As Passed by the House 1
123rd General Assembly 4
Regular Session Am. Sub. H. B. No. 508 5
1999-2000 6
REPRESENTATIVES OLMAN-WILLAMOWSKI-PATTON-REDFERN-ALLEN- 7
TERWILLEGER-HARTNETT-CALLENDER-D. MILLER-BRITTON-VESPER- 8
PERRY-JOLIVETTE-LOGAN-OGG-TAYLOR-GERBERRY-PETERSON-R. MILLER- 9
KRUPINSKI-J. BEATTY-DePIERO-HARRIS-CORBIN-HOOPS-SUTTON-HOLLISTER- 10
EVANS-BENDER-WILSON-WOMER BENJAMIN-JONES-DISTEL-VERICH-HARTLEY- 11
METTLER-TIBERI-BUEHRER-DAMSCHRODER-MOTTLEY-SCHULER-BOYD-BARRETT- 12
O'BRIEN-GOODING-BARNES-CATES-FERDERBER-JACOBSON-SMITH-WIDENER 13
_________________________________________________________________ 14
A B I L L
To amend section 3701.74 and to enact sections 16
3701.741 and 3701.742 of the Revised Code 17
relative to the fees health care providers and
medical records companies may charge for 18
providing copies of medical records. 19
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 21
Section 1. That section 3701.74 be amended and sections 23
3701.741 and 3701.742 of the Revised Code be enacted to read as 24
follows:
Sec. 3701.74. (A) As used in this section AND SECTION 33
3701.741 OF THE REVISED CODE: 34
(1) "Hospital" means any institution registered as a 36
hospital with the department of health pursuant to section 37
3701.07 of the Revised Code CHIROPRACTOR" MEANS AN INDIVIDUAL 38
LICENSED UNDER CHAPTER 4734. OF THE REVISED CODE TO PRACTICE 39
CHIROPRACTIC.
(2) "HEALTH CARE PROVIDER" HAS THE SAME MEANING AS IN 41
SECTION 3729.01 OF THE REVISED CODE. 42
(3) "Medical record" means DATA IN any document or 44
combination of documents FORM that pertains to a patient's 46
2
medical history, diagnosis, prognosis, or medical condition and 47
that is generated and maintained BY A HEALTH CARE PROVIDER in the 49
process of the patient's health care treatment at a hospital. 50
(3) "Finalized medical record" means a medical record that 53
is complete according to a hospital's bylaws.
(4) "MEDICAL RECORDS COMPANY" MEANS A PERSON WHO STORES, 55
LOCATES, OR COPIES MEDICAL RECORDS FOR A HEALTH CARE PROVIDER, OR 57
IS COMPENSATED FOR DOING SO BY A HEALTH CARE PROVIDER, AND
CHARGES A FEE FOR PROVIDING MEDICAL RECORDS TO A PATIENT OR 59
PATIENT'S REPRESENTATIVE.
(5) "Patient" means any EITHER OF THE FOLLOWING: 61
(a) AN individual who received health care treatment at a 64
hospital FROM A HEALTH CARE PROVIDER;
(b) A GUARDIAN, AS DEFINED IN SECTION 1337.11 OF THE 67
REVISED CODE, OF AN INDIVIDUAL DESCRIBED IN DIVISION (A)(5)(a) OF 68
THIS SECTION.
(6) "PATIENT'S REPRESENTATIVE" MEANS A PERSON TO WHOM A 70
PATIENT HAS GIVEN WRITTEN AUTHORIZATION TO ACT ON THE PATIENT'S 71
BEHALF REGARDING THE PATIENT'S MEDICAL RECORDS, EXCEPT THAT IF 72
THE PATIENT IS DECEASED, "PATIENT'S REPRESENTATIVE" MEANS THE 73
EXECUTOR OR ADMINISTRATOR OF THE PATIENT'S ESTATE OR THE PERSON 74
RESPONSIBLE FOR THE PATIENT'S ESTATE IF IT IS NOT TO BE PROBATED. 75
"PATIENT'S REPRESENTATIVE" DOES NOT INCLUDE AN INSURER AUTHORIZED 76
UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE BUSINESS OF
SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR A HEALTH 77
INSURING CORPORATION HOLDING A CERTIFICATE OF AUTHORITY UNDER 78
CHAPTER 1751. OF THE REVISED CODE.
(7) "PHYSICIAN" MEANS A PERSON AUTHORIZED UNDER CHAPTER 80
4731. OF THE REVISED CODE TO PRACTICE MEDICINE AND SURGERY, 81
OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY. 82
(B) A hospital shall prepare a finalized medical record 84
for each patient who receives health care treatment at the 85
hospital, within a reasonable time after treatment. 86
(C) A patient OR PATIENT'S REPRESENTATIVE who wishes to 88
3
examine or obtain a copy of part or all of a finalized medical 90
record covering a prior inpatient stay or outpatient treatment 91
shall submit to the hospital HEALTH CARE PROVIDER a signed, 93
written request SIGNED BY THE PATIENT dated not more than sixty 94
days before the date on which it is submitted. The patient OR 96
PATIENT'S REPRESENTATIVE who wishes to obtain a copy of the 98
record shall indicate in the request whether the copy is to be 99
sent to the patient's residence, PHYSICIAN OR CHIROPRACTOR, OR 100
REPRESENTATIVE, or held for the patient at the hospital OFFICE OF 101
THE HEALTH CARE PROVIDER. Within a reasonable time after 102
receiving a request that meets the requirements of this division 103
and includes sufficient information to identify the record 104
requested, the hospital A HEALTH CARE PROVIDER THAT HAS THE 106
PATIENT'S MEDICAL RECORDS shall permit the patient to examine the 107
record during regular business hours WITHOUT CHARGE or, ON 108
REQUEST, shall provide a copy of the record in accordance with 111
the request SECTION 3701.741 OF THE REVISED CODE, except that if 112
a physician OR CHIROPRACTOR who has treated the patient 113
determines for clearly stated treatment reasons that disclosure 115
of the requested record is likely to have an adverse effect on 116
the patient, the hospital HEALTH CARE PROVIDER shall provide the 118
record to a physician OR CHIROPRACTOR designated by the patient. 120
The hospital HEALTH CARE PROVIDER shall take reasonable steps to 121
establish the identity of the patient examining, PERSON MAKING 122
THE REQUEST TO EXAMINE or requesting OBTAIN a copy of, the 124
patient's record.
(D)(C) If a hospital HEALTH CARE PROVIDER fails to furnish 127
a finalized medical record as required by division (C)(B) of this 128
section, the patient OR PATIENT'S REPRESENTATIVE who requested 130
the record may bring a civil action to enforce the patient's 131
right of access to the record.
(E)(D)(1) This section does not apply to medical records 134
whose release is covered by SECTION 173.20 OR 3721.13 OF THE 135
REVISED CODE, BY Chapter 1347. or 5122. of the Revised Code or, 137
4
by 42 C.F.R. part 2, "Confidentiality of Alcohol and Drug Abuse 138
Patient Records.," Nothing OR BY 42 C.F.R. 483.10. 140
(2) NOTHING in this section is intended to supersede the 143
confidentiality provisions of sections 2305.24 to 2305.251 of the 144
Revised Code.
Sec. 3701.741. (A) THROUGH DECEMBER 31, 2004, EACH HEALTH 147
CARE PROVIDER AND MEDICAL RECORDS COMPANY SHALL PROVIDE COPIES OF 148
MEDICAL RECORDS IN ACCORDANCE WITH THIS SECTION. 149
(B) EXCEPT AS PROVIDED IN DIVISIONS (C) AND (E) OF THIS 152
SECTION, A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY THAT 153
RECEIVES A REQUEST FOR A COPY OF A PATIENT'S MEDICAL RECORD MAY 154
CHARGE NOT MORE THAN THE AMOUNTS SET FORTH IN THIS SECTION.
TOTAL COSTS FOR COPIES AND ALL SERVICES RELATED TO THOSE COPIES 155
SHALL NOT EXCEED THE SUM OF THE FOLLOWING: 156
(1) AN INITIAL FEE OF FIFTEEN DOLLARS, WHICH SHALL 158
COMPENSATE FOR THE RECORDS SEARCH; 159
(2) WITH RESPECT TO DATA RECORDED ON PAPER, THE FOLLOWING 162
AMOUNTS:
(a) ONE DOLLAR PER PAGE FOR THE FIRST TEN PAGES; 164
(b) FIFTY CENTS PER PAGE FOR PAGES ELEVEN THROUGH FIFTY; 166
(c) TWENTY CENTS PER PAGE FOR PAGES FIFTY-ONE AND HIGHER. 168
(3) WITH RESPECT TO DATA RECORDED OTHER THAN ON PAPER, THE 170
ACTUAL COST OF MAKING THE COPY; 171
(4) THE ACTUAL COST OF ANY RELATED POSTAGE INCURRED BY THE 173
HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY. 174
(C) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY 176
SHALL PROVIDE ONE COPY WITHOUT CHARGE TO THE FOLLOWING: 177
(1) THE BUREAU OF WORKERS' COMPENSATION, IN ACCORDANCE 179
WITH CHAPTERS 4121. AND 4123. OF THE REVISED CODE AND THE RULES 180
ADOPTED UNDER THOSE CHAPTERS; 181
(2) THE INDUSTRIAL COMMISSION, IN ACCORDANCE WITH CHAPTERS 183
4121. AND 4123. OF THE REVISED CODE AND THE RULES ADOPTED UNDER 184
THOSE CHAPTERS;
(3) THE DEPARTMENT OF JOB AND FAMILY SERVICES, IN 186
5
ACCORDANCE WITH CHAPTER 5101. OF THE REVISED CODE AND THE RULES 187
ADOPTED UNDER THOSE CHAPTERS;
(4) A PATIENT OR PATIENT'S REPRESENTATIVE IF THE MEDICAL 190
RECORD IS NECESSARY TO SUPPORT A CLAIM UNDER TITLE II OR TITLE 192
XVI OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 194
U.S.C.A. 401 AND 1381, AS AMENDED, AND THE REQUEST IS ACCOMPANIED 195
BY DOCUMENTATION THAT A CLAIM HAS BEEN FILED.
(D) DIVISION (C) OF THIS SECTION SHALL NOT BE CONSTRUED TO 198
SUPERSEDE ANY RULE OF THE BUREAU OF WORKERS' COMPENSATION, THE
INDUSTRIAL COMMISSION, OR THE DEPARTMENT OF JOB AND FAMILY 199
SERVICES.
(E) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY MAY 202
ENTER INTO A CONTRACT WITH A PATIENT, A PATIENT'S REPRESENTATIVE, 203
OR AN INSURER FOR THE COPYING OF MEDICAL RECORDS AT A FEE OTHER 204
THAN AS PROVIDED IN DIVISION (B) OF THIS SECTION. 205
(F) THIS SECTION DOES NOT APPLY TO EITHER OF THE 207
FOLLOWING:
(1) COPIES OF MEDICAL RECORDS PROVIDED TO INSURERS 209
AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE 210
BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 211
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 212
UNDER CHAPTER 1751. OF THE REVISED CODE;
(2) MEDICAL RECORDS THE COPYING OF WHICH IS COVERED BY 215
SECTION 173.20 OF THE REVISED CODE OR BY 42 C.F.R. 483.10. 216
(G) NOTHING IN THIS SECTION REQUIRES OR PRECLUDES THE 219
DISTRIBUTION OF MEDICAL RECORDS AT ANY PARTICULAR COST OR FEE TO
INSURERS AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO 221
THE BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 222
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 223
UNDER CHAPTER 1751. OF THE REVISED CODE.
Sec. 3701.742. IF THE DATE SPECIFIED IN SECTION 3701.741 225
OF THE REVISED CODE IS AMENDED TO REFLECT A DATE THAT OCCURS 226
AFTER DECEMBER 31, 2004, THEN NOT LATER THAN JANUARY 31, 2005, 227
THE AMOUNTS SPECIFIED IN DIVISION (B) OF SECTION 3701.741 OF THE 228
6
REVISED CODE AND, NOT LATER THAN THE FIRST DAY OF JANUARY OF EACH 229
YEAR THEREAFTER, ANY AMOUNTS COMPUTED BY ADJUSTMENTS MADE UNDER 230
THIS SECTION, SHALL BE INCREASED OR DECREASED BY THE AVERAGE 231
PERCENTAGE OF INCREASE OR DECREASE IN THE CONSUMER PRICE INDEX 232
FOR ALL URBAN CONSUMERS (UNITED STATES CITY AVERAGE, ALL ITEMS), 233
PREPARED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF 234
LABOR STATISTICS, FOR THE TWELVE-CALENDAR-MONTH PERIOD PRIOR TO 235
THE IMMEDIATELY PRECEDING FIRST DAY OF JANUARY OVER THE 236
IMMEDIATELY PRECEDING TWELVE-CALENDAR-MONTH PERIOD, AS REPORTED 237
BY THE BUREAU. THE DIRECTOR OF HEALTH SHALL MAKE THIS
DETERMINATION AND ADJUST THE AMOUNTS ACCORDINGLY. THE DIRECTOR 238
SHALL PROVIDE A LIST OF THE ADJUSTED AMOUNTS TO ANY PARTY UPON 239
REQUEST.
Section 2. That existing section 3701.74 of the Revised 241
Code is hereby repealed. 242