Enrolled Copy H.B. 312
1 PATIENT MEDICAL RECORD ACCESS AMENDMENTS
2 2023 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: James A. Dunnigan
5 Senate Sponsor: Michael K. McKell
6
7 LONG TITLE
8 General Description:
9 This bill modifies the fee a person may charge for providing medical records if the
10 medical records are not provided in a certain amount of time.
11 Highlighted Provisions:
12 This bill:
13 < defines terms;
14 < modifies the fee an entity may charge for providing medical records if the medical
15 records are not provided in a certain amount of time;
16 < requires the Division of Professional Licensing to maintain an index of third party
17 services that provide medical records on behalf of health care providers; and
18 < makes technical and conforming changes.
19 Money Appropriated in this Bill:
20 None
21 Other Special Clauses:
22 None
23 Utah Code Sections Affected:
24 AMENDS:
25 78B-5-618, as last amended by Laws of Utah 2022, Chapter 327
26
27 Be it enacted by the Legislature of the state of Utah:
28 Section 1. Section 78B-5-618 is amended to read:
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29 78B-5-618. Patient access to medical records -- Third-party access to medical
30 records -- Medical records services -- Fees -- Standard form.
31 (1) As used in this section:
32 (a) "Force majeure event" means an event or circumstance beyond the control of the
33 health care provider or the health care provider's third-party service, including fires, floods,
34 earthquakes, acts of God, lockouts, ransomware, or strikes.
35 (b) "Health care provider" means the same as that term is defined in Section
36 78B-3-403.
37 (c) "History of poor payment" means three or more invoices where payment is more
38 than 30 days late within a 12-month period.
39 [(b)] (d) "Indigent individual" means an individual whose household income is at or
40 below 100% of the federal poverty level as defined in Section 26-18-3.9.
41 [(c)] (e) "Inflation" means the unadjusted Consumer Price Index, as published by the
42 Bureau of Labor Statistics of the United States Department of Labor, that measures the average
43 changes in prices of goods and services purchased by urban wage earners and clerical workers.
44 [(d)] (f) "Qualified claim or appeal" means a claim or appeal under any:
45 (i) provision of the Social Security Act as defined in Section 67-11-2; or
46 (ii) federal or state financial needs-based benefit program.
47 (g) "Third-party service" means a service that has entered into a contract with a health
48 care provider to provide patient records on behalf of a health care provider.
49 (2) Pursuant to Standards for Privacy of Individually Identifiable Health Information,
50 45 C.F.R., Parts 160 and 164, a patient or a patient's personal representative may inspect or
51 receive a copy of the patient's records from a health care provider when that health care
52 provider is governed by the provisions of 45 C.F.R., Parts 160 and 164.
53 (3) When a health care provider is not governed by Standards for Privacy of
54 Individually Identifiable Health Information, 45 C.F.R., Parts 160 and 164, a patient or a
55 patient's personal representative may inspect or receive a copy of the patient's records unless
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56 access to the records is restricted by law or judicial order.
57 (4) A health care provider who provides a paper or electronic copy of a patient's
58 records to the patient or the patient's personal representative:
59 (a) shall provide the copy within the deadlines required by the Health Insurance
60 Portability and Accountability Act of 1996, Administrative Simplification rule, 45 C.F.R. Sec.
61 164.524(b); and
62 (b) may charge a reasonable cost-based fee provided that the fee includes only the cost
63 of:
64 (i) copying, including the cost of supplies for and labor of copying; and
65 (ii) postage, when the patient or patient's personal representative has requested the copy
66 be mailed.
67 (5) (a) Except for records provided [by a health care provider] under Section 26-1-37, a
68 health care provider [who] or a health care provider's third-party service that provides a copy of
69 a patient's records to a patient's attorney, legal representative, or other third party authorized to
70 receive records:
71 [(a)] (i) shall provide the copy within 30 days after receipt of notice; [and]
72 [(b)] (ii) may charge a reasonable fee for paper or electronic copies, but may not
73 exceed the following rates:
74 [(i)] (A) $30 per request for locating a patient's records;
75 [(ii)] (B) reproduction charges may not exceed 53 cents per page for the first 40 pages
76 and 32 cents per page for each additional page;
77 [(iii)] (C) the cost of postage when the requester has requested the copy be mailed;
78 [(iv)] (D) if requested, the [health care provider] person fulfilling the request will
79 certify the record as a duplicate of the original for a fee of $20; and
80 [(v)] (E) any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act[.]; and
81 (iii) may charge an expedition fee of $20 if:
82 (A) the requester's notice explicitly requests an expedited response; and
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83 (B) the person fulfilling the request postmarks or otherwise makes the record available
84 electronically within 15 days from the day the person fulfilling the request receives notice of
85 the request.
86 (b) Notwithstanding the provisions of Subsection (5)(a)(ii) and subject to Subsection
87 (5)(c), in the event the requested records are not postmarked or otherwise made available
88 electronically by the person fulfilling the request:
89 (i) within 30 days after the day on which notice is received by the person fulfilling the
90 request, the person fulfilling the request shall waive 50% of the fee; or
91 (ii) within 60 days after the day on which notice is received by the person fulfilling the
92 request, the person fulfilling the request shall provide the requested records free of charge to
93 the requester.
94 (c) Performance under Subsection (5)(b) shall be extended in accordance with
95 Subsection (5)(d) if the person fulfilling the request notifies the requester of:
96 (i) the occurrence of a force majeure event within 10 days from the day:
97 (A) the force majeure event occurs; or
98 (B) the person fulfilling the request receives notice of the request; and
99 (ii) the termination of the force majeure event within 10 days from the day the force
100 majeure event terminates.
101 (d) In accordance with Subsection (5)(c), for a force majeure event:
102 (i) that lasts less than eight days, the person fulfilling the request shall, if the records
103 are not postmarked or otherwise made available electronically within:
104 (A) 30 days of the day the force majeure event ends, waive 50% of the fee for
105 providing the records; and
106 (B) 60 days of the day the force majeure event ends, waive the entire fee for providing
107 the records;
108 (ii) that lasts at least eight days but less than 30 days, the person fulfilling the request
109 shall, if the records are not postmarked or otherwise made available electronically within:
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110 (A) 60 days of the day the force majeure event ends, waive 50% of the fee for
111 providing the records; and
112 (B) 90 days of the day the force majeure event ends, waive the entire fee for providing
113 the records; and
114 (iii) that lasts more than 30 days, the person fulfilling the request shall, if the records
115 are not postmarked or otherwise made available electronically within:
116 (A) 90 days of the day the force majeure event ends, waive 50% of the fee for
117 providing the records; and
118 (B) 120 days of the day the force majeure event ends, waive the entire fee for providing
119 the records.
120 (e) (i) A third-party service may require prepayment before sending records for a
121 request under this Subsection (5) if the third-party service:
122 (A) determines the requester has a history of poor payment; and
123 (B) notifies the requester, within the time periods described in Subsection (5)(b)(i) and
124 (ii), that the records will be sent as soon as the request has been prepaid.
125 (ii) The fee reductions described in Subsection (5)(d) do not apply if a third-party
126 service complies with Subsection (5)(e)(i).
127 (f) If a third-party service does not possess or have access to the data necessary to
128 fulfill a request, the third-party service shall notify:
129 (i) the requester that the request cannot be fulfilled; and
130 (ii) state the reasons for the third-party service's inability to fulfill the request within 30
131 days from the day on which the request is received by the third-party service.
132 (g) A patient's attorney, legal representative, or other third party authorized to receive
133 records may request patient records directly from a third-party service.
134 [(6) Except for records provided under Section 26-1-37, a contracted third party service
135 that provides medical records, other than a health care provider under Subsections (4) and (5),
136 who provides a copy of a patient's records to a patient's attorney, legal representative, or other
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137 third party authorized to receive records:]
138 [(a) shall provide the copy within 30 days after the request; and]
139 [(b) may charge a reasonable fee for paper or electronic copies, but may not exceed the
140 following rates:]
141 [(i) $30 per request for locating a patient's records;]
142 [(ii) reproduction charges may not exceed 53 cents per page for the first 40 pages and
143 32 cents per page for each additional page;]
144 [(iii) the cost of postage when the requester has requested the copy be mailed;]
145 [(iv) if requested, the health care provider or the health care provider's contracted third
146 party service will certify the record as a duplicate of the original for a fee of $20; and]
147 [(v) any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.]
148 (6) (a) A health care provider that contracts with a third-party service to fulfill the
149 health care provider's medical record requests shall file a statement with the Division of
150 Professional Licensing containing:
151 (i) the name of the third-party service;
152 (ii) the phone number of the third-party service; and
153 (iii) the fax number, email address, website portal address, if applicable, and mailing
154 address for the third-party service where medical record requests can be sent for fulfillment.
155 (b) A health care provider described in Subsection (6)(a) shall update the filing
156 described in Subsection (6)(a) as necessary to ensure that the information is accurate.
157 (c) The Division of Professional Licensing shall develop a form for a health care
158 provider to complete that provides the information required by Subsection (6)(a).
159 (d) The Division of Professional Licensing shall:
160 (i) maintain an index of statements described in Subsection (6)(a) arranged
161 alphabetically by entity; and
162 (ii) make the index available to the public electronically on the Division of
163 Professional Licensing's website.
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164 (7) A health care provider or the health care provider's [contracted third party]
165 third-party service shall deliver the medical records in the electronic medium customarily used
166 by the [health care provider or the health care provider's contracted third party service] person
167 fulfilling the request or in a universally readable image such as portable document format:
168 (a) if the patient, patient's personal representative, or a third party authorized to receive
169 the records requests the records be delivered in an electronic medium; and
170 (b) the original medical record is readily producible in an electronic medium.
171 (8) (a) Except as provided in Subsections (8)(b) [and (c),] through (d), the per page fee
172 in Subsections (4)[, (5), and (6)] and (5) applies to medical records reproduced electronically or
173 on paper.
174 (b) The per page fee for producing a copy of records in an electronic medium shall be
175 50% of the per page fee otherwise provided in this section, regardless of whether the original
176 medical records are stored in electronic format.
177 (c) (i) A health care provider or a health care provider's [contracted third party]
178 third-party service shall deliver the medical records in the electronic medium customarily used
179 by the health care provider or the health care provider's [contracted third party] third-party
180 service or in a universally readable image, such as portable document format, if the patient,
181 patient's personal representative, patient's attorney, legal representative, or a third party
182 authorized to receive the records, requests the records be delivered in an electronic medium.
183 (ii) [An entity providing requested information] A person fulfilling the request under
184 Subsection (8)(c)(i):
185 (A) shall provide the requested information within 30 days; and
186 (B) may not charge a fee for the electronic copy that exceeds $150 regardless of the
187 number of pages and regardless of whether the original medical records are stored in electronic
188 format.
189 (d) Subject to Subsection (8)(e), in the event the requested records under Subsection
190 (8)(c)(i) are not postmarked or otherwise made available electronically by the person fulfilling
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191 the request:
192 (i) within 30 days after the day notice is received by the person fulfilling the request,
193 the person fulfilling the request may not charge a fee for the electronic copy that exceeds $75
194 regardless of the number of pages and regardless of whether the original medical records are
195 stored in electronic format; or
196 (ii) within 60 days after the day notice is received by the person fulfilling the request,
197 the person fulfilling the request shall provide the requested records free of charge to the
198 requester.
199 (e) Performance under Subsection (8)(d) shall be extended in accordance with
200 Subsection (8)(f) if the person fulfilling the request notifies the requester of:
201 (i) the occurrence of a force majeure event within 10 days from the day:
202 (A) the force majeure event occurs; or
203 (B) the person fulfilling the request receives notice of the request; and
204 (ii) the termination of the force majeure event within 10 days from the day the force
205 majeure event terminates.
206 (f) In accordance with Subsection (8)(e), for a force majeure event:
207 (i) that lasts less than eight days, the person fulfilling the request, if the records are not
208 postmarked or otherwise made available electronically within:
209 (A) 30 days of the day the force majeure event ends, may not charge a fee for an
210 electronic copy that exceeds $75 regardless of the number of pages and regardless of whether
211 the original medical records are stored in electronic format; and
212 (B) 60 days of the day the force majeure event ends, shall waive the entire fee for
213 providing the records;
214 (ii) that lasts at least eight days but less than 30 days, the person fulfilling the request,
215 if the records are not postmarked or otherwise made available electronically within:
216 (A) 60 days of the day the force majeure event ends, may not charge a fee for an
217 electronic copy that exceeds $75 regardless of the number of pages and regardless of whether
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218 the original medical records are stored in electronic format; and
219 (B) 90 days of the day the force majeure event ends, shall waive the entire fee for
220 providing the records; and
221 (iii) that lasts more than 30 days, the person fulfilling the request, if the records are not
222 postmarked or otherwise made available electronically within:
223 (A) 90 days of the day the force majeure event ends, ma