HOUSE BILL NO. 1226 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE HARDWICK.
2748H.01I JOSEPH ENGLER, Chief Clerk
AN ACT To repeal section 191.227, RSMo, and to enact in lieu thereof one new section relating to medical records.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 191.227, RSMo, is repealed and one new section enacted in lieu 2 thereof, to be known as section 191.227, to read as follows: 191.227. 1. All physicians, chiropractors, hospitals, dentists, and other duly licensed 2 practitioners in this state, herein called "providers", shall, upon written request of a patient, or 3 guardian or legally authorized representative of a patient, furnish a copy of his or her record 4 of that patient's health history and treatment rendered to the person submitting a written 5 request, except that such right shall be limited to access consistent with the patient's condition 6 and sound therapeutic treatment as determined by the provider. Beginning August 28, 1994, 7 such record shall be furnished within a reasonable time of the receipt of the request therefor 8 and upon payment of a fee as provided in this section. 9 2. Health care providers may condition the furnishing of the patient's health care 10 records to the patient, the patient's authorized representative or any other person or entity 11 authorized by law to obtain or reproduce such records upon payment of a fee for: 12 (1) (a) Search and retrieval, in an amount not more than twenty-four dollars and 13 eighty-five cents plus copying in the amount of fifty-seven cents per page for the cost of 14 supplies and labor plus, if the health care provider has contracted for off-site records storage 15 and management, any additional labor costs of outside storage retrieval, not to exceed twenty- 16 three dollars and twenty-six cents, as adjusted annually pursuant to subsection 6 of this 17 section; or
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. HB 1226 2
18 (b) The records shall be furnished electronically upon payment of the search, 19 retrieval, and copying fees set under this section at the time of the request or one hundred 20 eight dollars and eighty-eight cents total, whichever is less, if such person: 21 a. Requests health records to be delivered electronically in a format of the health care 22 provider's choice; 23 b. The health care provider stores such records completely in an electronic health 24 record; and 25 c. The health care provider is capable of providing the requested records and 26 affidavit, if requested, in an electronic format; 27 (2) Postage, to include packaging and delivery cost; 28 (3) Notary fee, not to exceed two dollars, if requested. 29 30 Such fee shall be the fee in effect on February 1, 2018, increased or decreased annually under 31 this section. 32 3. For purposes of subsections 1 and 2 of this section, "a copy of his or her record of 33 that patient's health history and treatment rendered" or "the patient's health care records" 34 includes a statement or record that no such health history or treatment record responsive to the 35 request exists. 36 4. Notwithstanding provisions of this section to the contrary, providers may charge 37 for the reasonable cost of all duplications of health care record material or information which 38 cannot routinely be copied or duplicated on a standard commercial photocopy machine. 39 5. The transfer of the patient's record done in good faith shall not render the provider 40 liable to the patient or any other person for any consequences which resulted or may result 41 from disclosure of the patient's record as required by this section. 42 6. Effective February first of each year, the fees listed in subsection 2 of this section 43 shall be increased or decreased annually based on the annual percentage change in the 44 unadjusted, U.S. city average, annual average inflation rate of the medical care component of 45 the Consumer Price Index for All Urban Consumers (CPI-U). The current reference base of 46 the index, as published by the Bureau of Labor Statistics of the United States Department of 47 Labor, shall be used as the reference base. For purposes of this subsection, the annual average 48 inflation rate shall be based on a twelve-month calendar year beginning in January and ending 49 in December of each preceding calendar year. The department of health and senior services 50 shall report the annual adjustment and the adjusted fees authorized in this section on the 51 department's internet website by February first of each year. 52 7. A health care provider may disclose a deceased patient's health care records or 53 payment records to the executor or administrator of the deceased person's estate, or pursuant 54 to a valid, unrevoked power of attorney for health care that specifically directs that the HB 1226 3
55 deceased person's health care records be released to the agent after death. If an executor, 56 administrator, or agent has not been appointed, the deceased prior to death did not specifically 57 object to disclosure of his or her records in writing, and such disclosure is not inconsistent 58 with any prior expressed preference of the deceased that is known to the health care provider, 59 a deceased patient's health care records may be released upon written request of a person who 60 is deemed as the personal representative of the deceased person under this subsection. 61 Priority shall be given to the deceased patient's spouse and the records shall be released on the 62 affidavit of the surviving spouse that he or she is the surviving spouse. If there is no surviving 63 spouse, the health care records may be released to one of the following persons: 64 (1) The acting trustee of a trust created by the deceased patient either alone or with 65 the deceased patient's spouse; 66 (2) An adult child of the deceased patient on the affidavit of the adult child that he or 67 she is the adult child of the deceased; 68 (3) A parent of the deceased patient on the affidavit of the parent that he or she is the 69 parent of the deceased; 70 (4) An adult brother or sister of the deceased patient on the affidavit of the adult 71 brother or sister that he or she is the adult brother or sister of the deceased; 72 (5) A guardian or conservator of the deceased patient at the time of the patient's death 73 on the affidavit of the guardian or conservator that he or she is the guardian or conservator of 74 the deceased; or 75 (6) A guardian ad litem of the deceased's minor child based on the affidavit of the 76 guardian that he or she is the guardian ad litem of the minor child of the deceased. 77 8. Notwithstanding any provisions of this section to the contrary, a health care 78 provider or health care facility shall not charge a fee for medical or mental health 79 records requested by a patient, former patient, or attorney or other authorized 80 representative of a patient or former patient for use in supporting an application for 81 benefits under: 82 (1) Chapter 287; 83 (2) 42 U.S.C. Section 401 et seq.; 84 (3) 42 U.S.C. Section 1382 et seq.; 85 (4) 42 U.S.C. Section 1395 et seq.; 86 (5) 38 U.S.C. Section 1101 et seq.; or 87 (6) 38 U.S.C. Section 1501 et seq. 88 HB 1226 4
89 The health care provider or health care facility may provide the records in the form that 90 is most cost-effective, provided that records provided electronically shall be produced in 91 a universally accessible format. ✔
Statutes affected: