HHS Urges Court to Dismiss Lawsuit from ROI Vendor

In response to a lawsuit filed against it by release of information (ROI) vendor Ciox, the US Department of Health and Human Services (HHS) contends that the suit lacks standing and is asking the US District Court in Washington, DC to dismiss it.

In January of this year, Ciox filed a lawsuit against HHS in regards to two updates to HIPAA—updates which the vendor claims are “irrational, arbitrary, capricious and absurd.” In 2013, HHS released a final rule requiring providers “to respond to transmit health records to a designated individual, and include any medical information housed electronically, even if it is not stored in an electronic health record,” according to FierceHealthcare’s summary.

Additionally, Ciox took issue with 2016 HHS guidance that states any individual or entity requesting a person’s medical records, including ROI vendors, insurance companies, and law firms, can only be charged a reasonable, cost-based fee. Those fees, which also apply to business associates of covered entities, can be determined by the actual cost of labor, the average cost of labor, or a flat $6.50 rate. In its lawsuit, Ciox asked the court to invalidate the 2013 and 2016 modifications that are “in excess of statutory jurisdiction, authority, or limitations, or short of statutory right,” Healthcare IT News reported.

“The long-term viability of the medical-records industry is critical to the delivery of high-quality, error-free and cost-effective healthcare services to patients by ensuring that healthcare providers have timely access to individual medical records,” Ciox said in a statement to FierceHealthcare.

In response, HHS stated in a court filing that Ciox’s claims should be dismissed in full because it lacks “third-party standing to challenge the rule and guidance and because Ciox’s claims are unripe… Indeed, because HHS has not and cannot take enforcement action against Ciox regarding the fees it charges for individual requests of PHI, Ciox cannot raise either an enforcement or pre-enforcement challenge to the Privacy Rule provision and guidance at issue,” the court filing states.

FierceHealthcare reports that Ciox received a warning from the HHS Office for Civil Rights (OCR) for charging an individual $224.65 after sending 353 pages of medical records to her lawyer.

Mary Butler is the associate editor at Journal of AHIMA.


  1. I wish so badly that HHS would stay out of any business. I also operate a medical record copy service and I have suffered plenty from these new fees. Sadly enough no one else has regulations on how much they can charge, so why do they think they should regulate ours. I have also been warned from the HHS about the fees that we charged and the complaint was from a law firm over a $35.00 charge for medical records. We copy medical records for attorney’s who get medical records for law suits. They charge $150.00 an hour to start with and if they win they get more. Insurance companies get medical records to write policies and draws premiums monthly. I understand that patients should not pay that amount and I can justify the $6.50 cent charge, but the insurance companies and attorney’s are now having the clients requesting records that they need so they don’t pay for records but they continue to charge they’re outrageous fees. I’ve had to lay of two employees which has put a strain on my company. As far as I can tell there will be more layoffs shortly as we continue to loose money because of the HHS regulations. I wish so badly I would have know of this law suit as I would have loved to have put my two bits in. I’m a family owned business that has been in business for 24 years. Sadly enough I can see that we’ll have to fold shortly if things don’t change. Our job is very time consuming, but HHS, attorney and insurance companies seems to think that it’s as simple as pushing a button. I would love for someone to come sit and see what we do all day instead of just assuming it just a touch of a button.

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  2. Our state mandates billable copy fees. Now HHS under cuts that fee to 6.50 flat rate. We are a critical access hospital and my department is greatly affected by this slash is our services. I provide the patient with a free copy or to a patient representative. Now the lawyers are writing up request having the patient sign.
    I have a couple of issues with this.
    1. unless the lawyer has been given the right to make medical decision for the patient then they do not qualify as a patient representative.
    2. The cost that HHS had set is not even 1/2 the proposed amount of minimum wage increase. Who came up with 6.50.? We work on 5 legacy systems most are paper. Have they see the cost of toner or paper or wages?
    3. We now have to keep death records for 50 years per HIPAA regulations. Has HHS considered the cost of storage, staff for 50 years? Who came up with that 6.50?

    CIOX is right this is ridiculous.

    4. Lawyer requested copies are for litigation not continuation of care. HHS should recognize the difference.

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