B 24-0133 — Personal Medical Record Fee Amendment Act of 2021

ENGROSSEDENROLLED ORIGINAL AAN BILLACT 3____________ 24-133 5 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA 7 __________________ 9 To amend the District of Columbia Health Occupations Revision Act of 1985 to limit the amount of fees chargedthat bya health care entity tomay charge persons authorized or designated to receive information by the patient or client or on behalf of the patient or client to obtain personal medical records and to extend the period of time personal medical records must be stored.

The District of Columbia Health Occupations Revision Act of 1985, March 25, 1986 (D.C.

(a) The table of contents is amended by adding a new designation for section 1011a to read as follows:

ENGROSSED ORIGINAL “(A) A copy of a medical bill or a medical billing record with individually identifiable health information, including an audit trail of any additions, deletions, or revisions to the record,record; if specifically requested;

or “(B) Protected health information as that term is defined in 45 CFRC.F.R. § 160.103.”.

§ 160.103.”.

“(a)“Upon Upon written request from a patient or client, or person authorized to have access to the patient’s personal medical record under a healthcarehealth care power of attorney for the patient or client, a health care entity having custody and control of the patient’s or client’s personal medical record shall furnish a complete and current copy of that personal medical record.

ENROLLED ORIGINAL (C) Paragraph (6) is amended to read as follows:

“(6) Any survivor of the decedent or other persons involved in the decedent’s health care or payment prior to the decedent’s death, unless doing so iswould be inconsistent with any prior expressed preference of the decedent that is known to the health care entity.”.

ENGROSSED ORIGINAL (A) Paragraph (1) is amended by striking the phrase “A health care provider may require the patient or client, or person authorized to have access to the patient’s or client’s record,” and inserting the phrase “A health care entity may require the patient or client, a person authorized to have access to the patient’s or client’s record under a health care power of attorney for the patient or client, or, if the patient or client is deceased, a person listed under subsection (a) of this section,” in its place.

“(2) A health care entity shall not charge a person authorized to have access to a patient’s or client’s personal medical record under a health care power of attorney for the patient or client or, if the patient or client is decease,deceased, a person listed under subsection (a) of this section, a fee different tothan the one athe health care entity would charge athe patient or client.”.

“(d) For purposes of this sectionsection, and section 1011a, the term “health care entity” means a health care provider or a business associate as those terms are defined in 45 CFRC.F.R. § 160.103.”.

§ 160.103.”.

ENGROSSED ORIGINAL “Sec.

“(a)(1) ProvidedSubject to paragraph (3) of this subsection and provided that the authorization is clear, conspicuous, and specific, if a patient or client authorizes a person to receive their personal medical records and the authorized person requests the patient’s or client’s personal medical record from a health care entity having custody and control of the personal medical record, the health care entity shall transmit to the requester, within 30 days from the date the request was receivedreceived, excepta ascomplete otherwiseand providedcurrent incopy paragraphof (3)the ofpersonal thismedical subsection,record ain completethe form and currentformat copyrequested ofprovided that the personal medical record is readily producible in the form and format requested;requested.

provided“(2) If the personal medical record is readilynot producible in suchthe form and format;format requested, the health care entity shall produce the personal medical record to the requester in a readable electronic form and format either by email or by uploading the personal medical record to an electronic portal accessible to the requestor.

“(2)ENROLLED ORIGINAL “(3)(A) If the personal medical record iscannot notbe producibleproduced inwithin the form30-day andperiod formatas requested,provided thein healthparagraph care(1) entityof shallthis producesubsection, the personalhealth medicalcare recordentity toshall thestate requester in awriting readablethe electronicreason formfor andthe format,delay eitherand bythe emaildate or by uploadingwhich the personal medical record towill anbe electronicproduced; portal accessible to the requestor.

“(3)(A)provided, Ifthat the personal medical record cannot be produced within the 30-day period, the health care entity shall issuetransmit a written statement of the reasonrecord forwithin the60 delaydays andfrom the date by which the recordrequest shallwas bereceived. produced;

provided“(B) thatIf the health care entity shallfails transmitto furnish the requested personal medical record within 60the days60-day fromperiod, the datehealth care entity shall reduce its fee for producing the requestpersonal wasmedical received.record as provided for under subsection (b) of this section by 15 dollars for each day of non-compliance;

“(B)provided, Ifthat the healthfee carereduction entityshall failsnot toexceed furnish the requestedamount personal medical record within the 60-day timeframe, the health care entity shallwould reducehave itsotherwise feecharged for producing the ENGROSSEDrequestor. ORIGINAL personal medical record under subsection (b) of this section by 15 dollars for each day of non- compliance;

provided“(C) theNo fee reduction shall notbe exceedmade thewhen amounta the health care entity wouldhas havea otherwiselegal chargedbasis thefor requestorwithholding undera subsectionpersonal (b)medical ofrecord. this section.

“(C) No fine shall be assessed when a health care entity has a legal basis for withholding a personal medical record.

“(1) For anya personal medical record that is produced in an electronic format:

provided the total amount for the personal medical record shall not exceed $86.54.

and “(C) The actual cost for postage and handlinghandling. of the personal medical record.

“(c) The fees enumerated in subsection (b) of this section are the only fees that a health care entity may becharge chargedan authorized person for the production of a personal medical recordrecord; to an authorized person;

providedexcept, ENGROSSEDthat ORIGINAL nothing in this section shall be construed or applied to require or excuse noncompliance with any federal law or regulation.

“(d)(1) The fees enumerated in subsection (b) of this section shall be adjusted for inflation on an annual basis starting on January 1, 2024, in accordance with the Consumer Price Index (“CPI”) for the District as calculated by the United States Department of Labor, Bureau of Labor Statistics.

“(2) The Department of Health shall calculate the CPI adjustments and publish the adjusted fee amounts on the Department’s website no later than February 1 of each year.”.year.

“(e) For purposes of this section, the term “health care entity” means a health care provider or a business associate as defined in 45 C.F.R.

§ 160.103.”.

ENROLLED ORIGINAL Sec.

______________________________ Chairman Council of the District of Columbia _________________________________ Mayor District of Columbia 4