charge fees for records needed in pursuit of a Social Security disability claim, a surprising percentage of doctors and hospitals still try to make patients or their attorneys pay for the records.
We run into this problem every week. Our response is to send a copy of the law to the doctor or hospital, and after we do that we usually don't have further problems — especially if we explain the next step is to have the Social Security Administration subpoena the records.
In case you need it, here is the actual Texas statute stating these medical records must be provided at no charge:
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE H. PUBLIC HEALTH PROVISIONS
CHAPTER 161. PUBLIC HEALTH PROVISIONS
SUBCHAPTER M. MEDICAL OR MENTAL HEALTH RECORDS
Sec. 161.201. DEFINITION. In this subchapter, "health care provider" means a person who is licensed, certified, or otherwise authorized by the laws of this state to provide or render health care in the ordinary course of business or practice of a profession.
Added by Acts 1995, 74th Leg., ch. 707, Sec. 1, eff. Aug. 28, 1995.
Sec. 161.202. FEES. (a) A health care provider or health care facility may not charge a fee for a medical or mental health record requested by a patient or former patient, or by an attorney or other authorized representative of the patient or former patient, for use in supporting an application for disability benefits or other benefits or assistance the patient or former patient may be eligible to receive based on that patient's or former patient's disability, or an appeal relating to denial of those benefits or assistance under:
(1) Chapter 31, Human Resources Code;
(2) the state Medicaid program;
(3) Title II, the federal Social Security Act, as amended (42 U.S.C. Section 401 et seq.);
(4) Title XVI, the federal Social Security Act, as amended (42 U.S.C. Section 1382 et seq.);
(5) Title XVIII, the federal Social Security Act, as amended (42 U.S.C. Section 1395 et seq.);
(6) 38 U.S.C. Section 1101 et seq., as amended; or
(7) 38 U.S.C. Section 1501 et seq., as amended.
(b) A health care provider or health care facility may charge a fee for the medical or mental health record of a patient or former patient requested by a state or federal agency in relation to the patient or former patient's application for benefits or assistance under Subsection (a) or an appeal relating to denial of those benefits or assistance.
(c) A person, including a state or federal agency, that requests a record under this section shall include with the request a statement or document from the department or agency that administers the issuance of the assistance or benefits that confirms the application or appeal.
(d) A health care provider or health facility is not required to provide more than one complete record for a patient or former patient requested under Subsection (a)(6) or (7) without charge. If additional material is added to the patient or former patient's record, on request the health care provider or health facility shall supplement the record provided under Subsection (a)(6) or (7) without charge. This subsection does not affect the ability of a person to receive a medical or mental health record under Subsections (a)(1)-(5).
Added by Acts 1995, 74th Leg., ch. 707, Sec. 1, eff. Aug. 28, 1995. Amended by Acts 1999, 76th Leg., ch. 201, Sec. 1, eff. Sept. 1, 1999.
Sec. 161.203. DISTRIBUTION OF RECORDS. A health care provider or health care facility shall provide to the requestor a medical or mental health record requested under Section 161.202 not later than the 30th day after the date on which the provider or facility receives the request.
Added by Acts 1995, 74th Leg., ch. 707, Sec. 1, eff. Aug. 28, 1995.
Sec. 161.204. APPLICATION OF OTHER LAW. This subchapter controls over Section 611.0045 of this code and Section 159.006, Occupations Code, and any other provision that authorizes the charging of a fee for providing medical or mental health records.
Added by Acts 1995, 74th Leg., ch. 707, Sec. 1, eff. Aug. 28, 1995. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.783, eff. Sept. 1, 2001.
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