1     
PATIENT ACCESS TO MEDICAL RECORDS AMENDMENTS

2     
2018 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: LaVar Christensen

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions relating to access to medical records by a patient or the
10     patient's representative.
11     Highlighted Provisions:
12          This bill:
13          ▸     creates certain requirements for a health care provider when a patient or the patient's
14     representative requests medical records to support a claim or appeal for federal or
15     state public benefits.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          None
20     Utah Code Sections Affected:
21     AMENDS:
22          78B-5-618, as last amended by Laws of Utah 2015, Chapter 217
23     

24     Be it enacted by the Legislature of the state of Utah:
25          Section 1. Section 78B-5-618 is amended to read:
26          78B-5-618. Patient access to medical records -- Third party access to medical
27     records.

28          (1) Pursuant to Standards for Privacy of Individually Identifiable Health Information,
29     45 C.F.R., Parts 160 and 164, a patient or a patient's personal representative may inspect or
30     receive a copy of the patient's records from a health care provider as defined in Section
31     78B-3-403, when that health care provider is governed by the provisions of 45 C.F.R., Parts
32     160 and 164.
33          (2) When a health care provider as defined in Section 78B-3-403 is not governed by
34     Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R., Parts 160 and
35     164, a patient or a patient's personal representative may inspect or receive a copy of the
36     patient's records unless access to the records is restricted by law or judicial order.
37          (3) A health care provider who provides a copy of a patient's records to the patient or
38     the patient's personal representative:
39          (a) shall provide the copy within the deadlines required by the Health Insurance
40     Portability and Accountability Act of 1996, Administrative Simplification rule, 45 C.F.R. Sec.
41     164.524(b); and
42          (b) may charge a reasonable cost-based fee provided that the fee includes only the cost
43     of:
44          (i) copying, including the cost of supplies for and labor of copying; and
45          (ii) postage, when the patient or patient representative has requested the copy be
46     mailed.
47          (4) Except for records provided by a health care provider under Section 26-1-37, a
48     health care provider who provides a copy of a patient's records to a third party authorized to
49     receive records:
50          (a) shall provide the copy within 30 days after receipt of notice; and
51          (b) may charge a reasonable fee, but may not exceed the following rates:
52          (i) $21.16 for locating a patient's records, per request;
53          (ii) reproduction charges may not exceed 53 cents per page for the first 40 pages and 32
54     cents per page for each additional page;
55          (iii) the cost of postage when the third party has requested the copy be mailed; and
56          (iv) any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.
57          (5) Except for records provided under Section 26-1-37, a contracted third party service
58     which provides medical records, other than a health care provider under Subsections (3) and

59     (4), who provides a copy of a patient's records to a party authorized to receive records:
60          (a) shall provide the copy within 30 days after the request; and
61          (b) may charge a reasonable fee, but may not exceed the following rates:
62          (i) $21.16 per request for locating a patient's records;
63          (ii) reproduction charges may not exceed 53 cents per page for the first 40 pages and 32
64     cents per page for each additional page;
65          (iii) the cost of postage when the third party has requested the copy be mailed; and
66          (iv) any sales tax owed under Title 59, Chapter 12, Sales and Use Tax Act.
67          (6) A health care provider or its contracted third party service shall deliver the medical
68     records in the digital or electronic medium customarily used by the health care provider or its
69     contracted third party service or in a portable document format:
70          (a) if the patient, patient's personal representative, or a third party authorized to receive
71     the records requests the records be delivered in a digital or electronic medium; and
72          (b) the original medical record is readily producible in a digital or electronic medium.
73          (7) (a) The per page fee in Subsections (3), (4), [and] (5), and (9) applies to medical
74     records reproduced on paper.
75          (b) For record requests made on or before June 30, 2018, the per page fee for
76     producing a copy of records on a digital or electronic medium shall be 60% of the per page fee
77     otherwise provided in this section, regardless of whether the original medical records are stored
78     in electronic format.
79          (c) For record requests made on or after July 1, 2018, the per page fee for producing a
80     copy of records on a digital or electronic medium shall be 50% of the per page fee otherwise
81     provided in this section, regardless of whether the original medical records are stored in
82     electronic format.
83          (8) Beginning January 1, 2016, the fee described in Subsections (3) through (5) for
84     providing patient's records shall be adjusted annually as specified in this section based on the
85     most recent changes to the Consumer Price Index, as published by the Bureau of Labor
86     Statistics of the United States Department of Labor, that measures the average changes in
87     prices of goods and services purchased by urban wage earners, clerical workers' families, and
88     single workers living alone.
89          (9) (a) As used in this section, "qualified claim or appeal" means a claim or appeal

90     under any:
91          (i) provision of the Social Security Act, 42 U.S.C. Sec. 301 et seq., as amended; or
92          (ii) federal or state financial needs-based benefit program.
93          (b) Notwithstanding Subsections (3) through (5), if a request for a health record is
94     accompanied by documentation of a qualified claim or appeal, a health care provider:
95          (i) for the first copy of any records that are necessary to support the qualified claim or
96     appeal, may not charge a fee;
97          (ii) for a second or subsequent copy of any records that are necessary to support the
98     qualified claim or appeal, may charge a reasonable fee that may not:
99          (A) exceed 60 cents per page for photocopies;
100          (B) exceed a reasonable cost for copies of X-ray photographs and other health care
101     records produced by similar processes; or
102          (C) include an administrative fee or additional service fee of any kind;
103          (iii) shall provide the health record within 30 days after the day on which the request is
104     received by the health care provider; and
105          (iv) may not deny a request for a health care record solely because the patient or the
106     patient's agent is unable to pay the fees described in this Subsection (9).






Legislative Review Note
Office of Legislative Research and General Counsel