Bill Summary: This legislation modifies the charges imposed for copying patient health care records.

ESTIMATED NET EFFECT ON GENERAL REVENUE FUND
FUND AFFECTED	FY 2009	FY 2010	FY 2011
General Revenue	($107,377)	($132,771)	($136,754)

Total Estimated Net Effect on General Revenue Fund	($107,377)	($132,771)	($136,754)

ESTIMATED NET EFFECT ON OTHER STATE FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011


Total Estimated Net Effect on Other State Funds	$0	$0	$0

ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011
Federal*	$0	$0	$0

Total Estimated Net Effect on All Federal Funds	$0	$0	$0

*Incomes and costs of $107,377 in FY09, $132,771 in FY10 and $136,754 in FY11 would net to $0.

ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)
FUND AFFECTED	FY 2009	FY 2010	FY 2011


Total Estimated Net Effect on FTE	0	0	0

☐ Estimated Total Net Effect on All funds expected to exceed $100,000 savings or (cost).

☒ Estimated Net Effect on General Revenue Fund expected to exceed $100,000 (cost).

ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011
Local Government	$0	$0	$0

Officials from the Department of Insurance, Financial Institutions & Professional Registration assume the proposal would have no fiscal impact on their agency.

Officials from the Department of Health and Senior Services (DHSS) state health care providers may charge copy fees for medical records requested by any authorized entity, which would include the Division of Senior and Disability Services (DSDS) in its role as investigator of reports of abuse and/or neglect. The DHSS assumes any costs will be absorbed by existing resources. This legislation is not expected to fiscally impact the operations of DSDS. If a fiscal impact were to result, funds to support the program would be sought through the appropriations process.

Bureau of Special Health Care Needs (BSHCN) is required to treat medically eligible clients. To determine the medical eligibility, BSHCN must obtain copies of medical records and to periodically review clients medical conditions. (19 CSR 40-1.020 Program Eligibility, (C) medically-eligible client). If the provider is not a contracted provider with BSHCN, BSHCN is required to pay for the requested medical records. If a fiscal impact were to result, funds to support the program would be sought through the appropriations process.

Officials from the Department of Mental Health (DMH) state in FY07 the DMH paid $16,010 for copies of medical records. A thirteen percent (13%) increase would result in approximately $2,081 in additional expenditures by DMH.

In FY07, DMH facilities received revenues for copying public records, including medical records, in the amount of $24,509. A thirteen percent (13%) increase would increase revenues by approximately $3,186 for the Department. Since not all records copied by facilities are medical records, the actual increase would likely be less. Given that the slight increase in expenditures would be off-set by additional revenues; this legislation has no fiscal impact to the Department.

Officials from the Department of Social Services-Division of Legal Services assume the proposal would have no fiscal impact on their agency.

Officials from the Department of Social Services-MO HealthNet Division (MHD) assume the proposal increases the fee for copies of medical records. The increase in fees will have a very minimal impact on the MHD and it is assumed the extra cost can be absorbed; therefore the fiscal impact is zero.

Officials from the Department of Social Services-Children’s Division (CD) assume the proposal increases the amount of copying patient medical records from $17 to $19.31 and increases the amount of per page copies from $.40 to $.46. It also increases certification and notary fees from $2 to $8.

The CD is currently paying $18.49 for retrieval fees and $.44 per page for medical records which is less than the amounts specified in the proposal. The CD's total expenditures for copies of medical records in the past 12 months were $35,864.28. This proposal will create an approximate 4.5% increase, or $1,614 per year. Because the increase in health care record copying costs would not be significant at approximately $1,614 per year, the CD would absorb this cost.

Officials from the Department of Social Services-Family Support Division (FSD) states based on current estimates of copying costs of $236,222 per month for medical records, FSD anticipates the copying costs to increase to $257,706 per month, for an annual increase of $257,808 ($257,706 - $236,222 = $21,484 x 12 months).

Doctor's and medical providers may have an increase in the amount covering their costs.

The proposed legislation clarifies that the current fee for copies of medical records is $19.31 plus 46 cents per page for supplies and labor. The combination of the notary and certification fee, if

This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space.

FISCAL IMPACT - State Government	FY 2009 (10 Mo.)	FY 2010	FY 2011

GENERAL REVENUE FUND

Costs - Department of Social Services
Increase in Copying Costs	($107,377)	($132,771)	($136,754)

ESTIMATED NET EFFECT ON GENERAL REVENUE FUND	($107,377)	($132,771)	($136,754)

FEDERAL FUNDS

Income - Department of Social Services
Federal Assistance	$107,377	$132,771	$136,754

Costs - Department of Social Services Increase in Copying Costs	($107,377)	($132,771)	($136,754)

ESTIMATED NET EFFECT ON FEDERAL FUNDS	$0	$0	$0