Michigan medical records fees for 2026 are capped by the Medical Records Access Act at $32.08 as an initial fee, $1.60 a page for the first 20 pages, $0.80 a page for pages 21 to 50 and $0.32 a page after that, plus postage. A patient asking for their own record cannot be charged the initial fee, and for a patient's own request HIPAA adds its own limit: a reasonable, cost-based fee. The deadline is federal: 30 days from receipt, with one 30-day extension if you tell the patient why in writing within the first 30. On August 27, 2026 the HHS Office for Civil Rights announced a $50,000 settlement with an eye-care practice that took almost two years.
In short
- $32.08, $1.60, $0.80, $0.32: Michigan's 2026 maximum initial fee and per-page fees, set by MDHHS on February 18, 2026 from the Detroit consumer price index (MDHHS, 2026).
- 30 days: the HIPAA deadline to act on a request, with one extension of no more than 30 days (45 CFR 164.524).
- $6.50: the flat fee HHS allows for an electronic copy of electronic records, inclusive of labor, supplies and postage (HHS).
- $50,000: what Azul Vision paid in OCR's 55th right of access enforcement action (HHS OCR, 2026).
What Michigan allows in 2026
The Medical Records Access Act, MCL 333.26269, sets base fees and requires MDHHS to adjust them every year by the change in the Detroit consumer price index. The 2026 notice, signed by Director Elizabeth Hertel on February 18, 2026, sets these maximums:
| Fee | 2026 maximum |
|---|---|
| Initial fee per request | $32.08 |
| Pages 1 to 20 | $1.60 a page |
| Pages 21 to 50 | $0.80 a page |
| Pages 51 and over | $0.32 a page |
Three rules sit around the table. The notice says a patient "shall not be charged the initial fee for the patient's own medical record," though per-page fees may apply. The Act lets a provider add postage or shipping, and the actual cost of retrieving records seven years old or older. And it says a provider "shall waive all fees for a medically indigent individual," limited to one free set per provider.
The per-page schedule is written for paper. For records "in some form or medium other than paper," the Act allows "the actual cost of preparing a duplicate." That may change: House Bill 5681, analysed by the House Fiscal Agency as of May 12, 2026, would reset the amounts and apply the schedule to electronic copies as well. The analysis describes it as introduced; check its status before relying on it.
Where HIPAA sets a lower ceiling
Michigan's table is the most Michigan law allows. When the request is a patient's own, HIPAA's right of access applies too, and it limits the fee to a "reasonable, cost-based fee" covering labor for copying, supplies, postage when the patient asks for mailing, and a summary only if the patient agreed to one (45 CFR 164.524(c)(4)).
HHS gives practices three ways to set that fee: actual costs per request, a schedule of average costs, or, for an electronic copy of records kept electronically, a flat fee "not to exceed $6.50 (inclusive of all labor, supplies, and postage)." Whichever you choose, HHS says you must tell the patient the approximate fee in advance.
Take a patient who asks for a 60-page paper copy of their own chart. Michigan's schedule would allow 20 pages at $1.60, 30 at $0.80 and 10 at $0.32, which is $59.20 before postage, with no initial fee. Whether $59.20 is a reasonable, cost-based fee for your office is a separate question under HIPAA. For a patient's own request, the safe practice is to charge the lower of the two, and to have your fee method written down. Ask your counsel where the line falls for your practice.
What the Azul Vision settlement shows
OCR's August 27, 2026 announcement is short and specific. A patient requested records from Azul Vision, a California optometry and ophthalmology provider, in January 2023. She complained to OCR in April 2023. She received her records in January 2025, "almost two years after her initial request, and after OCR initiated this investigation." Azul Vision paid $50,000 and accepted a corrective action plan OCR will monitor for two years.
The plan is the useful part for a practice manager. Azul Vision must "regularly submit to HHS a list of requests for access to PHI received," with "the date the request was received and the date the response to the request was completed," and train every workforce member on the right of access. That list is a log any small practice could keep today. OCR Director Paula M. Stannard said it "should not be necessary for OCR to initiate a right of access investigation before a covered entity will provide an individual with access to their requested records."
A records request log in five columns
- Date received. The day it reached anyone in the practice, by any route: fax, email, portal message, letter or the front desk. That starts the 30 days.
- Who asked, and for whom. The patient, a personal representative, or a third party such as an attorney or insurer. The initial fee and the HIPAA fee limit depend on the answer.
- Due date. Receipt plus 30 days. If you need the extension, send the written reason and the new date before day 30, and log both.
- Format and fee quoted. Paper or electronic, the method used to set the fee, and the approximate amount given in advance. HIPAA requires the format the patient asks for "if it is readily producible."
- Date completed. When the copy was sent or made available. This is the column OCR asked Azul Vision to report.
The mistake most practices make at step 1
They log the request when the records staff pick it up, not when it arrived. A request faxed on a Friday to a machine nobody checks until Tuesday has already used four days. A portal message read by a medical assistant who does not know it is a records request can lose a week. Date received means received by the practice. The fix is a rule, not software: every channel that can receive a request has someone who logs it that day.
Auto injury claims add a second stream of requests from adjusters, and those records are what decide payment; our note on the Michigan no-fault fee schedule covers the record an office keeps for each claim.
Where this fits in a practice's front office
The rules on records requests, fees and deadlines are the kind of thing staff ask about once a month and get wrong when the person who knew has left. A private assistant that answers staff only from the practice's own written policies, and says where the answer came from, is part of the healthcare practice work we build. It does not decide what to release or what to charge; your privacy officer does. The security side of the same rules is in our note on the 2026 HIPAA Security Rule update.
Michigan sets the price ceiling. HIPAA sets the clock. Both are cheaper to follow than a two-year request.
