This isn't totally a legal problem, it's also an adherence problem. I'd estimate about half of providers don't know what exactly they are required to do and at what cost. Our company helped patients request their own records and half the time we had to call and talk to the provider about the legal requirements and ask them to comply or reduce the price.
Even before October 6 and the Cures Act, HIPAA law already required very cheap access to your own medical records. It's something like a base maximum cost of $6.50 plus a per-page printing fee but ONLY if you request paper format. HIPAA law directly states that the format requested by the patient MUST be given if readily available. Digital format doesn't require printing.
I got an email a little bit later asking follow-up questions. It seems like something might happen. Or at least I'll be part of a tally of violations.
Some of that is true, some of that is hype.
Last week I asked a mid-sized healthcare company for my records from ten years ago.
I was told that they could not be transmitted digitally, only on CDROM. And that the price for duplication started at $500 and would go up from there.
I was also told that if my current doctor requested the records, it would all be free.
So yes, the records can be moved around digitally, but actually personally owning a copy of the records dos not seem "unfettered."