This document includes House Committee Amendments incorporated into the bill on Thu, Feb 9, 2023 at 10:57 AM by pflowers.
Representative Raymond P. Ward proposes the following substitute bill:


1     
MEDICAL RECORD ACCESS AMENDMENTS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Raymond P. Ward

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill enacts provisions related to a patient's health information contained by hospital
10     systems.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     requires certain hospital systems to collectively select a method that allows a health
15     care provider to access patient information for the patient the health care provider is
16     treating;
17          ▸     requires the Department of Health and Human Services (department) to facilitate
18     discussions between the hospital systems; and
19          ▸     allows the department to designate a health information exchange that hospital
20     systems must adopt if the hospital systems are unable to collectively make a
21     decision.
22     Money Appropriated in this Bill:
23          This bill appropriates in fiscal year 2024:
24          ▸     to the Department of Health and Human Services - Operations - Data, Systems, &
25     Evaluations, as an ongoing appropriation:

26               •     from the General Fund, $1,500,000.
27     Other Special Clauses:
28          None
29     Utah Code Sections Affected:
30     AMENDS:
31          26-70-101, as enacted by Laws of Utah 2022, Chapter 327
32          63I-1-226, as last amended by Laws of Utah 2022, Chapters 194, 206, 224, 253, 255,
33     347, and 451
34     ENACTS:
35          26-21-36, Utah Code Annotated 1953
36          26-70-103, Utah Code Annotated 1953
37     

38     Be it enacted by the Legislature of the state of Utah:
39          Section 1. Section 26-21-36 is enacted to read:
40          26-21-36. Health care facilities within a hospital system.
41          (1) As used in this section:
42          (a) "Hospital system" means the same as that term is defined in Section 26-70-101.
43          (b) "Medical information" means the same as that term is defined in Section
44     26-70-101.
45          (2) Beginning July 1, 2025, a health care facility that is owned or operated by a hospital
46     system shall ensure that medical information collected by the health care facility is accessible
47     in accordance with Section 26-70-103.
48          Section 2. Section 26-70-101 is amended to read:
49     
CHAPTER 70. PATIENT HEALTH RECORD ACCESS

50          26-70-101. Definitions.
51          As used in this chapter:
52          (1) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
53     Pub. L. No. 104-191, 110 Stat. 1936, as amended.
54          (2) "Hospital" means:
55          (a) a general acute hospital as defined in Section 26-21-2; and
56          (b) a specialty hospital as defined in Section 26-21-2.

57          (3) "Hospital system" means an entity that owns or operates at least five hospitals that
58     are licensed under Chapter 21, Health Care Facility Licensing and Inspection Act.
59          (4) "Medical information" means one or more of the following regarding a patient:
60          (a) for each time the patient is hospitalized:
61          (i) an admission history and physical exam; or
62          (ii) a discharge summary;
63          (b) the health care provider's notes regarding:
64          (i) an emergency room visit;
65          (ii) an urgent care visit;
66          (iii) a primary care outpatient care visit; or
67          (iv) a consultation office visit;
68          (c) a radiology report;
69          (d) a lab report; or
70          (e) a pathology report.
71          [(2)] (5) "Patient" means the individual whose information is being requested.
72          [(3)] (6) "Personal representative" means an individual described in 45 C.F.R. Sec.
73     164.502(g).
74          Section 3. Section 26-70-103 is enacted to read:
75          26-70-103. Patient information access by a health care provider.
76          (1) Ĥ→ [
Beginning July 1, 2025, each hospital system, collectively, shall ensure that a
77     patient's medical information that is created when the patient receives care from the hospital
78     system is accessible to a physician designated by the patient, preferably through the use of
79     single login.
] Beginning July 1, 2025, each hospital system shall ensure for a patient receiving

79a     care in their hospital that the patient's medical information maintained by all of the hospital
79b     systems is accessible to a physician designated by the patient, preferably through the use of
79c     single login. ←Ĥ
80          (2) The department shall facilitate discussions with each hospital system and the One
81     Utah Health Collaborative as to how to best achieve the requirement described in Subsection
82     (1).
83          (3) The liability protections of Subsection 26-1-37(5) a hospital system's compliance
84     with Subsection (1).
85          (4) To better improve patient access to the patient's medical information, the
86     department shall communicate with each hospital system and with the One Utah Health
87     Collaborative to determine whether each hospital system, collectively, will create and adopt the

88     same policies regarding one or all of the following:
89          (a) the creation of a published provider directory that contains identifying information
90     of the providers to facilitate interfaces between systems;
91          (b) the establishment of technical specifications that would enable identity verification
92     and authentication both for a patient and a health care provider; and
93          (c) the creation of a consensus data sharing agreement for health care providers and
94     hospitals that is consistent with applicable federal and state laws.
95          (5) The department shall report to the Health and Human Services Interim Committee
96     before November 1, 2023, and again between June 1, 2024, and November 1, 2024, regarding:
97          (a) any progress towards the hospital systems complying with Subsection (1); and
98          (b) whether a consensus has been achieved on any of the items listed in Subsection (4).
99          (6) To better improve a patient's access and control of the patient's own medical
100     information when a patient receives care from more than one hospital system, the department
101     shall communicate with each hospital system and with the One Utah Health Collaborative to
102     determine which policies or projects would best improve:
103          (a) the accuracy of any information that the patient requests to have shared;
104          (b) the completeness of any information that the patient requests to have shared;
105          (c) the security of any information that the patient requests to have shared;
106          (d) the timeliness of any information that the patient requests to have shared;
107          (e) the ability of the patient to block any of the patient's data from being shared; or
108          (f) the ability of the patient to block the patient's data from any individual source from
109     being shared.
110          Section 4. Section 63I-1-226 is amended to read:
111          63I-1-226. Repeal dates: Title 26 through 26B.
112          (1) Section 26-1-7.5, which creates the Utah Health Advisory Council, is repealed July
113     1, 2025.
114          (2) Section 26-1-40 is repealed July 1, 2022.
115          (3) Section 26-1-41 is repealed July 1, 2026.
116          (4) Section 26-1-43 is repealed December 31, 2025.
117          (5) Section 26-7-10 is repealed July 1, 2025.
118          (6) Subsection 26-7-11(5), regarding reports to the Legislature, is repealed July 1,

119     2028.
120          (7) Section 26-7-14 is repealed December 31, 2027.
121          (8) Section 26-8a-603 is repealed July 1, 2027.
122          (9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
123     1, 2025.
124          (10) Subsection 26-10-6(5), which creates the Newborn Hearing Screening Committee,
125     is repealed July 1, 2026.
126          (11) Section 26-10b-106, which creates the Primary Care Grant Committee, is repealed
127     July 1, 2025.
128          (12) Subsection 26-15c-104(3), relating to a limitation on the number of
129     microenterprise home kitchen permits that may be issued, is repealed July 1, 2022.
130          (13) Subsection 26-18-2.6(9), which addresses reimbursement for dental hygienists, is
131     repealed July 1, 2028.
132          (14) Section 26-18-27 is repealed July 1, 2025.
133          (15) Section 26-18-28 is repealed June 30, 2027.
134          (16) Title 26, Chapter 18, Part 2, Drug Utilization Review Board, is repealed July 1,
135     2027.
136          (17) Subsection 26-18-418(2), the language that states "and the Behavioral Health
137     Crisis Response Commission created in Section 63C-18-202" is repealed July 1, 2023.
138          (18) Section 26-33a-117 is repealed December 31, 2023.
139          (19) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
140          (20) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
141     2024.
142          (21) Title 26, Chapter 36c, Medicaid Expansion Hospital Assessment Act, is repealed
143     July 1, 2024.
144          (22) Title 26, Chapter 36d, Hospital Provider Assessment Act, is repealed July 1, 2024.
145          (23) Section 26-39-201, which creates the Residential Child Care Licensing Advisory
146     Committee, is repealed July 1, 2024.
147          (24) Section 26-39-405, Drinking water quality in child care centers, is repealed July 1,
148     2027.
149          (25) Section 26-40-104, which creates the Utah Children's Health Insurance Program

150     Advisory Council, is repealed July 1, 2025.
151          (26) Section 26-50-202, which creates the Traumatic Brain Injury Advisory
152     Committee, is repealed July 1, 2025.
153          (27) Title 26, Chapter 54, Spinal Cord and Brain Injury Rehabilitation Fund and
154     Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
155          (28) Title 26, Chapter 66, Early Childhood Utah Advisory Council, is repealed July 1,
156     2026.
157          (29) Title 26, Chapter 68, COVID-19 Vaccine Restrictions Act, is repealed July 1,
158     2024.
159          (30) Section 26-69-406 is repealed July 1, 2025.
160          (31) Section 26-70-103 is repealed July 1, 2027.
161          [(31)] (32) Subsection 26B-1-204(2)(i), related to the Residential Child Care Licensing
162     Advisory Committee, is repealed July 1, 2024.
163          [(32)] (33) Subsection 26B-1-204(2)(k), related to the Primary Care Grant Committee,
164     is repealed July 1, 2025.
165          Section 5. Appropriation.
166          The following sums of money are appropriated for the fiscal year beginning July 1,
167     2023, and ending June 30, 2024. These are additions to amounts previously appropriated for
168     fiscal year 2024. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
169     Act, the Legislature appropriates the following sums of money from the funds or accounts
170     indicated for the use and support of the government of the state of Utah.
171     ITEM 1
172     To Department of Health and Human Services - Operations
173          From General Fund
1,500,000

174          Schedule of Programs:
175               Data, Systems, & Evaluations                    1,500,000
176          The Legislature intends that the Department of Health and Human Services use the
177     appropriation, through one or more requests for proposal, to:
178          (1) assist the hospital systems to meet the obligations of Subsection 26-70-103(1);
179          (2) assist in facilitating discussions and creating policies upon consensus as described
180     in Subsection 26-70-103(5); and

181          (3) accomplish the projects described in Subsection 26-70-103(6).