As Introduced                            1            

123rd General Assembly                                             4            

   Regular Session                                 H. B. No. 508   5            

      1999-2000                                                    6            


     REPRESENTATIVES OLMAN-WILLAMOWSKI-PATTON-REDFERN-ALLEN-       8            

    TERWILLEGER-HARTNETT-CALLENDER-D. MILLER-BRITTON-VESPER-       9            

  PERRY-JOLIVETTE-LOGAN-OGG-TAYLOR-GERBERRY-PETERSON-R. MILLER-    10           

KRUPINSKI-J. BEATTY-DePIERO-HARRIS-CORBIN-HOOPS-SUTTON-HOLLISTER-  11           

             EVANS-BENDER-WISON-WOMER BENJAMIN-JONES               12           


_________________________________________________________________   13           

                          A   B I L L                                           

             To amend section 3701.74 and to enact sections        15           

                3701.741 and 3701.742 of the Revised Code          16           

                relative to the fees health care providers and                  

                medical records companies may charge for           17           

                providing copies of medical records.               18           




BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:        20           

      Section 1.  That section 3701.74 be amended and sections     22           

3701.741 and 3701.742 of the Revised Code be enacted to read as    23           

follows:                                                                        

      Sec. 3701.74.  (A)  As used in this section AND SECTION      32           

3701.741 OF THE REVISED CODE:                                      33           

      (1)  "Hospital" means any institution registered as a        35           

hospital with the department of health pursuant to section         36           

3701.07 of the Revised Code CHIROPRACTOR" MEANS AN INDIVIDUAL      37           

LICENSED UNDER CHAPTER 4734. OF THE REVISED CODE TO PRACTICE       38           

CHIROPRACTIC.                                                                   

      (2)  "HEALTH CARE PROVIDER" HAS THE SAME MEANING AS IN       40           

SECTION 3729.01 OF THE REVISED CODE AND ALSO INCLUDES A GENERAL    41           

X-RAY MACHINE OPERATOR, RADIOGRAPHER, RADIATION THERAPY            42           

TECHNOLOGIST, OR NUCLEAR MEDICINE TECHNOLOGIST LICENSED UNDER      43           

CHAPTER 4773. OF THE REVISED CODE.                                              

      (3)  "Medical record" means DATA IN any document or          45           

                                                          2      


                                                                 
combination of documents FORM that pertains to a patient's         47           

medical history, diagnosis, prognosis, or medical condition and    48           

that is generated and maintained BY A HEALTH CARE PROVIDER in the  50           

process of the patient's health care treatment at.  IN THE CASE    51           

OF a hospital.                                                                  

      (3),  "Finalized medical record" means a medical record      53           

that is complete according to a THE hospital's bylaws.             54           

      (4)  "MEDICAL RECORDS COMPANY" MEANS A PERSON WHO STORES,    56           

LOCATES, OR COPIES MEDICAL RECORDS FOR A HEALTH CARE PROVIDER, OR  58           

IS COMPENSATED FOR DOING SO BY A HEALTH CARE PROVIDER, AND                      

CHARGES A FEE FOR PROVIDING MEDICAL RECORDS TO A PATIENT OR        60           

PATIENT'S REPRESENTATIVE.                                                       

      (5)  "Patient" means any individual who received health      62           

care treatment at a hospital FROM A HEALTH CARE PROVIDER, OR THE   64           

INDIVIDUAL'S GUARDIAN AS DEFINED IN SECTION 1337.11 OF THE         66           

REVISED CODE.                                                                   

      (6)  "PATIENT'S REPRESENTATIVE" MEANS A PERSON TO WHOM A     68           

PATIENT HAS GIVEN WRITTEN AUTHORIZATION TO ACT ON THE PATIENT'S    69           

BEHALF REGARDING THE PATIENT'S MEDICAL RECORDS, EXCEPT THAT IF     70           

THE PATIENT IS DECEASED, "PATIENT REPRESENTATIVE" MEANS THE        71           

EXECUTOR OR ADMINISTRATOR OF THE PATIENT'S ESTATE OR THE PERSON    72           

RESPONSIBLE FOR THE PATIENT'S ESTATE IF IT IS NOT TO BE PROBATED.  73           

      (7)  "PHYSICIAN" MEANS A PERSON AUTHORIZED UNDER CHAPTER     75           

4731. OF THE REVISED CODE TO PRACTICE MEDICINE AND SURGERY,        76           

OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY.                     77           

      (B)  A hospital shall prepare a finalized medical record     79           

for each patient who receives health care treatment at the         80           

hospital, within a reasonable time after treatment.                81           

      (C)  A patient OR PATIENT'S REPRESENTATIVE who wishes to     83           

examine or obtain a copy of part or all of a finalized medical     85           

record covering a prior inpatient stay or outpatient treatment     86           

shall submit to the hospital HEALTH CARE PROVIDER a signed,        88           

written request dated not more than sixty days before the date on  89           

which it is submitted.  The patient OR PATIENT'S REPRESENTATIVE    90           

                                                          3      


                                                                 
who wishes to obtain a copy of the record shall indicate in the    91           

request whether the copy is to be sent to the patient's            92           

residence, PHYSICIAN OR CHIROPRACTOR, OR REPRESENTATIVE, or held   93           

for the patient at the hospital OFFICE OF THE HEALTH CARE          94           

PROVIDER.  Within a reasonable time after receiving a request      96           

that meets the requirements of this division and includes          97           

sufficient information to identify the record requested, the       98           

hospital A HEALTH CARE PROVIDER THAT HAS THE PATIENT'S MEDICAL     99           

RECORDS shall permit the patient OR THE PATIENT'S REPRESENTATIVE   101          

to examine the record during regular business hours WITHOUT        102          

CHARGE or, ON REQUEST, shall provide a copy of the record in       105          

accordance with the request SECTION 3701.741 OF THE REVISED CODE,  106          

except that if a physician who has treated the patient determines  107          

for clearly stated treatment reasons that disclosure of the        108          

requested record is likely to have an adverse effect on the        109          

patient, the hospital HEALTH CARE PROVIDER shall provide the       111          

record to a physician designated by the patient.  The hospital     112          

HEALTH CARE PROVIDER shall take reasonable steps to establish the  114          

identity of the patient examining, PERSON MAKING THE REQUEST TO                 

EXAMINE or requesting OBTAIN a copy of, the patient's record.      116          

      (D)(C)  If a hospital HEALTH CARE PROVIDER fails to furnish  119          

a finalized medical record as required by division (C)(B) of this  120          

section, the patient OR PATIENT'S REPRESENTATIVE who requested     122          

the record may bring a civil action to enforce the patient's       123          

right of access to the record.                                                  

      (E)(D)  This section does not apply to medical records       125          

whose release is covered by Chapter 1347. or 5122. of the Revised  126          

Code or by 42 C.F.R. part 2, "Confidentiality of Alcohol and Drug  127          

Abuse Patient Records."  Nothing in this section is intended to    128          

supersede the confidentiality provisions of sections 2305.24 to    129          

2305.251 of the Revised Code.                                      130          

      Sec. 3701.741.  (A)  EACH HEALTH CARE PROVIDER AND MEDICAL   132          

RECORDS COMPANY SHALL PROVIDE COPIES OF MEDICAL RECORDS IN         133          

ACCORDANCE WITH THIS SECTION.                                      134          

                                                          4      


                                                                 
      (B)  EXCEPT AS PROVIDED IN DIVISIONS (C) AND (D) OF THIS     137          

SECTION, AND SUBJECT TO SECTION 3701.742 OF THE REVISED CODE, A                 

HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY THAT RECEIVES A    138          

REQUEST FOR A COPY OF A PATIENT'S MEDICAL RECORD, MAY CHARGE AN    139          

AMOUNT NOT EXCEEDING THE SUM OF THE FOLLOWING:                                  

      (1)  AN INITIAL FEE OF FIFTEEN DOLLARS, WHICH SHALL          141          

COMPENSATE FOR THE RECORDS SEARCH AND, WITH RESPECT TO DATA        142          

RECORDED ON PAPER, THE FIRST TEN PAGES OF THE RECORD;              143          

      (2)  WITH RESPECT TO DATA RECORDED ON PAPER, TWENTY CENTS    146          

PER PAGE FOR ALL PAGES PROVIDED AFTER THE FIRST TEN;                            

      (3)  WITH RESPECT TO DATA RECORDED OTHER THAN ON PAPER, THE  148          

ACTUAL COST OF MAKING THE COPY;                                    149          

      (4)  THE ACTUAL COST OF ANY RELATED POSTAGE INCURRED BY THE  151          

HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY.                   152          

      (C)  A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY       154          

SHALL PROVIDE ONE COPY WITHOUT CHARGE TO THE FOLLOWING:            155          

      (1)  A PHYSICIAN OR CHIROPRACTOR, IF THE PHYSICIAN OR        157          

CHIROPRACTOR REQUESTING THE MEDICAL RECORD HAS OBTAINED A          158          

PROPERLY EXECUTED MEDICAL RECORDS RELEASE FORM FROM THE PATIENT    159          

OR THE PATIENT'S REPRESENTATIVE;                                                

      (2)  THE BUREAU OF WORKERS' COMPENSATION, THE INDUSTRIAL     161          

COMMISSION, OR THE DEPARTMENT OF HUMAN SERVICES, IF THE            162          

GOVERNMENTAL ENTITY REQUESTING THE MEDICAL RECORD HAS OBTAINED A   163          

PROPERLY EXECUTED MEDICAL RECORDS RELEASE FORM FROM THE PATIENT    164          

OR THE PATIENT'S REPRESENTATIVE;                                                

      (3)  A PATIENT OR PATIENT'S REPRESENTATIVE IF THE MEDICAL    167          

RECORD IS NECESSARY TO SUPPORT A CLAIM UNDER TITLE II OR TITLE     169          

XVI OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42          171          

U.S.C.A. 401 AND 1381, AS AMENDED, AND THE REQUEST IS ACCOMPANIED  172          

BY DOCUMENTATION THAT A CLAIM HAS BEEN OR WILL BE FILED.                        

      (D)  A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY MAY   174          

ENTER INTO A CONTRACT WITH A PATIENT'S REPRESENTATIVE OR AN        175          

INSURANCE COMPANY FOR THE COPYING OF MEDICAL RECORDS AT A FEE      176          

OTHER THAN AS PROVIDED IN DIVISION (B) OF THIS SECTION.            177          

                                                          5      


                                                                 
      Sec. 3701.742.  NOT LATER THAN JANUARY 31, 2002, THE         179          

AMOUNTS SPECIFIED IN DIVISION (B) OF SECTION 3701.741 OF THE       180          

REVISED CODE AND, NOT LATER THAN THE THIRTY-FIRST DAY OF JANUARY   181          

OF EACH YEAR THEREAFTER, ANY AMOUNTS COMPUTED BY ADJUSTMENTS MADE  182          

UNDER THIS SECTION, SHALL BE INCREASED OR DECREASED BY THE         183          

AVERAGE PERCENTAGE OF INCREASE OR DECREASE IN THE CONSUMER PRICE   184          

INDEX FOR ALL URBAN CONSUMERS (UNITED STATES CITY AVERAGE, ALL     185          

ITEMS), PREPARED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU  186          

OF LABOR STATISTICS, FOR THE TWELVE-CALENDAR-MONTH PERIOD PRIOR    187          

TO THE IMMEDIATELY PRECEDING FIRST DAY OF JANUARY OVER THE         188          

IMMEDIATELY PRECEDING TWELVE-CALENDAR-MONTH PERIOD, AS REPORTED    189          

BY THE BUREAU.  THE DIRECTOR OF HEALTH SHALL MAKE THIS                          

DETERMINATION AND ADJUST THE AMOUNTS ACCORDINGLY.  THE DIRECTOR    190          

SHALL PROVIDE A LIST OF THE ADJUSTED AMOUNTS TO ANY PARTY UPON     191          

REQUEST.                                                                        

      Section 2.  That existing section 3701.74 of the Revised     193          

Code is hereby repealed.                                           194