HB 1496 — Strengthening patients' rights regarding their health care information.

(iii) Billing, claims management, collection activities, obtaining payment under a contract for reinsurance, including stop- loss insurance and excess of loss insurance, and related health care data processing;

(iv) Review of health care services with respect to medical necessity, coverage under a health plan, appropriateness of care, or justification of charges;

(v) Utilization review activities, including precertification and preauthorization of services, and concurrent and retrospective review of services;

and (vi) Disclosure to consumer reporting agencies of any of the following health care information relating to collection of premiums or reimbursement:

(A) Name and address;

(B) Date of birth;

(C) Social security number;

(D) Payment history;

(E) Account number;

and (F) Name and address of the health care provider, health care facility, and/or third-party payor.

(((36))) (35) "Person" means an individual, corporation, business trust, estate, trust, partnership, association, joint venture, government, governmental subdivision or agency, or any other legal or commercial entity.

(((37))) (36) "Professional person" has the same meaning as in RCW 71.05.020.

(((38))) (37) "Psychiatric advanced registered nurse practitioner" has the same meaning as in RCW 71.05.020.

p.

7 SHB 1496 (((39))) (38) "Psychotherapy notes" means notes recorded, in any medium, by a mental health professional documenting or analyzing the contents of conversations during a private counseling session or group, joint, or family counseling session, and that are separated from the rest of the individual's medical record.

The term excludes ((mediation)) medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items:

Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

(((40))) (39) "Reasonable fee" means the charges for duplicating or searching the record, but shall not exceed 65 cents per page for the first 30 pages and 50 cents per page for all other pages.

In addition, a clerical fee for searching and handling may be charged not to exceed $15.

These amounts shall be adjusted biennially in accordance with changes in the consumer price index, all consumers, for Seattle-Tacoma metropolitan statistical area as determined by the secretary of health.

However, where editing of records by a health care provider is required by statute and is done by the provider personally, the fee may be the usual and customary charge for a basic office visit.

(((41))) (40) "Release" has the same meaning as in RCW 71.05.020.

(((42))) (41) "Resource management services" has the same meaning as in RCW 71.05.020.

(((43))) (42) "Serious violent offense" has the same meaning as in RCW 9.94A.030.

(((44))) (43) "Sexually transmitted infection" or "sexually transmitted disease" has the same meaning as "sexually transmitted disease" in RCW 70.24.017.

(((45))) (44) "Test for a sexually transmitted disease" has the same meaning as in RCW 70.24.017.

(((46))) (45) "Third-party payor" means an insurer regulated under Title 48 RCW authorized to transact business in this state or other jurisdiction, including a health care service contractor, and health maintenance organization;

or an employee welfare benefit plan, excluding fitness or wellness plans;

or a state or federal health benefit program.

(((47))) (46) "Treatment" means the provision, coordination, or management of health care and related services by one or more health care providers or health care facilities, including the coordination p.

8 SHB 1496 or management of health care by a health care provider or health care facility with a third party;

consultation between health care providers or health care facilities relating to a patient;

or the referral of a patient for health care from one health care provider or health care facility to another.

(((48))) (47) "Tribal public health authority" means a tribe that is responsible for public health matters as a part of its official mandate.

(((49))) (48) "Tribal public health officer" means the individual appointed as the health officer for the tribe.

(((50))) (49) "Tribe" has the same meaning as in RCW 71.24.025.

Sec.

3.

RCW 70.02.010 and 2025 c 58 s 5128 are each amended to read as follows:

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

(1) "Admission" has the same meaning as in RCW 71.05.020.

(2) "Audit" means an assessment, evaluation, determination, or investigation of a health care provider by a person not employed by or affiliated with the provider to determine compliance with:

(a) Statutory, regulatory, fiscal, medical, or scientific standards;

(b) A private or public program of payments to a health care provider;

or (c) Requirements for licensing, accreditation, or certification.

(3) "Authority" means the Washington state health care authority.

(4) "Commitment" has the same meaning as in RCW 71.05.020.

(5) "Custody" has the same meaning as in RCW 71.05.020.

(6) "Deidentified" means health information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual.

(7) "Department" means the department of social and health services.

(8) "Designated crisis responder" has the same meaning as in RCW 71.05.020 or 71.34.020, as applicable.

(9) "Detention" or "detain" has the same meaning as in RCW 71.05.020.

(10) "Directory information" means information disclosing the presence, and for the purpose of identification, the name, location p.

9 SHB 1496 within a health care facility, and the general health condition of a particular patient who is a patient in a health care facility or who is currently receiving emergency health care in a health care facility.

(11) "Discharge" has the same meaning as in RCW 71.05.020.

(12) "Evaluation and treatment facility" has the same meaning as in RCW 71.05.020 or 71.34.020, as applicable.

(13) "Federal, state, or local law enforcement authorities" means an officer of any agency or authority in the United States, a state, a tribe, a territory, or a political subdivision of a state, a tribe, or a territory who is empowered by law to:

(a) Investigate or conduct an official inquiry into a potential criminal violation of law;

or (b) prosecute or otherwise conduct a criminal proceeding arising from an alleged violation of law.

(14) "General health condition" means the patient's health status described in terms of "critical," "poor," "fair," "good," "excellent," or terms denoting similar conditions.

(15) "Health care" means any care, service, or procedure provided by a health care provider:

(a) To diagnose, treat, or maintain a patient's physical or mental condition;

or (b) That affects the structure or any function of the human body.

(16) "Health care facility" means a hospital, clinic, nursing home, laboratory, office, or similar place where a health care provider provides health care to patients.

(17) "Health care information" means any information, whether oral or recorded in any form or medium, that identifies or can readily be associated with the identity of a patient and directly relates to the patient's health care, including a patient's deoxyribonucleic acid and identified sequence of chemical base pairs.

The term includes any required accounting of disclosures of health care information.

(18) "Health care operations" means any of the following activities of a health care provider, health care facility, or third- party payor to the extent that the activities are related to functions that make an entity a health care provider, a health care facility, or a third-party payor:

(a) Conducting:

Quality assessment and improvement activities, including outcomes evaluation and development of clinical guidelines, if the obtaining of generalizable knowledge is not the primary p.

10 SHB 1496 purpose of any studies resulting from such activities;

population- based activities relating to improving health or reducing health care costs, protocol development, case management and care coordination, contacting of health care providers and patients with information about treatment alternatives;

and related functions that do not include treatment;

(b) Reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance and third-party payor performance, conducting training programs in which students, trainees, or practitioners in areas of health care learn under supervision to practice or improve their skills as health care providers, training of nonhealth care professionals, accreditation, certification, licensing, or credentialing activities;

(c) Underwriting, premium rating, and other activities relating to the creation, renewal, or replacement of a contract of health insurance or health benefits, and ceding, securing, or placing a contract for reinsurance of risk relating to claims for health care, including stop-loss insurance and excess of loss insurance, if any applicable legal requirements are met;

(d) Conducting or arranging for medical review, legal services, and auditing functions, including fraud and abuse detection and compliance programs;

(e) Business planning and development, such as conducting cost- management and planning-related analyses related to managing and operating the health care facility or third-party payor, including formulary development and administration, development, or improvement of methods of payment or coverage policies;

and (f) Business management and general administrative activities of the health care facility, health care provider, or third-party payor including, but not limited to:

(i) Management activities relating to implementation of and compliance with the requirements of this chapter;

(ii) Customer service, including the provision of data analyses for policyholders, plan sponsors, or other customers, provided that health care information is not disclosed to such policyholder, plan sponsor, or customer;

(iii) Resolution of internal grievances;

(iv) The sale, transfer, merger, or consolidation of all or part of a health care provider, health care facility, or third-party payor with another health care provider, health care facility, or third- p.

11 SHB 1496 party payor or an entity that following such activity will become a health care provider, health care facility, or third-party payor, and due diligence related to such activity;

and (v) Consistent with applicable legal requirements, creating deidentified health care information or a limited data set for the benefit of the health care provider, health care facility, or third- party payor.

(19) "Health care provider" means a person who is licensed, certified, registered, or otherwise authorized by the law of this state to provide health care in the ordinary course of business or practice of a profession.

(20) "Human immunodeficiency virus" or "HIV" has the same meaning as in RCW 70.24.017.

(21) "Imminent" has the same meaning as in RCW 71.05.020.

(22) "Indian health care provider" has the same meaning as in RCW 43.71B.010(11).

(23) "Information and records related to mental health services" means a type of health care information that relates to all information and records compiled, obtained, or maintained in the course of providing services by a mental health service agency or mental health professional to persons who are receiving or have received services for mental illness.

The term includes mental health information contained in a medical bill, registration records, and all other records regarding the person maintained by the department, by the authority, by behavioral health administrative services organizations and their staff, managed care organizations contracted with the authority under chapter 74.09 RCW and their staff, and by treatment facilities.

The term further includes documents of legal proceedings under chapter 71.05, 71.34, or 10.77 RCW, or somatic health care information.

For health care information maintained by a hospital as defined in RCW 70.41.020 or a health care facility or health care provider that participates with a hospital in an organized health care arrangement defined under federal law, "information and records related to mental health services" is limited to information and records of services provided by a mental health professional or information and records of services created by a hospital-operated community behavioral health program as defined in RCW 71.24.025.

The term does not include psychotherapy notes.

(24) "Information and records related to sexually transmitted diseases" means a type of health care information that relates to the p.

12 SHB 1496 identity of any person upon whom an HIV antibody test or other sexually transmitted infection test is performed, the results of such tests, and any information relating to diagnosis of or treatment for any confirmed sexually transmitted infections.

(25) "Institutional review board" means any board, committee, or other group formally designated by an institution, or authorized under federal or state law, to review, approve the initiation of, or conduct periodic review of research programs to assure the protection of the rights and welfare of human research subjects.

(26) (("Legal counsel" has the same meaning as in RCW 71.05.020.

(27))) "Local public health officer" has the same meaning as the term "local health officer" as defined in RCW 70.24.017.

(((28))) (27) "Maintain," as related to health care information, means to hold, possess, preserve, retain, store, or control that information.

(((29))) (28) "Managed care organization" has the same meaning as provided in RCW 71.24.025.

(((30))) (29) "Mental health professional" means a psychiatrist, psychologist, psychiatric advanced practice registered nurse, psychiatric nurse, or social worker, and such other mental health professionals as may be defined by rules adopted by the secretary of health under chapter 71.05 RCW, whether that person works in a private or public setting.

(((31))) (30) "Mental health service agency" means a public or private agency that provides services to persons with mental disorders as defined under RCW 71.05.020 or 71.34.020 and receives funding from public sources.

This includes evaluation and treatment facilities as defined in RCW 71.34.020, community mental health service delivery systems, or community behavioral health programs, as defined in RCW 71.24.025, and facilities conducting competency evaluations and restoration under chapter 10.77 RCW.

(((32))) (31) "Minor" has the same meaning as in RCW 71.34.020.

(((33))) (32) "Parent" has the same meaning as in RCW 71.34.020.

(((34))) (33) "Patient" means an individual who receives or has received health care.

The term includes a deceased individual who has received health care.

(((35))) (34) "Payment" means:

(a) The activities undertaken by:

p.

13 SHB 1496 (i) A third-party payor to obtain premiums or to determine or fulfill its responsibility for coverage and provision of benefits by the third-party payor;

(E)p. Account number;

7 HB 1496 (E) Account number;

p.(((38))) (37) "Psychiatric advanced registered nurse practitioner" has the same meaning as in RCW 71.05.020.

14 SHB 1496 (((38))) (37) "Psychiatric advanced practice registered nurse" has the same meaning as in RCW 71.05.020.

(((40)))(((40) (39) "Reasonable fee" means the charges for duplicating or searching the record, but shall not exceed 65 cents per page for the first 30 pages and 50 cents per page for all other pages.

(((41)))(41))) (40)(39) "Release" has the same meaning as in RCW 71.05.020.

(((42))) (41)(40) "Resource management services" has the same meaning as in RCW 71.05.020.

(((43))) (42)(41) "Serious violent offense" has the same meaning as in RCW 9.94A.030.

(((44))) (43)(42) "Sexually transmitted infection" or "sexually transmitted disease" has the same meaning as "sexually transmitted disease" in RCW 70.24.017.

(((45)))p. (44) "Test for a sexually transmitted disease" has the same meaning as in RCW 70.24.017.

(((46)))8 (45)HB "Third-party1496 payor"(((45))) means(43) an"Test insurerfor regulateda undersexually Titletransmitted 48disease" RCWhas authorizedthe tosame transactmeaning businessas in thisRCW state70.24.017. or other jurisdiction, including a health care service contractor, and health maintenance organization;

(((46))) (44) "Third-party payor" means an insurer regulated under Title 48 RCW authorized to transact business in this state or other jurisdiction, including a health care service contractor, and health maintenance organization;

p.(((47))) (45) "Treatment" means the provision, coordination, or management of health care and related services by one or more health care providers or health care facilities, including the coordination or management of health care by a health care provider or health care facility with a third party;

15 SHB 1496 (((47))) (46) "Treatment" means the provision, coordination, or management of health care and related services by one or more health care providers or health care facilities, including the coordination or management of health care by a health care provider or health care facility with a third party;

(((48))) (47)(46) "Tribal public health authority" means a tribe that is responsible for public health matters as a part of its official mandate.

(((49))) (48)(47) "Tribal public health officer" means the individual appointed as the health officer for the tribe.

(((50))) (49)(48) "Tribe" has the same meaning as in RCW 71.24.025.

4.3.

(b) Upon request of a patient or a patient's personal representative, a health care facility or health care provider shall provide the patient or representative with one copy of the patient's healthp. care information free of charge if the patient is appealing the denial of federal supplemental security income or social security disability benefits.

9 HB 1496 health care information free of charge if the patient is appealing the denial of federal supplemental security income or social security disability benefits.

A health care facility or health care provider is not p.required to provide a patient or a patient's personal representative with a free copy of health care information that has previously been provided free of charge pursuant to a request within the preceding two years.

16 SHB 1496 required to provide a patient or a patient's personal representative with a free copy of health care information that has previously been provided free of charge pursuant to a request within the preceding two years.

(a) Be in writing, dated, and signed by the patient;patient, the patient's personal representative, or any person or entity designated by the patient to receive the information;

(((6))) (5) When an authorization permits the disclosure of health care information to a financial institution or an employer of thep. patient for purposes other than payment, the authorization as it pertains to those disclosures shall expire one year after the signing of the authorization, unless the authorization is renewed by the patient.

10 HB 1496 the patient for purposes other than payment, the authorization as it pertains to those disclosures shall expire one year after the signing of the authorization, unless the authorization is renewed by the patient.

(((8))) (7) Where the patient is under the supervision of the department of corrections, an authorization signed pursuant to this p.section for health care information related to mental health or drug or alcohol treatment expires at the end of the term of supervision, unless the patient is part of a treatment program that requires the continued exchange of information until the end of the period of treatment.

17 SHB 1496 section for health care information related to mental health or drug or alcohol treatment expires at the end of the term of supervision, unless the patient is part of a treatment program that requires the continued exchange of information until the end of the period of treatment.

5.4.

(a) Make the information available for examination during regular business hours and provide a copy, if requested, to the patientpatient, the patient's personal representative, or anany individualperson listedor inentity sectiondesignated 1(2)(a)by ofthe thispatient act;to receive the information;

(2)p. Upon request, the health care provider shall provide an explanation of any code or abbreviation used in the health care information.

11 HB 1496 (2) Upon request, the health care provider shall provide an explanation of any code or abbreviation used in the health care information.

Except as provided in ((RCW 70.02.030)) section 1 of this act, the health care provider may charge a reasonable fee for ((providing)) assisting the designated recipient to obtain the health care information and is not required p.to ((permit examination or copying)) provide the health care information until the fee is paid.

18 SHB 1496 to ((permit examination or copying)) provide the health care information until the fee is paid.

6.5.

(3)p. If a health care provider denies a patient's request for ((examination and copying)) obtaining health care information, in whole or in part, under subsection (1)(a) or (c) of this section, the provider shall permit ((examination and copying of the record by)) another health care provider((,)) to obtain the health care information if the other health care provider has been selected by the patient((, who)) and is licensed, certified, registered, or otherwise authorized under the laws of this state to treat the patient for the same condition as the health care provider denying the request.

The12 HB 1496 (3) If a health care provider denyingdenies thea patient's request shallfor inform((examination and copying)) obtaining health care information, in whole or in part, under subsection (1)(a) or (c) of this section, the patientprovider shall permit ((examination and copying of the patient'srecord rightby)) another health care provider((,)) to selectobtain anotherthe health p.care information if the other health care provider has been selected by the patient((, who)) and is licensed, certified, registered, or otherwise authorized under the laws of this state to treat the patient for the same condition as the health care provider denying the request.

19The SHBhealth 1496care provider denying the request shall inform the patient of the patient's right to select another health care provider under this subsection.

7.6.

Sec.p.

8.13 HB 1496 Sec.

7.

A person may disclose information related to sexually transmitted diseases about a patient without the patient's p.authorization, to the extent a recipient needs to know the information, if the disclosure is to:

20 SHB 1496 authorization, to the extent a recipient needs to know the information, if the disclosure is to:

Upon the granting of the order, the court, in determining the extent to which any disclosure of all or any part of the record of any such test is necessary, shall impose appropriate safeguards against unauthorized disclosure.p.

14 HB 1496 disclosure.

(f) Persons who, because of their behavioral interaction with the infected individual, have been placed at risk for acquisition of a sexually transmitted disease, as provided in RCW 70.24.022, if the health officer or authorized representative believes that the exposed p.person was unaware that a risk of disease exposure existed and that the disclosure of the identity of the infected person is necessary;

21 SHB 1496 person was unaware that a risk of disease exposure existed and that the disclosure of the identity of the infected person is necessary;

This information may also be received by a person responsible for providing residential care for such a child when the department of social and health services, the department of children, youth, and families, or a licensedp. child-placing agency determines that it is necessary for the provision of child care services.

15 HB 1496 licensed child-placing agency determines that it is necessary for the provision of child care services.

(a) The sexually transmitted disease status of a department of corrections offender who has had a mandatory test conducted pursuant to RCW 70.24.340(((1))), 70.24.360, or 70.24.370 must be made p.available by department of corrections health care providers and local public health officers to the department of corrections health care administrator or infection control coordinator of the facility in which the offender is housed.

22 SHB 1496 available by department of corrections health care providers and local public health officers to the department of corrections health care administrator or infection control coordinator of the facility in which the offender is housed.

(c) Information regarding the sexually transmitted disease status of an offender or detained person is confidential and may be disclosed by a correctional health care administrator or infection control coordinator or local jail health care administrator or infection control coordinator only as necessary for disease prevention or control and for protection of the safety and security ofp. the staff, offenders, and the public.

16 HB 1496 of the staff, offenders, and the public.

p.Disclosure must be accompanied by appropriate counseling for the staff member, including information regarding follow-up testing and treatment.

23 SHB 1496 Disclosure must be accompanied by appropriate counseling for the staff member, including information regarding follow-up testing and treatment.

The county prosecutingp. attorney shall notify the victim of the right to such disclosure.

17 HB 1496 prosecuting attorney shall notify the victim of the right to such disclosure.

or when needed to protect the public p.health.

24 SHB 1496 health.

9.8.

or (C) Was charged with a serious violent offense and the charges were dismissed under RCW 10.77.645.10.77.086.

(c)p. Nothing in this subsection requires the disclosure of attorney work product or attorney-client privileged information.

18 HB 1496 (c) Nothing in this subsection requires the disclosure of attorney work product or attorney-client privileged information.

No mental health p.service agency or person employed by a mental health service agency, or its legal counsel, may be liable for information released to or used under the provisions of this section or rules adopted under this section except under RCW 71.05.680.

25 SHB 1496 service agency or person employed by a mental health service agency, or its legal counsel, may be liable for information released to or used under the provisions of this section or rules adopted under this section except under RCW 71.05.680.

(i) Has engaged in activity indicating that a crime or a violation of community custody or parole has been committed or, based uponp. his or her current or recent past behavior, is likely to be committed in the near future;

19 HB 1496 upon his or her current or recent past behavior, is likely to be committed in the near future;

(i) The information may be shared with other persons who have the right to request similar information under subsection (2) of this p.section, solely for the purpose of coordinating activities related to the individual who is the subject of the information in a manner consistent with the official responsibilities of the persons involved;

26 SHB 1496 section, solely for the purpose of coordinating activities related to the individual who is the subject of the information in a manner consistent with the official responsibilities of the persons involved;

Information released in response top. an oral request is limited to a statement as to whether the offender is or is not being treated by the mental health service agency and the address or information about the location or whereabouts of the offender.

20 HB 1496 to an oral request is limited to a statement as to whether the offender is or is not being treated by the mental health service agency and the address or information about the location or whereabouts of the offender.

p.(8) This section does not modify the terms and conditions of disclosure of information related to sexually transmitted diseases under this chapter.

27 SHB 1496 (8) This section does not modify the terms and conditions of disclosure of information related to sexually transmitted diseases under this chapter.

NEW SECTION.

Sec.

10.

Section 2 of this act expires June 30, 2027.

NEW SECTION.

Sec.

11.

Section 3 of this act takes effect June 30, 2027.

2821 SHBHB 1496