Legal Question in Civil Litigation in Maryland

There are 2 laws regarding medical records in this state. For providers falling under HIPAA, federal law requires that they charge no more than a reasonable, "Cost Based" fee to patients requesting records under HIPAA. In other words, this seems to be the actual costs of copying which is usually modest (perhaps 10 cents / page).

Maryland law separately (and long before HIPAA) limits medical records to a certain price per page (currently $0.76 per page) , plus a handling fee of around $22.88 if the records are going to someone other than the patient. (Health General Sec. 4-304) Many providers take the position that the state fee is reasonable, however, an argument exists that the federal cost-based approach trumps any reasonable per-page caps set by individual states and that the provider should pay the lesser of the two. Please note that is not a favored interpretation and more likely than not a provider will try to charge the full $.76 per page listed in statute, adjusted each year for inflation.

However, one can always request a waiver of the fees directly to the provider. To my knowledge there is no way to force a provider to copy records if you can't pay for the copying costs allowed by law, but if you've been a long term patient and the cost is onerous, ask if they'll reduce the fee. Note that the law does say a doctor cannot withhold records if you owe a medical bill.