Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 225 Second Substitute (2022GS)

Sponsor

Rep. Dunnigan, J.

Final action

Governor Signed 3/24/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• requires the Division of Family Health and Preparedness to create a uniform HIPAA form;
• requires a health care provider and the health care provider's contracted third party service provider to accept the uniform HIPAA form; and
• makes technical changes.

Every vote on this bill

Bill text

ACCESS TO MEDICAL RECORDS AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: James A. Dunnigan
Senate Sponsor: 
____________
LONG TITLE
General Description:
This bill creates a uniform HIPAA form.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ requires the Division of Family Health and Preparedness to create a uniform HIPAA
form;
▸ requires a health care provider and the health care provider's contracted third party
service provider to accept the uniform HIPAA form; and
▸ makes technical changes.
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 2021, Chapter 338
ENACTS:
26-69-101
, Utah Code Annotated 1953
26-69-102
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-69-101
 is enacted to read:
CHAPTER 69. UNIFORM HIPAA FORM
 26-69-101.
Definitions.
As used in this chapter:
(1) "Division" means the Division of Family Health and Preparedness.
(2) "Patient" means the individual whose information is being requested.
Section 2. Section 
26-69-102
 is enacted to read:
 26-69-102.
Uniform HIPAA form.
(1) On or before June 30, 2022, the division shall create a uniform HIPAA form:
(a) for a patient to request the sharing of health records; and
(b) that is compliant with the Standards for Privacy of Individually Identifiable Health
Information, 45 C.F.R., Parts 160 and 164.
(2) The form shall include fields for:
(a) the patient's name;
(b) the patient's date of birth;
(c) the patient's phone number;
(d) the patient's address;
(e) (i) the patient's signature and date of signature, which may not require notarization;
or
(ii) the signature of the patient's legal representative as defined in Section 
26-21-302
,
and date of signature, which may not require notarization;
(f) the name, address, and phone number of the person to which the information will be
disclosed;
(g) the records requested, including whether the patient is requesting paper or
electronic records;
(h) the duration of time the authorization is valid; and
(i) the dates of service requested.
(3) The form shall include the following options for the field described in Subsection
(2)(g):
(a) history and physical examination records;
(b) treatment plans;
(c) emergency room records;
(d) radiology and lab reports;
(e) operative reports;
(f) pathology reports;
(g) consultations;
(h) discharge summary;
(i) outpatient clinic records and progress notes;
(j) behavioral health evaluation;
(k) behavioral health discharge summary;
(l) mental health therapy records;
(m) financial information including an itemized billing statement;
(n) health insurance claim form;
(o) billing form; and
(p) other.
Section 3. Section 
78B-5-618
 is amended to read:
78B-5-618.
Patient access to medical records -- Third party access to medical
records.
(1) As used in this section:
(a) "Health care provider" means the same as that term is defined in Section
78B-3-403
.
(b) "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
.
(c) "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 and clerical workers.
(d) "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.
[
(1)
] 
(2)
 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)
] 
(3)
 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)
] 
(4)
 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's personal representative has requested the copy
be mailed.
[
(4)
] 
(5)
 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) $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 requester has requested the copy be mailed;
(iv) if requested, the health care provider will certify the record as a duplicate of the
original for a fee of $20; and
(v) any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.
[
(5)
] 
(6)
 Except for records provided under Section 
26-1-37
, a contracted third party
service [
which
] 
that
 provides medical records, other than a health care provider under
Subsections [
(3)
] 
(4)
 and [
(4)
] 
(5)
, 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) $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 requester has requested the copy be mailed;
(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
(v) any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.
[
(6)
] 
(7)
 A health care provider or the 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:
(a) if the patient, patient's personal representative, or a third party authorized to receive
the records requests the records be delivered in an electronic medium; and
(b) the original medical record is readily producible in an electronic medium.
[
(7)
] 
(8)
 (a) Except as provided in Subsections [
(7)
] 
(8)
(b) and (c), the per page fee in
Subsections [
(3), (4), and (5)
] 
(4), (5), and (6)
 applies to medical records reproduced
electronically or on paper.
(b) [
For record requests made on or after July 1, 2018, the
] 
The
 per page fee for
producing a copy of records 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
] 
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)
] 
(8)
(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) 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 and clerical workers.
]
[
(b)
] 
(9) (a)
 [
Beginning January 1, 2022, and on January 1 of each year thereafter,
] 
On
January 1 of each year,
 the state treasurer shall adjust the following fees for inflation:
(i) the fee for providing patient's records under:
(A) Subsections [
(4)
] 
(5)
(b)(i) through (ii); and
(B) Subsections [
(5)
] 
(6)
(b)(i) through (ii); and
(ii) the maximum amount that may be charged for an electronic copy under Subsection
[
(7)
] 
(8)
(c)(ii)(B).
[
(c)
] 
(b)
 [
On or before January 30, 2022, and on or before January 30 of each year
thereafter
] 
On or before January 30 of each year
, 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)
] 
(9)(b)(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)
] 
(10)
 Notwithstanding Subsections [
(3) through (5)
] 
(4) through (6)
, 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)
] 
(a)
 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)
] 
(b)
 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)
] 
(i)
 exceed 60 cents per page for paper photocopies;
[
(B)
] 
(ii)
 exceed a reasonable cost for copies of X-ray photographs and other health
care records produced by similar processes;
[
(C)
] 
(iii)
 include an administrative fee or additional service fee related to the
production of the medical record; or
[
(D)
] 
(iv)
 exceed the fee provisions for an electronic copy under Subsection [
(7)
]
(8)
(c); and
[
(iii)
] 
(c)
 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)
] 
(11) (a)
 Except as otherwise provided in Subsections [
(3) through (5)
] 
(4) through
(6)
, 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)
] 
(b)
 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)
] 
(c)
 (i) An indigent individual that receives copies of a medical record at no charge
under this Subsection [
(10)
] 
(11)
 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)
] 
(11)(c)
 is subject to the fee provisions described in Subsection [
(9)
]
(10)
.
(12) By July 1, 2022, a health care provider and all of the health care provider's
contracted third-party health related services shall accept a properly executed uniform HIPAA
form described in Title 26, Chapter 69, Uniform HIPAA Form.