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; and
17          ▸     requires the Department of Health and Human Services to facilitate discussions
18     between the hospital systems and other entities for improving patient access and
19     patient control of medical information.
20     Money Appropriated in this Bill:
21          This bill appropriates in fiscal year 2024:
22          ▸     to the Department of Health and Human Services - Operations - Data, Systems, &
23     Evaluations, as an ongoing appropriation:
24               •     from the General Fund, $300,000.
25     Other Special Clauses:

26          None
27     Utah Code Sections Affected:
28     AMENDS:
29          26-70-101, as enacted by Laws of Utah 2022, Chapter 327
30          63I-1-226, as last amended by Laws of Utah 2022, Chapters 194, 206, 224, 253, 255,
31     347, and 451
32     ENACTS:
33          26-21-36, Utah Code Annotated 1953
34          26-70-103, Utah Code Annotated 1953
35     

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

48          26-70-101. Definitions.
49          As used in this chapter:
50          (1) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
51     Pub. L. No. 104-191, 110 Stat. 1936, as amended.
52          (2) "Hospital" means:
53          (a) a general acute hospital as defined in Section 26-21-2; and
54          (b) a specialty hospital as defined in Section 26-21-2.
55          (3) "Hospital system" means an entity that owns or operates at least five hospitals that
56     are licensed under Chapter 21, Health Care Facility Licensing and Inspection Act.

57          (4) "Medical information" means one or more of the following regarding a patient:
58          (a) for each time the patient is hospitalized:
59          (i) an admission history and physical exam; or
60          (ii) a discharge summary;
61          (b) the health care provider's notes regarding:
62          (i) an emergency room visit;
63          (ii) an urgent care visit;
64          (iii) a primary care outpatient care visit; or
65          (iv) a consultation office visit;
66          (c) a radiology report;
67          (d) a lab report; or
68          (e) a pathology report.
69          [(2)] (5) "Patient" means the individual whose information is being requested.
70          [(3)] (6) "Personal representative" means an individual described in 45 C.F.R. Sec.
71     164.502(g).
72          Section 3. Section 26-70-103 is enacted to read:
73          26-70-103. Patient information access by a health care provider.
74          (1) Beginning July 1, 2025, each hospital system shall ensure for a patient receiving
75     care in the hospital system's hospital that the patient's medical information maintained by all of
76     the hospital systems is accessible to a physician designated by the patient, preferably through
77     the use of single login.
78          (2) (a) The department shall facilitate discussions with each hospital system and the
79     One Utah Health Collaborative as to how to best achieve the requirement described in
80     Subsection (1).
81          (b) The department shall facilitate discussions with each hospital system and the
82     qualified networks within the state to accurately determine the costs of meeting the requirement
83     of Subsection (1) and determine where those costs would occur.
84          (c) The department shall facilitate discussions with each hospital system and the
85     qualified networks within the state to make recommendations about how to best improve a
86     patient's ability to control how, when, and where the patient's medical information is shared.
87          (3) The liability protections of Subsection 26-1-37(5) apply to a hospital system's

88     compliance with Subsection (1).
89          (4) To better improve patient access to the patient's medical information, the
90     department shall communicate with each hospital system and with the One Utah Health
91     Collaborative to determine whether each hospital system, collectively, will create and adopt the
92     same policies regarding one or all of the following:
93          (a) the creation of a published provider directory that contains identifying information
94     of the providers to facilitate interfaces between systems;
95          (b) the establishment of technical specifications that would enable identity verification
96     and authentication both for a patient and a health care provider; and
97          (c) the creation of a consensus data sharing agreement for health care providers and
98     hospitals that is consistent with applicable federal and state laws.
99          (5) The department shall report to the Health and Human Services Interim Committee
100     before November 1, 2023, and again between June 1, 2024, and November 1, 2024, regarding:
101          (a) any progress towards the hospital systems complying with Subsection (1);
102          (b) an analysis of costs as described in Subsection (2)(b);
103          (c) recommendations regarding the patient's control of medical information as
104     described in Subsection (2)(c); and
105          (d) whether a consensus has been achieved on any of the items listed in Subsection (4).
106          (6) Nothing in this section requires a hospital system to pay for a system described in
107     Subsection (1) that the hospital system does not control.
108          Section 4. Section 63I-1-226 is amended to read:
109          63I-1-226. Repeal dates: Title 26 through 26B.
110          (1) Section 26-1-7.5, which creates the Utah Health Advisory Council, is repealed July
111     1, 2025.
112          (2) Section 26-1-40 is repealed July 1, 2022.
113          (3) Section 26-1-41 is repealed July 1, 2026.
114          (4) Section 26-1-43 is repealed December 31, 2025.
115          (5) Section 26-7-10 is repealed July 1, 2025.
116          (6) Subsection 26-7-11(5), regarding reports to the Legislature, is repealed July 1,
117     2028.
118          (7) Section 26-7-14 is repealed December 31, 2027.

119          (8) Section 26-8a-603 is repealed July 1, 2027.
120          (9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
121     1, 2025.
122          (10) Subsection 26-10-6(5), which creates the Newborn Hearing Screening Committee,
123     is repealed July 1, 2026.
124          (11) Section 26-10b-106, which creates the Primary Care Grant Committee, is repealed
125     July 1, 2025.
126          (12) Subsection 26-15c-104(3), relating to a limitation on the number of
127     microenterprise home kitchen permits that may be issued, is repealed July 1, 2022.
128          (13) Subsection 26-18-2.6(9), which addresses reimbursement for dental hygienists, is
129     repealed July 1, 2028.
130          (14) Section 26-18-27 is repealed July 1, 2025.
131          (15) Section 26-18-28 is repealed June 30, 2027.
132          (16) Title 26, Chapter 18, Part 2, Drug Utilization Review Board, is repealed July 1,
133     2027.
134          (17) Subsection 26-18-418(2), the language that states "and the Behavioral Health
135     Crisis Response Commission created in Section 63C-18-202" is repealed July 1, 2023.
136          (18) Section 26-33a-117 is repealed December 31, 2023.
137          (19) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
138          (20) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
139     2024.
140          (21) Title 26, Chapter 36c, Medicaid Expansion Hospital Assessment Act, is repealed
141     July 1, 2024.
142          (22) Title 26, Chapter 36d, Hospital Provider Assessment Act, is repealed July 1, 2024.
143          (23) Section 26-39-201, which creates the Residential Child Care Licensing Advisory
144     Committee, is repealed July 1, 2024.
145          (24) Section 26-39-405, Drinking water quality in child care centers, is repealed July 1,
146     2027.
147          (25) Section 26-40-104, which creates the Utah Children's Health Insurance Program
148     Advisory Council, is repealed July 1, 2025.
149          (26) Section 26-50-202, which creates the Traumatic Brain Injury Advisory

150     Committee, is repealed July 1, 2025.
151          (27) Title 26, Chapter 54, Spinal Cord and Brain Injury Rehabilitation Fund and
152     Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
153          (28) Title 26, Chapter 66, Early Childhood Utah Advisory Council, is repealed July 1,
154     2026.
155          (29) Title 26, Chapter 68, COVID-19 Vaccine Restrictions Act, is repealed July 1,
156     2024.
157          (30) Section 26-69-406 is repealed July 1, 2025.
158          (31) Section 26-70-103 is repealed July 1, 2025.
159          [(31)] (32) Subsection 26B-1-204(2)(i), related to the Residential Child Care Licensing
160     Advisory Committee, is repealed July 1, 2024.
161          [(32)] (33) Subsection 26B-1-204(2)(k), related to the Primary Care Grant Committee,
162     is repealed July 1, 2025.
163          Section 5. Appropriation.
164          The following sums of money are appropriated for the fiscal year beginning July 1,
165     2023, and ending June 30, 2024. These are additions to amounts previously appropriated for
166     fiscal year 2024. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
167     Act, the Legislature appropriates the following sums of money from the funds or accounts
168     indicated for the use and support of the government of the state of Utah.
169     ITEM 1
170     To Department of Health and Human Services - Operations
171          From General Fund
300,000

172          Schedule of Programs:
173               Data, Systems, & Evaluations                    300,000
174          The Legislature intends that the Department of Health and Human Services use the
175     appropriation, through one or more requests for proposal, to assist:

176          (1) the hospital systems to meet the obligations of Subsection 26-70-103(1); and
177          (2) in facilitating discussions and creating policies upon reaching a consensus as
178     described in Subsection 26-70-103(4).

179