As Reported by House Commerce and Labor Committee 1
123rd General Assembly 4
Regular Session Sub. 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-WILSON-WOMER BENJAMIN-JONES-DISTEL-VERICH-HARTLEY 12
_________________________________________________________________
A B I L L
To amend section 3701.74 and to enact sections 14
3701.741 and 3701.742 of the Revised Code 15
relative to the fees health care providers and
medical records companies may charge for 16
providing copies of medical records. 17
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 19
Section 1. That section 3701.74 be amended and sections 21
3701.741 and 3701.742 of the Revised Code be enacted to read as 22
follows:
Sec. 3701.74. (A) As used in this section AND SECTION 31
3701.741 OF THE REVISED CODE: 32
(1) "Hospital" means any institution registered as a 34
hospital with the department of health pursuant to section 35
3701.07 of the Revised Code CHIROPRACTOR" MEANS AN INDIVIDUAL 36
LICENSED UNDER CHAPTER 4734. OF THE REVISED CODE TO PRACTICE 37
CHIROPRACTIC.
(2) "HEALTH CARE PROVIDER" HAS THE SAME MEANING AS IN 39
SECTION 3729.01 OF THE REVISED CODE. 40
(3) "Medical record" means DATA IN any document or 42
combination of documents FORM that pertains to a patient's 44
medical history, diagnosis, prognosis, or medical condition and 45
that is generated and maintained BY A HEALTH CARE PROVIDER in the 47
2
process of the patient's health care treatment at a hospital. 48
(3) "Finalized medical record" means a medical record that 51
is complete according to a hospital's bylaws.
(4) "MEDICAL RECORDS COMPANY" MEANS A PERSON WHO STORES, 53
LOCATES, OR COPIES MEDICAL RECORDS FOR A HEALTH CARE PROVIDER, OR 55
IS COMPENSATED FOR DOING SO BY A HEALTH CARE PROVIDER, AND
CHARGES A FEE FOR PROVIDING MEDICAL RECORDS TO A PATIENT OR 57
PATIENT'S REPRESENTATIVE.
(5) "Patient" means any EITHER OF THE FOLLOWING: 59
(a) AN individual who received health care treatment at a 62
hospital FROM A HEALTH CARE PROVIDER;
(b) A GUARDIAN, AS DEFINED IN SECTION 1337.11 OF THE 65
REVISED CODE, OF AN INDIVIDUAL DESCRIBED IN DIVISION (A)(5)(a) OF 66
THIS SECTION.
(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'S 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
"PATIENT'S REPRESENTATIVE" DOES NOT INCLUDE AN INSURER AUTHORIZED 74
UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE BUSINESS OF
SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR A HEALTH 75
INSURING CORPORATION HOLDING A CERTIFICATE OF AUTHORITY UNDER 76
CHAPTER 1751. OF THE REVISED CODE.
(7) "PHYSICIAN" MEANS A PERSON AUTHORIZED UNDER CHAPTER 78
4731. OF THE REVISED CODE TO PRACTICE MEDICINE AND SURGERY, 79
OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY. 80
(B) A hospital shall prepare a finalized medical record 82
for each patient who receives health care treatment at the 83
hospital, within a reasonable time after treatment. 84
(C) A patient OR PATIENT'S REPRESENTATIVE who wishes to 86
examine or obtain a copy of part or all of a finalized medical 88
record covering a prior inpatient stay or outpatient treatment 89
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shall submit to the hospital HEALTH CARE PROVIDER a signed, 91
written request SIGNED BY THE PATIENT dated not more than sixty 92
days before the date on which it is submitted. The patient OR 94
PATIENT'S REPRESENTATIVE who wishes to obtain a copy of the 96
record shall indicate in the request whether the copy is to be 97
sent to the patient's residence, PHYSICIAN OR CHIROPRACTOR, OR 98
REPRESENTATIVE, or held for the patient at the hospital OFFICE OF 99
THE HEALTH CARE PROVIDER. Within a reasonable time after 100
receiving a request that meets the requirements of this division 101
and includes sufficient information to identify the record 102
requested, the hospital A HEALTH CARE PROVIDER THAT HAS THE 104
PATIENT'S MEDICAL RECORDS shall permit the patient to examine the 105
record during regular business hours WITHOUT CHARGE or, ON 106
REQUEST, shall provide a copy of the record in accordance with 109
the request SECTION 3701.741 OF THE REVISED CODE, except that if 110
a physician OR CHIROPRACTOR who has treated the patient 111
determines for clearly stated treatment reasons that disclosure 113
of the requested record is likely to have an adverse effect on 114
the patient, the hospital HEALTH CARE PROVIDER shall provide the 116
record to a physician OR CHIROPRACTOR designated by the patient. 118
The hospital HEALTH CARE PROVIDER shall take reasonable steps to 119
establish the identity of the patient examining, PERSON MAKING 120
THE REQUEST TO EXAMINE or requesting OBTAIN a copy of, the 122
patient's record.
(D)(C) If a hospital HEALTH CARE PROVIDER fails to furnish 125
a finalized medical record as required by division (C)(B) of this 126
section, the patient OR PATIENT'S REPRESENTATIVE who requested 128
the record may bring a civil action to enforce the patient's 129
right of access to the record.
(E)(D)(1) This section does not apply to medical records 132
whose release is covered by SECTION 173.20 OR 3721.13 OF THE 133
REVISED CODE, BY Chapter 1347. or 5122. of the Revised Code or, 135
by 42 C.F.R. part 2, "Confidentiality of Alcohol and Drug Abuse 136
Patient Records.," Nothing OR BY 42 C.F.R. 483.10. 137
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(2) NOTHING in this section is intended to supersede the 140
confidentiality provisions of sections 2305.24 to 2305.251 of the 141
Revised Code.
Sec. 3701.741. (A) THROUGH DECEMBER 31, 2004, EACH HEALTH 144
CARE PROVIDER AND MEDICAL RECORDS COMPANY SHALL PROVIDE COPIES OF 145
MEDICAL RECORDS IN ACCORDANCE WITH THIS SECTION. 146
(B) EXCEPT AS PROVIDED IN DIVISIONS (C) AND (E) OF THIS 149
SECTION, A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY THAT 150
RECEIVES A REQUEST FOR A COPY OF A PATIENT'S MEDICAL RECORD MAY 151
CHARGE NOT MORE THAN THE AMOUNTS SET FORTH IN THIS SECTION.
TOTAL COSTS FOR COPIES AND ALL SERVICES RELATED TO THOSE COPIES 152
SHALL NOT EXCEED THE SUM OF THE FOLLOWING: 153
(1) AN INITIAL FEE OF FIFTEEN DOLLARS, WHICH SHALL 155
COMPENSATE FOR THE RECORDS SEARCH; 156
(2) WITH RESPECT TO DATA RECORDED ON PAPER, THE FOLLOWING 159
AMOUNTS:
(a) ONE DOLLAR PER PAGE FOR THE FIRST TEN PAGES; 161
(b) FIFTY CENTS PER PAGE FOR PAGES ELEVEN THROUGH FIFTY; 163
(c) TWENTY CENTS PER PAGE FOR PAGES FIFTY-ONE AND HIGHER. 165
(3) WITH RESPECT TO DATA RECORDED OTHER THAN ON PAPER, THE 167
ACTUAL COST OF MAKING THE COPY; 168
(4) THE ACTUAL COST OF ANY RELATED POSTAGE INCURRED BY THE 170
HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY. 171
(C) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY 173
SHALL PROVIDE ONE COPY WITHOUT CHARGE TO THE FOLLOWING: 174
(1) THE BUREAU OF WORKERS' COMPENSATION, IN ACCORDANCE 176
WITH CHAPTERS 4121. AND 4123. OF THE REVISED CODE AND THE RULES 177
ADOPTED UNDER THOSE CHAPTERS; 178
(2) THE INDUSTRIAL COMMISSION, IN ACCORDANCE WITH CHAPTERS 180
4121. AND 4123. OF THE REVISED CODE AND THE RULES ADOPTED UNDER 181
THOSE CHAPTERS;
(3) THE DEPARTMENT OF JOB AND FAMILY SERVICES, IN 183
ACCORDANCE WITH CHAPTER 5101. OF THE REVISED CODE AND THE RULES 184
ADOPTED UNDER THOSE CHAPTERS;
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(4) A PATIENT OR PATIENT'S REPRESENTATIVE IF THE MEDICAL 187
RECORD IS NECESSARY TO SUPPORT A CLAIM UNDER TITLE II OR TITLE 189
XVI OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 191
U.S.C.A. 401 AND 1381, AS AMENDED, AND THE REQUEST IS ACCOMPANIED 192
BY DOCUMENTATION THAT A CLAIM HAS BEEN FILED.
(D) DIVISION (C) OF THIS SECTION SHALL NOT BE CONSTRUED TO 195
SUPERSEDE ANY RULE OF THE BUREAU OF WORKERS' COMPENSATION, THE
INDUSTRIAL COMMISSION, OR THE DEPARTMENT OF JOB AND FAMILY 196
SERVICES.
(E) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY MAY 199
ENTER INTO A CONTRACT WITH A PATIENT, A PATIENT'S REPRESENTATIVE, 200
OR AN INSURER FOR THE COPYING OF MEDICAL RECORDS AT A FEE OTHER 201
THAN AS PROVIDED IN DIVISION (B) OF THIS SECTION. 202
(F) THIS SECTION DOES NOT APPLY TO EITHER OF THE 204
FOLLOWING:
(1) COPIES OF MEDICAL RECORDS PROVIDED TO INSURERS 206
AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE 207
BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 208
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 209
UNDER CHAPTER 1751. OF THE REVISED CODE;
(2) MEDICAL RECORDS THE COPYING OF WHICH IS COVERED BY 212
SECTION 173.20 OF THE REVISED CODE OR BY 42 C.F.R. 483.10. 213
(G) NOTHING IN THIS SECTION REQUIRES OR PRECLUDES THE 216
DISTRIBUTION OF MEDICAL RECORDS AT ANY PARTICULAR COST OR FEE TO
INSURERS AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO 218
THE BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 219
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 220
UNDER CHAPTER 1751. OF THE REVISED CODE.
Sec. 3701.742. IF THE DATE SPECIFIED IN SECTION 3701.741 222
OF THE REVISED CODE IS AMENDED TO REFLECT A DATE THAT OCCURS 223
AFTER DECEMBER 31, 2004, THEN NOT LATER THAN JANUARY 31, 2005, 224
THE AMOUNTS SPECIFIED IN DIVISION (B) OF SECTION 3701.741 OF THE 225
REVISED CODE AND, NOT LATER THAN THE FIRST DAY OF JANUARY OF EACH 226
YEAR THEREAFTER, ANY AMOUNTS COMPUTED BY ADJUSTMENTS MADE UNDER 227
6
THIS SECTION, SHALL BE INCREASED OR DECREASED BY THE AVERAGE 228
PERCENTAGE OF INCREASE OR DECREASE IN THE CONSUMER PRICE INDEX 229
FOR ALL URBAN CONSUMERS (UNITED STATES CITY AVERAGE, ALL ITEMS), 230
PREPARED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF 231
LABOR STATISTICS, FOR THE TWELVE-CALENDAR-MONTH PERIOD PRIOR TO 232
THE IMMEDIATELY PRECEDING FIRST DAY OF JANUARY OVER THE 233
IMMEDIATELY PRECEDING TWELVE-CALENDAR-MONTH PERIOD, AS REPORTED 234
BY THE BUREAU. THE DIRECTOR OF HEALTH SHALL MAKE THIS
DETERMINATION AND ADJUST THE AMOUNTS ACCORDINGLY. THE DIRECTOR 235
SHALL PROVIDE A LIST OF THE ADJUSTED AMOUNTS TO ANY PARTY UPON 236
REQUEST.
Section 2. That existing section 3701.74 of the Revised 238
Code is hereby repealed. 239