Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 173 First Substitute (2021GS)

Sponsor

Sen. Mayne, K.

Final action

Governor Signed 3/17/2021

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• clarifies certain provisions relating to access to medical records;
• enacts new requirements relating to requests for medical records in an electronic format; and
• requires a health care provider to waive certain fees for a request for medical records for an indigent individual and an individual making a qualified claim.

Every vote on this bill

Bill text

MEDICAL RECORDS AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Karen Mayne
House Sponsor: 
Nelson T. Abbott
LONG TITLE
General Description:
This bill amends provisions relating to access to medical records.
Highlighted Provisions:
This bill:
▸ clarifies certain provisions relating to access to medical records;
▸ enacts new requirements relating to requests for medical records in an electronic
format; and
▸ requires a health care provider to waive certain fees for a request for medical
records for an indigent individual and an individual making a qualified claim.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
78B-5-618
, as last amended by Laws of Utah 2015, Chapter 217
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
78B-5-618
 is amended to read:
78B-5-618.
Patient access to medical records -- Third party access to medical
records.
(1) Pursuant to Standards for Privacy of Individually Identifiable Health Information,
45 C.F.R., Parts 160 and 164, a patient or a patient's personal representative
 may inspect or
receive a copy of the patient's records from a health care provider as defined in Section
78B-3-403
, when that health care provider is governed by the provisions of 45 C.F.R., Parts
160 and 164.
(2) When a health care provider as defined in Section 
78B-3-403
 is not governed by
Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R., Parts 160 and
164, a patient or a patient's personal representative may inspect or receive a copy of the
patient's records unless access to the records is restricted by law or judicial order.
(3) A health care provider who provides a 
paper or electronic
 copy of a patient's
records to the patient or the patient's personal representative:
(a) shall provide the copy within the deadlines required by the Health Insurance
Portability and Accountability Act of 1996, Administrative Simplification rule, 45 C.F.R. Sec.
164.524(b); and
(b) may charge a reasonable cost-based fee provided that the fee includes only the cost
of:
(i) copying, including the cost of supplies for and labor of copying; and
(ii) postage, when the patient or [
patient
] 
patient's personal
 representative has
requested the copy be mailed.
(4) Except for records provided by a health care provider under Section 
26-1-37
, a
health care provider who provides a copy of a patient's records to a 
patient's attorney, legal
representative, or other
 third party authorized to receive records:
(a) shall provide the copy within 30 days after receipt of notice; and
(b) may charge a reasonable fee 
for paper or electronic copies
, but may not exceed the
following rates:
(i) [
$21.16
] 
$30 per request
 for locating a patient's records[
, per request
];
(ii) reproduction charges may not exceed 53 cents per page for the first 40 pages and 32
cents per page for each additional page;
(iii) the cost of postage when the [
third party
] 
requester
 has requested the copy be
mailed; [
and
]
(iv) if requested, the health care provider will certify the record as a duplicate of the
original for a fee of $20; and
[
(iv)
] 
(v)
 any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.
(5) Except for records provided under Section 
26-1-37
, a contracted third party service
which provides medical records, other than a health care provider under Subsections (3) and
(4), who provides a copy of a patient's records to a 
patient's attorney, legal representative, or
other third
 party authorized to receive records:
(a) shall provide the copy within 30 days after the request; and
(b) may charge a reasonable fee 
for paper or electronic copies
, but may not exceed the
following rates:
(i) [
$21.16
] 
$30
 per request for locating a patient's records;
(ii) reproduction charges may not exceed 53 cents per page for the first 40 pages and 32
cents per page for each additional page;
(iii) the cost of postage when the [
third party
] 
requester
 has requested the copy be
mailed; [
and
]
(iv) if requested, the health care provider or the health care provider's contracted third
party service will certify the record as a duplicate of the original for a fee of $20; and
[
(iv)
] 
(v)
 any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.
(6) A health care provider or [
its
] 
the health care provider's
 contracted third party
service shall deliver the medical records in the [
digital or
] electronic medium customarily used
by the health care provider or [
its
] 
the health care provider's
 contracted third party service or in
a 
universally readable image such as
 portable document format:
(a) if the patient, patient's personal representative, or a third party authorized to receive
the records requests the records be delivered in [
a digital or
] 
an
 electronic medium; and
(b) the original medical record is readily producible in [
a digital or
] 
an
 electronic
medium.
(7) (a) [
The
] 
Except as provided in Subsections (7)(b) and (c), the
 per page fee in
Subsections (3), (4), and (5) applies to medical records reproduced 
electronically or
 on paper.
[
(b) For record requests made on or before June 30, 2018, the per page fee for
producing a copy of records on a digital or electronic medium shall be 60% of the per page fee
otherwise provided in this section, regardless of whether the original medical records are stored
in electronic format.
]
[
(c)
] 
(b)
 For record requests made on or after July 1, 2018, the per page fee for
producing a copy of records [
on a digital or
] 
in an
 electronic medium shall be 50% of the per
page fee otherwise provided in this section, regardless of whether the original medical records
are stored in electronic format.
(c) (i) For electronic record requests made on or after July 1, 2021, a health care
provider or a health care provider's contracted third party service shall deliver the medical
records in the electronic medium customarily used by the health care provider or the health care
provider's contracted third party service or in a universally readable image, such as portable
document format, if the patient, patient's personal representative, patient's attorney, legal
representative, or a third party authorized to receive the records, requests the records be
delivered in an electronic medium.
(ii) An entity providing requested information under Subsection (7)(c)(i):
(A) shall provide the requested information within 30 days; and
(B) may not charge a fee for the electronic copy that exceeds $150 regardless of the
number of pages and regardless of whether the original medical records are stored in electronic
format.
(8) 
(a)
 [
Beginning January 1, 2016, the fee for providing patient's records shall be
adjusted annually as specified in this section based on the most recent changes to the
] 
As used
in this section, "inflation" means the unadjusted
 Consumer Price Index, as published by the
Bureau of Labor Statistics of the United States Department of Labor, that measures the average
changes in prices of goods and services purchased by urban wage earners[
, clerical workers'
families, and single workers living alone
] 
and clerical workers
.
(b) Beginning January 1, 2022, and on January 1 of each year thereafter, the state
treasurer shall adjust the following fees for inflation:
(i) the fee for providing patient's records under:
(A) Subsections (4)(b)(i) through (ii); and
(B) Subsections (5)(b)(i) through (ii); and
(ii) the maximum amount that may be charged for an electronic copy under Subsection
(7)(c)(ii)(B).
(c) On or before January 30, 2022, and on or before January 30 of each year thereafter,
the state treasurer shall:
(i) certify the inflation-adjusted fees and maximum amounts calculated under this
section; and
(ii) notify the Administrative Office of the Courts of the information described in
Subsection (8)(c)(i) for posting on the court's website.
(9) (a) As used in this Subsection (9), "qualified claim or appeal" means a claim or
appeal under any:
(i) provision of the Social Security Act as defined in Section 
67-11-2
; or
(ii) federal or state financial needs-based benefit program.
(b) Notwithstanding Subsections (3) through (5), if a request for a medical record is
accompanied by documentation of a qualified claim or appeal, a health care provider or the
health care provider's contracted third party service:
(i) may not charge a fee for the first copy of the record for each date of service that is
necessary to support the qualified claim or appeal in each calendar year;
(ii) for a second or subsequent copy in a calendar year of a date of service that is
necessary to support the qualified claim or appeal, may charge a reasonable fee that may not:
(A) exceed 60 cents per page for paper photocopies;
(B) exceed a reasonable cost for copies of X-ray photographs and other health care
records produced by similar processes;
(C) include an administrative fee or additional service fee related to the production of
the medical record; or
(D) exceed the fee provisions for an electronic copy under Subsection (7)(c); and
(iii) shall provide the health record within 30 days after the day on which the request is
received by the health care provider.
(10) (a) As used in this Subsection (10), "indigent individual" means an individual
whose household income is at or below 100% of the federal poverty level as defined in Section
26-18-3.9
.
(b) Except as otherwise provided in Subsections (3) through (5), a health care provider
or the health care provider's contracted third party service shall waive all fees under this section
for an indigent individual.
(c) A health care provider or the health care provider's contracted third party service
may require the indigent individual or the indigent individual's authorized representative to
provide proof that the individual is an indigent individual by executing an affidavit.
(d) (i) An indigent individual that receives copies of a medical record at no charge
under this Subsection (10) is limited to one copy for each date of service for each health care
provider, or the health care provider's contracted third party service, in each calendar year.
(ii) Any request for additional copies in addition to the one copy allowed under
Subsection (10)(d)(i) is subject to the fee provisions described in Subsection (9).