People with disabilities are often caught in a Kafkaesque situation when it comes to receiving disability benefits from the federal government: they need the safety-net money because their disability makes them poor.
But they can’t easily get their medical records to prove they are disabled because health plans, hospitals and providers sometimes charge them hundreds of dollars to retrieve those records.
Senate Bill 710 would change that and allow an individual or their personal representative to receive one free copy of their records from each healthcare entity that provides them medical care, expanding it from a current law that applies only to medical doctors, not psychologists or other healthcare professionals or health entities.
Several other states, particularly in the South, have already adopted this policy.
The bill applies to cases where the person has been denied a Social Security Insurance or Social Security Disability request but is awaiting an appeal, which may take up to two years. Social Security will check medical records before its initial decision, but the system is set up to deny most applicants their first go-round.
While awaiting an appeal, a person may pile up a long list of medical services that will help his or her claim, but have no access to those records.
“For these individuals, the hardship of paying for these records can be a serious impediment for their ability to get access to Social Security disability benefits,” said Sen. Michael Dembrow, D-Portland, when SB 710 passed the Senate unanimously in April.
Cheryl Coon, an attorney who represents people who fight for disability benefits, tried to get the term “personal representative” in the Senate version altered to just “representative” but giving that leeway to patients suddenly drew a curious $100,000 fiscal cost to Oregon Health & Science University, which reported no increased cost otherwise.
She told Rep. Mitch Greenlick, D-Portland, that she was willing to let go of that provision to get the bill passed, which led the Health Committee chairman to call for a vote on SB 710, which passed unanimously out of committee and is headed to the floor next week.
That amendment was an attempt to get a House version closer to the original bill than the one passed by the Senate, and allow for a broader team of people who could help with the process. Coon described hospital bureaucracies as cumbersome for a healthy person, let alone someone suffering from a disability. Attorneys on the other hand, are experienced in navigating the system.
Patty O’Sullivan, the lobbyist for the Oregon Association of Hospitals and Health Systems, testified that she was unsure who was charging for medical records, saying that’s not true of the larger systems such as Legacy Health and Providence Health & Services.
But Coon was nonplussed by O’Sullivan’s testimony: “It’s not been our experience that the records have been free. Our problems with getting records free of charge are across the board.”
Bob Joondeph, the executive director of Disabilities Rights Oregon, argued that SB 710 will save the state money if people who are disabled can receive federal benefits -- they’re less likely to end up homeless or in the throes of addiction and mental illness, and the state can receive a better federal match rate for its social services.
A leading opponent of SB 710 was DBS Health Services, a medical records company that makes money processing medical records for healthcare facilities and could stand to lose if the records were free. Tracy Paul of DBS Health argued that the attorneys should pay for the records, since they gain financially if a client wins a disability claim.
But Coon said most attorneys are unwilling to pay for these records because the odds of winning a case is not great. “Most disability attorneys don't want to put out any money on client's behalf because the rate of winning cases has plummeted,” Coon said. “I still do, because to me it's an access to justice issue; these folks cannot afford to pay until and unless they win benefits.”
Legal advocacy for the disabled is not a lucrative field -- federal law caps the amount an attorney may receive for assisting a person at $6,000 or 25 percent of backlogged disability payments, whichever is less. A typical payout is $3,000 a person. If their client loses, attorneys receive nothing, she added.
The fact that a person has to pay for one copy of their medical record at all, in any circumstance, is troubling to me. I've heard the costs of copying or making an electronic copy of the record cited, but one might make the assumption that those costs are more than covered by the profit of the care the person has received. The record should belong to the patient, not the facility.