SB 326 — AN ACT CONCERNING ACCESS TO MEDICAL RECORDS AND THE FEES CHARGED FOR MEDICAL RECORDS.

General Assembly   ProposedCommittee Bill No.

326   January Session, 2017   LCO No.

25503762   *02550**03762SB00326PH_* Referred to Committee on PUBLIC HEALTH   Introduced by:

  SEN.(PH)   AN ACT CONCERNING ACCESS TO MEDICAL RECORDS AND THE FEES CHARGED FOR MEDICAL RECORDS.

MARKLEY, 16th Dist.

  AN ACT CONCERNING ACCESS TO MEDICAL RECORDS AND THE FEES CHARGED FOR MEDICAL RECORDS.

ThatSection the1. general statutes be amended to require a health care provider or health care facility to:

(1)Section Furnish20-7c aof patient's health record to the patient'sgeneral personalstatutes representative,is includingrepealed (A) the patient's parent, guardian or other person with authority to act on behalf of the patient, and (B) the executor,following administratoris orsubstituted otherin personlieu authorizedthereof to(Effective actOctober on1, behalf2017): of a deceased patient;

(2)(a) produceFor apurposes patientof healththis recordsection, pursuant"clinical tolaboratory" ahas subpoenathe orsame courtmeaning order;as provided in section 19a-30.

(3)"Clinical chargelaboratory" fordoes reproductionnot ofinclude medicalany recordsstate atlaboratory established by the ratesDepartment of:of Public Health pursuant to section 19a-26 or 19a-29.

(A)(b) Sixty-fiveExcept centsas perprovided page,for (B)in asubsection research[(e)] and(i) handlingof feethis ofsection, twentya dollars,provider exceptshall if(1) requestedsupply byto a patient orupon personalrequest representativecomplete forand whichcurrent thereinformation shallpossessed beby nothat researchprovider concerning any diagnosis, treatment and handlingprognosis fee,of the patient, and (C)(2) notify a certificationpatient fee of tenany dollars,test ifresults certificationin isthe requested,provider's whichpossession feesor shallrequested beby increasedthe basedprovider onfor changesthe inpurposes theof consumerdiagnosis, pricetreatment index;or prognosis of such patient.

andIn (4)addition, produceupon recordsthe inrequest anof electronica formatpatient ifor a provider who orders medical tests on behalf of a patient, a clinical laboratory shall provide medical test results relating to the requestpatient isto for(A) recordsthe inpatient, anor electronic(B) formatany andother provider who is treating the requestedpatient recordsfor arethe maintainedpurposes andof candiagnosis, betreatment transmittedor inprognosis anof electronicsuch format.patient.

Statement(c) A provider, who requests that his or her patient submit to repeated medical testing at regular intervals, over a specified period of Purpose:time, for purposes of ascertaining a diagnosis, prognosis or recommended course of treatment for such patient, may issue a single authorization that allows the entity that conducts such medical testing, including, but not limited to, a clinical laboratory, to directly communicate the results of such testing to the patient for the period of time that such testing is requested by the provider.

To(d) make[Upon] changesExcept as provided in subsection (i) of this section and section 4-194, upon a written request of a patient, a patient's attorney or authorized representative, or pursuant to thea statuteswritten concerningauthorization, accessa provider [, except as provided in section 4-194,] shall furnish to medicalthe recordsperson making such request a copy of the patient's health record, including but not limited to, bills, x-rays and copies of laboratory reports, contact lens specifications based on examinations and final contact lens fittings given within the feespreceding charged[three formonths] medicalthree-month period or such longer period of time as determined by the provider but no longer than [six months] a six-month period, records toof conformprescriptions withand changesother technical information used in assessing the patient's health carecondition. industry.

(e) No provider shall refuse to return to a patient original records or copies of records that the patient has brought to the provider from another provider.

When returning records to a patient, a provider may retain copies of such records for the provider's file, provided such provider does not charge the patient for the costs incurred in copying such records.

(f) No provider shall charge more than (1) sixty-five cents per page, [including any research fees, handling fees or related costs, and the cost of first class postage, if applicable, for furnishing a health record pursuant to this subsection, except such provider may charge a patient] (2) twenty dollars for research and handling fees for furnishing a paper or electronic copy of a health record, or any part thereof, pursuant to this section, except no research and handling fees shall be charged for furnishing a paper or electronic copy of a health record to (A) a patient, or (B) an attorney for a patient who has previously made a request of such provider for the patient's health record and obtained a copy of such health record, provided (i) the attorney requests only the part of such health record that has been generated since the date of the initial request, (ii) the part of such health record furnished under this subparagraph is maintained in the same health records system as the health record previously furnished to such attorney, (iii) the part of such health record furnished under this subparagraph was not included in the health record furnished in response to the initial request, and (iv) the request is made not more than twelve months after the date the health record furnished in response to the initial request was sent or delivered to the attorney, and (3) one hundred fifty-five dollars for furnishing an electronic copy of a health record, or any part thereof, pursuant to this subsection.

Except as otherwise provided in this section, a provider may charge a patient or other person (I) for the cost of first class postage for furnishing a copy of a health record pursuant to this section, (II) the amount necessary to cover the cost of materials for furnishing a copy of an x-ray, [provided no such charge shall be made] and (III) a certification fee of not more than ten dollars, if certification of the health record is requested.

No provider shall charge for furnishing a paper or electronic copy of a health record, or part thereof, to a patient, a patient's attorney or authorized representative if the health record [or part thereof] is necessary for the purpose of supporting a claim or appeal under any provision of the Social Security Act or a claim or appeal for veterans' benefits under any provision of Title 38 of the United States Code or chapter 506 and the request for the health record is accompanied by documentation of the claim or appeal.

(g) A provider shall furnish a health record requested pursuant to this section [within] not later than thirty days [of] after the request.

(h) No health care provider, who has purchased or assumed the practice of a provider who is retiring or deceased, may refuse to return original records or copied records to a patient who decides not to seek care from the successor provider.

When returning records to a patient who has decided not to seek care from a successor provider, such provider may not charge a patient for costs incurred in copying the records of the retired or deceased provider.

[(e)] (i) If a provider reasonably determines that the information is detrimental to the physical or mental health of the patient, or is likely to cause the patient to harm himself, herself or another, the provider may withhold the information from the patient.

The information may be supplied to an appropriate third party or to another provider who may release the information to the patient.

If disclosure of information is refused by a provider under this subsection, any person aggrieved thereby may, [within] not later than thirty days [of] after such refusal, petition the superior court for the judicial district in which such person resides for an order requiring the provider to disclose the information.

Such a proceeding shall be privileged with respect to assignment for trial.

The court, after hearing and an in camera review of the information in question, shall issue the order requested unless it determines that such disclosure would be detrimental to the physical or mental health of the person or is likely to cause the person to harm himself, herself or another.

[(f)] (j) The provisions of this section shall not apply to any information relative to any psychiatric or psychological [problems or conditions] illness or condition.

[(g)] (k) In the event that a provider abandons his or her practice, the Commissioner of Public Health may appoint a licensed health care provider to be the keeper of the records.

[, who] The keeper of the records shall be responsible for disbursing the original health records to the provider's patients, upon the request of any such patient.

[(h)] (l) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the provisions of this section.

Sec.

2.

Section 19a-490b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(a) Upon the written request of a patient or the patient's attorney or authorized representative, or pursuant to a written authorization, an institution licensed pursuant to this chapter shall furnish to the person making such request a copy of the patient's health record, including but not limited to, copies of bills, laboratory reports, prescriptions and other technical information used in assessing the patient's health condition.

In addition, an institution shall provide the patient or the patient's designated health care provider with a reasonable opportunity to examine retained tissue slides and retained pathology tissue blocks.

Upon the written request of the patient, the patient's attorney or the patient's designated health care provider, an institution shall send the original retained tissue slide or original retained tissue block directly to the patient's designated licensed institution, laboratory or physician.

If the original slide or block is not available or if a new section cut of the original slide or block is a fair representation of the original slide or block, then the institution may send the new section cut, [which] that is clearly labeled as a new section cut, to the patient's designated health care provider.

Any patient or [the] a patient's attorney or authorized representative who is provided with an original retained slide, tissue block or a new section under the provisions of this subsection shall be solely responsible for safeguarding and returning the slide, block or new section to the institution.

Any institution [or laboratory] that has released an original slide, an original tissue block or new section pursuant to the provisions of this subsection shall not be subject to any liability arising out of releasing or not retaining the slide, block or new section and no cause of action for damages shall arise against any such institution for releasing or not retaining the slide, block or new section.