In proposed § 164.514(d)(3)(iv), we would permit a covered plan or provider to charge a reasonable, cost-based fee for copying health information provided pursuant to this section. We considered whether we should follow the practice in the FOIA and include a structured fee schedule. We concluded that the FOIA was developed to reflect the relatively uniform government costs and that this proposed rule would apply to a broader range of entities. Depending on the size of the entity, copying costs could vary significantly. Therefore, we propose that the entity simply charge a reasonable, cost-based fee.
The inclusion of a fee for copying is not intended to impede the ability of individuals to copy their records. Rather, it is intended to reduce the burden on covered plans and providers. When establishing a fee for copying, we encourage covered plans and providers to consider the impact on individuals of such a cost. If the cost is excessively high, some individuals would not be able to obtain a copy. We would encourage covered plans or providers to make efforts to keep the fee for copying within reach of all individuals.