180.000 MEDICAL DATA

(See also Acquired Immunodeficiency Syndrome (AIDS), 15.000)

180.974           Public Safety Agencies Data Collection Enhancement

MSSNY shall actively collaborate with the National Emergency Medical Services Information System (NEMSIS) to develop a listing of necessary data points and variables to be added to the currently available information collection systems, in a mandatory and searchable fashion, to facilitate the required research.

MSSNY shall actively collaborate with the American College of Surgeons to add these variable fields to data collection systems of the National Trauma Data Bank (NTDB) and the Trauma Quality Improvement Program (TQIP), in a mandatory and searchable fashion, to facilitate the required research.
MSSNY shall lobby the New York State Legislature to mandate the collection of these data and fund the transition to and the ongoing collection of these data.

MSSNY will forward similar resolution(s) to the American Medical Association for consideration at the 2024 AMA House of Delegates. (HOD 2024 – 165)

180.975           United Healthcare Group Abuse of Physicians

The Medical Society of the State of New York (MSSNY) will use all means available, regulatory, legislative, or legal, to force United to cease its demands for excessive records. United Healthcare should also be obligated to allow electronic uploading of medical records. (HOD 2024 – 254)

180.976           Electronic Submission of Medical Records

MSSNY will advocate for legislation, regulations other regulatory intervention that require insurers to provide the means for electronic submission of requested records for medical necessity reviews. (HOD 2022-60)

180.977           Hospital Discharge Summaries

The MSSNY will support and seek legislation or regulation of an opt-out policy where patients must explicitly request in writing for records not to be shared, encouraging seamless sharing of personal health information among all New York State clinicians. (HOD 2022-105)

180.978           Physician Access to their Medical and Billing Records

Licensed physicians must always have access to all medical and billing records for their patients from and after date of service including after physician termination.  MSSNY will press for legislation to eliminate contractual language that bars or limits the treating physician’s access to the medical and billing records, such as treating these records as trade secrets or proprietary.  This resolution will be brought to AMA for consideration. (HOD 2019-114)

180.979           Integrating Medical Records

MSSNY will correspond with the State Office of Mental Health, the Office of Alcoholism and Substance Abuse Services and the Department of Health to determine the mechanism for primary care physicians to access records of mental health and substance use disorders to afford those patients the best medical care.  MSSNY will educate its members about what options are currently available to primary care physicians to view the records of patients suffering from mental health conditions and/or substance use disorders.  MSSNY will forward this resolution to the AMA with a request that the AMA Task Force on Opioids work toward federal regulations that would allow seamless interaction for primary care physicians to be able to assess a patient’s mental health and/or substance use disorder record. (HOD 2018-63; Council, March 5, 2019)

180.980             SHIN-NY Connectivity

The Medical Society of the State of New York will work with the New York eHealth Collaborative and the State Health Information Network – New York (SHIN-NY) to make sure that physicians do not have to pay any of the costs associated with connecting to, accessing or downloading data from the SHIN-NY network.

The Medical Society of the State of New York will oppose any state requirement or mandate to participate in the SHIN-NY as a condition of physician licensure. (HOD 2014-104; Reaffirmed HOD 2024)

180.981            Correct Record Access

MSSNY supports action to assure that the imbedded costs of EHR technology, interoperability and additional administrative expenses associated with patient record access are added separately to the rate of payment currently received by the physician from the patient’s health payer. In order to govern privacy and security of record transfer through the SHIN-NY, the State of New York should promote patient record access in accordance with rules developed through the Statewide Collaboration Process (SCP) which are delineated in the document entitled “Privacy and Security Policies and Procedures for Qualified Entities and their Participants in New York State, Version 3.0. (HOD 2014-106; Reaffirmed HOD 2024)

180.982              Charges for Copies of Medical Records

The Medical Society of the State of New York, working with other health care stakeholders, will advocate for a higher charge for copies of paper medical records which is related to the actual cost of reproduction. The Medical Society of the State of New York will publish educational articles in its News of New York and eNEWS concerning the limitations of its ability to advocate for increases for the charge for copies of medical records. (HOD 2013-265, referred to, amended, adopted by Council 11/7/2013; Reaffirmed HOD in lieu of 2017-102)

180.983:            Clear, Informed Consent Regarding Release of Medical Records

MSSNY will seek legislation, regulation or other appropriate means to assure that insurance companies obtain informed consent from patients that contains clear, concise and easy to understand wording; provides a detailed explanation of exactly how the information will be used; and notifies the signing party/parties that they can limit the scope of their consent. MSSNY will also seek to assure that, when insurers request medical records for a patient, they clearly state the intended use for their records and provide a copy of such request to the patient. (HOD 2013-68; Reaffirmed HOD 2023)

180.984        Privacy in Electronic Health Records: 

MSSNY endorses the recommendations of the Tiger Team of the National Health Information Policy Committee and supports their implementation by the State Department of Health, the New York eHealth Collaborative and all health information exchanges operating in the State of New York. (HOD 2011-100; Reaffirmed HOD 2021)

180.985        Insurance Company Requests for Medical Records:

MSSNY will:
Seek legislation/regulation which requires that when insurance carriers request copies of medical records:

1. They allow at least 30 days for physicians to forward the records to the requestor;
2. There be a clear identification as to the reason for requesting the medical records;
3. Physicians be notified as to the outcome of the medical record review;
4. A reasonable cap be placed on the number of records an insurance carrier can  request per patient;
5. They follow the guidelines of the Recovery Audit Contractors (RACs) Summary of
   Additional Documentation Limits as listed below:
   Sole Practitioner:  10 medical records per 45 days per NPI
   Partnership (2-5 individuals):  20 medical records per 45 days per NPI
   Group (6-15 individuals):  30 medical records per 45 days per NPI
   Large Group (16+ individuals):  50 medical records per 45 days per NPI;
6. Requiring the managed care organization to render, in advance, a per-page fee,  pursuant to Public Health Law Section 18.
7. Reaffirm and actively pursue legislation in accordance with MSSNY Policies 180.988, 180.989, 180.992, 180.995.
8. Ensure that the drafted legislation include language that clarifies the physician’s ability to charge and collect for any/all postage costs.  (HOD 2010-257; Reaffirmed HOD 2020)

180.986           Methodology for Efficiency/Quality Indicator Data Collection and Analysis:

MSSNY will seek legislation and/or regulation that (1) permits patient data to be excluded from calculations utilized to develop physician profiles where medical advice and patient noncompliance are clearly documented, and such noncompliance has an adverse effect on a physician’s “quality,” “efficiency” and/or other similar rating; and (2) limits physician profiling data to the time period that the doctor-patient relationship existed.  (HOD 2010-94; Reaffirmed HOD 2020)

180.987            Social Security Form Completion:

MSSNY to seek legislation that increases the cost of completing this form to an inflation adjusted rate. (HOD 2008-259; Reaffirmed HOD 2018)

180.988           Charges for Copies of Medical Records:

MSSNY will seek changes in state law to allow physicians to charge $2 per page for the first 15 pages and $1 per page thereafter, for photocopies of records requested for purposes unrelated to ongoing patient care and to allow other charges for mailing costs. (HOD 03-59; Reaffirmed HOD 2010-257; Reaffirmed HOD in lieu of 2017-102)

180.989        Realistic Time Frame to Comply with Requests for the Release of Medical  Records:

In an attempt to minimize any accusations for professional misconduct for failure to comply within a reasonable period of time, with requests for copies of medical records, MSSNY will aggressively pursue modification to Section 18 of the New York State Public Health Law which would redefine the “reasonable period of time” which physicians have to comply with requests for copies of medical records from its current definition of 10 days to a more realistic 30 days.  (HOD 2002-55; Reaffirmed HOD 2010-257; Reaffirmed HOD 2020)

180.990             FBI Raids:

MSSNY will take all necessary steps to ensure that government investigators not be permitted to remove records of patients from a physician’s office without copies being made prior to removal. MSSNY’s position is that if patient records are seized and there is no provision made for copying of records at Government expense, copies must be made on side and left for the affected practitioners’ use in ongoing care of their patients.State and Federal legislation must be sought which would provide immunity for physicians from any physicians from any suit or administrative proceedings where it can be shown that absence of the patient records contributed to an alleged negligent act or where the patient records seized contain information relevant to defending against an alleged negligent act.MSSNY will seek passage of State and Federal legislation that would ensure that FBI investigations regarding physicians should be done in a matter that is sensitive to the health of patients and the viability of the medical practice under investigation, and that physicians not be required to pay any fees to receive copies of their patient records which have been seized by the FBI. (HOD 2000-73; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

180.991             Privacy and Confidentiality:

MSSNY will seek legislative/regulatory relief to prevent insurance companies and other managed care organizations from selling, trading, transmitting, or in any way communicating, individually identifiable health information to third parties. Such legislative/regulatory relief should include a provision that patients be permitted to opt to provide individually identifiable information to third parties. (HOD 2000-69; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

180.992             Increase Fees for Medical Records Reproduction:

American College of Obstetricians and Gynecologists – District II

• Greater New York Hospital Association
• Healthcare Association of New York State
• Medical Society of the State of New York
• New York Chapter, American College of Physicians
• New York Chapter of the American College of Surgeons
• The major components of the plan are as follows
  1. Medical Malpractice Civil Litigation Process Reform

  Systemic Remedies
  Immediate Remedies

  2. Financial Relief
  3. Quality and Outcome Improvement Measures

  (More detailed information about the plan is available from MSSNY’s Division of Governmental Affairs.) (Council 9/20/07; Reaffirmed HOD 2017)

MSSNY will seek legislation to a) increase the amount annually by the previous year’s Consumer Price Index (CPI) that physicians can charge to reproduce copies of medical records in order to reflect inflation and the higher cost of living endured by physicians in New York; and b) to allow physicians to charge a search and retrieval fee of $15.00 plus $1.00 per page and that both fees be increased annually by an amount equal to the previous year’s CPI. (HOD 2000-53; Reaffirmed HOD 1905-86; Reaffirmed HOD 2010-257; Reaffirmed HOD in lieu of 2017-102)

180.993              Privacy of Medical Records: SUNSET HOD 2014

180.994              Confidentiality of Patient and Physician Data:

MSSNY will continue to take whatever measures appropriate to discourage insurance companies and other health care agencies from publishing social security numbers and tax identification numbers whether it is stored, transmitted, or disposed of, in paper, electronic, or other media, and will become a strong proponent in efforts that may be underway to protect the confidentiality of patient and physician information whether it is stored, transmitted, or disposed of, in paper, electronic, or other media. (HOD 1998-88; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

180.995               Compensation for Providing a Patient’s Medical Record:

MSSNY will seek legislation to amend the New York State Public Health Law 17 and 18 to include language that would call for a charge of $1.00 per page for copies of patient information requested by a patient for use to facilitate the patient’s health care; and such legislation should include a provision that when copies are requested by other parties or for other purposes, the provider may impose a fee of up to $50.00 for search and retrieval, one dollar per page for paper copies, and two dollars per page for microfilm copies. (HOD 1998-66; Reaffirmed HOD 2010-257; Reaffirmed HOD in lieu of 2017-102)

180.996             Access to Medical Records by Insurance Companies: SUNSET HOD 2014

180.997             Privacy of Medical Records:

MSSNY supports the enactment of legislation to preserve patient privacy that includes the following:

(1) that HMOs as well as other financial or insurance organizations obtaining medical information preserve this information in such a manner that only personnel under the authority of a physician (MD or DO) have the right to peruse the medical information and that records be kept of those who do access any medical records indicating the purpose for which it was accessed and the person, time and date when it was accessed.

(2) that consent for release of information be limited to particular purposes.

(3) that information used to determine medical necessity for payment be covered by the rules established above. This would ensure that decisions regarding such necessity for payment would be subject only to medical rather than lay review.

(4) that penalties established as a result of these evaluations be assessed in terms of gross revenues to prevent the larger entities from being able to violate the rules since the penalties might not affect them in any significant degree.

(5) that repeated violations could result in loss of ability to conduct business in the health care field.

(6) that violations by the supervising medical personnel be subject to professional sanctions and that repeated violations by personnel being supervised who disregard their organization’s and supervisor’s rules regarding confidentiality be subject to criminal as well as civil penalties. (Council 10/24/96; Reaffirmed HOD 2015; Reaffirmed HOD in lieu of 2017-102)

180.998           Medical Data Confidentiality: 

MSSNY formally recognizes the importance of safeguarding the confidentiality of patients’ records and, to this end, strongly supports appropriate legislation to protect this confidentiality regardless of form (paper, electronic, etc.) and prevent unauthorized persons from having access to sensitive, personally identifiable health data.  (HOD 1996-51; Reaffirmed HOD 2010-257; Reaffirmed HOD 2020)

180.999           Amendment of NYS Public Health Law 17 and 18: 

In order to adequately compensate a provider relative to the office time and resources expended for retrieval, inspection, copying and delivery of a patient’s medical records, MSSNY will seek legislation to amend Section 18 of the Public Health Law accordingly.(HOD 1996-91; Reaffirmed HOD 1997-65; Reaffirmed HOD 2010-95; Reaffirmed HOD 2011-118; Reaffirmed HOD 2021)