As Reported by the Senate Insurance, Commerce 2
and Labor Committee 2
123rd General Assembly 5
Regular Session Am. Sub. H. B. No. 508 6
1999-2000 7
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
METTLER-TIBERI-BUEHRER-DAMSCHRODER-MOTTLEY-SCHULER-BOYD-BARRETT- 13
O'BRIEN-GOODING-BARNES-CATES-FERDERBER-JACOBSON-SMITH-WIDENER- 14
SENATOR CUPP 15
_________________________________________________________________ 17
A B I L L
To amend section 3701.74 and to enact sections 19
3701.741 and 3701.742 of the Revised Code 20
relative to the fees health care providers and
medical records companies may charge for 21
providing copies of medical records. 22
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 24
Section 1. That section 3701.74 be amended and sections 26
3701.741 and 3701.742 of the Revised Code be enacted to read as 27
follows:
Sec. 3701.74. (A) As used in this section AND SECTION 36
3701.741 OF THE REVISED CODE: 37
(1) "Hospital" means any institution registered as a 39
hospital with the department of health pursuant to section 40
3701.07 of the Revised Code CHIROPRACTOR" MEANS AN INDIVIDUAL 41
LICENSED UNDER CHAPTER 4734. OF THE REVISED CODE TO PRACTICE 42
CHIROPRACTIC.
(2) "HEALTH CARE PROVIDER" HAS THE SAME MEANING AS IN 44
SECTION 3729.01 OF THE REVISED CODE. 45
2
(3) "Medical record" means DATA IN any document or 47
combination of documents FORM that pertains to a patient's 49
medical history, diagnosis, prognosis, or medical condition and 50
that is generated and maintained BY A HEALTH CARE PROVIDER in the 52
process of the patient's health care treatment at a hospital. 53
(3) "Finalized medical record" means a medical record that 56
is complete according to a hospital's bylaws.
(4) "MEDICAL RECORDS COMPANY" MEANS A PERSON WHO STORES, 58
LOCATES, OR COPIES MEDICAL RECORDS FOR A HEALTH CARE PROVIDER, OR 60
IS COMPENSATED FOR DOING SO BY A HEALTH CARE PROVIDER, AND
CHARGES A FEE FOR PROVIDING MEDICAL RECORDS TO A PATIENT OR 62
PATIENT'S REPRESENTATIVE.
(5) "Patient" means any EITHER OF THE FOLLOWING: 64
(a) AN individual who received health care treatment at a 67
hospital FROM A HEALTH CARE PROVIDER;
(b) A GUARDIAN, AS DEFINED IN SECTION 1337.11 OF THE 70
REVISED CODE, OF AN INDIVIDUAL DESCRIBED IN DIVISION (A)(5)(a) OF 71
THIS SECTION.
(6) "PATIENT'S REPRESENTATIVE" MEANS A PERSON TO WHOM A 73
PATIENT HAS GIVEN WRITTEN AUTHORIZATION TO ACT ON THE PATIENT'S 74
BEHALF REGARDING THE PATIENT'S MEDICAL RECORDS, EXCEPT THAT IF 75
THE PATIENT IS DECEASED, "PATIENT'S REPRESENTATIVE" MEANS THE 76
EXECUTOR OR ADMINISTRATOR OF THE PATIENT'S ESTATE OR THE PERSON 77
RESPONSIBLE FOR THE PATIENT'S ESTATE IF IT IS NOT TO BE PROBATED. 78
"PATIENT'S REPRESENTATIVE" DOES NOT INCLUDE AN INSURER AUTHORIZED 79
UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE BUSINESS OF
SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR A HEALTH 80
INSURING CORPORATION HOLDING A CERTIFICATE OF AUTHORITY UNDER 81
CHAPTER 1751. OF THE REVISED CODE.
(7) "PHYSICIAN" MEANS A PERSON AUTHORIZED UNDER CHAPTER 83
4731. OF THE REVISED CODE TO PRACTICE MEDICINE AND SURGERY, 84
OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY. 85
(B) A hospital shall prepare a finalized medical record 87
for each patient who receives health care treatment at the 88
3
hospital, within a reasonable time after treatment. 89
(C) A patient OR PATIENT'S REPRESENTATIVE who wishes to 91
examine or obtain a copy of part or all of a finalized medical 93
record covering a prior inpatient stay or outpatient treatment 94
shall submit to the hospital HEALTH CARE PROVIDER a signed, 96
written request SIGNED BY THE PATIENT dated not more than sixty 97
days before the date on which it is submitted. The patient OR 99
PATIENT'S REPRESENTATIVE who wishes to obtain a copy of the 101
record shall indicate in the request whether the copy is to be 102
sent to the patient's residence, PHYSICIAN OR CHIROPRACTOR, OR 103
REPRESENTATIVE, or held for the patient at the hospital OFFICE OF 104
THE HEALTH CARE PROVIDER. Within a reasonable time after 105
receiving a request that meets the requirements of this division 106
and includes sufficient information to identify the record 107
requested, the hospital A HEALTH CARE PROVIDER THAT HAS THE 109
PATIENT'S MEDICAL RECORDS shall permit the patient to examine the 110
record during regular business hours WITHOUT CHARGE or, ON 111
REQUEST, shall provide a copy of the record in accordance with 114
the request SECTION 3701.741 OF THE REVISED CODE, except that if 115
a physician OR CHIROPRACTOR who has treated the patient 116
determines for clearly stated treatment reasons that disclosure 118
of the requested record is likely to have an adverse effect on 119
the patient, the hospital HEALTH CARE PROVIDER shall provide the 121
record to a physician OR CHIROPRACTOR designated by the patient. 123
The hospital HEALTH CARE PROVIDER shall take reasonable steps to 124
establish the identity of the patient examining, PERSON MAKING 125
THE REQUEST TO EXAMINE or requesting OBTAIN a copy of, the 127
patient's record.
(D)(C) If a hospital HEALTH CARE PROVIDER fails to furnish 130
a finalized medical record as required by division (C)(B) of this 131
section, the patient OR PATIENT'S REPRESENTATIVE who requested 133
the record may bring a civil action to enforce the patient's 134
right of access to the record.
(E)(D)(1) This section does not apply to medical records 137
4
whose release is covered by SECTION 173.20 OR 3721.13 OF THE 138
REVISED CODE, BY Chapter 1347. or 5122. of the Revised Code or, 140
by 42 C.F.R. part 2, "Confidentiality of Alcohol and Drug Abuse 141
Patient Records.," Nothing OR BY 42 C.F.R. 483.10. 143
(2) NOTHING in this section is intended to supersede the 146
confidentiality provisions of sections 2305.24 to 2305.251 of the 147
Revised Code.
Sec. 3701.741. (A) THROUGH DECEMBER 31, 2004, EACH HEALTH 150
CARE PROVIDER AND MEDICAL RECORDS COMPANY SHALL PROVIDE COPIES OF 151
MEDICAL RECORDS IN ACCORDANCE WITH THIS SECTION. 152
(B) EXCEPT AS PROVIDED IN DIVISIONS (C) AND (E) OF THIS 155
SECTION, A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY THAT 156
RECEIVES A REQUEST FOR A COPY OF A PATIENT'S MEDICAL RECORD MAY 157
CHARGE NOT MORE THAN THE AMOUNTS SET FORTH IN THIS SECTION.
TOTAL COSTS FOR COPIES AND ALL SERVICES RELATED TO THOSE COPIES 158
SHALL NOT EXCEED THE SUM OF THE FOLLOWING: 159
(1) AN INITIAL FEE OF FIFTEEN DOLLARS, WHICH SHALL 161
COMPENSATE FOR THE RECORDS SEARCH; 162
(2) WITH RESPECT TO DATA RECORDED ON PAPER, THE FOLLOWING 165
AMOUNTS:
(a) ONE DOLLAR PER PAGE FOR THE FIRST TEN PAGES; 167
(b) FIFTY CENTS PER PAGE FOR PAGES ELEVEN THROUGH FIFTY; 169
(c) TWENTY CENTS PER PAGE FOR PAGES FIFTY-ONE AND HIGHER. 171
(3) WITH RESPECT TO DATA RECORDED OTHER THAN ON PAPER, THE 173
ACTUAL COST OF MAKING THE COPY; 174
(4) THE ACTUAL COST OF ANY RELATED POSTAGE INCURRED BY THE 176
HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY. 177
(C) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY 179
SHALL PROVIDE ONE COPY WITHOUT CHARGE TO THE FOLLOWING: 180
(1) THE BUREAU OF WORKERS' COMPENSATION, IN ACCORDANCE 182
WITH CHAPTERS 4121. AND 4123. OF THE REVISED CODE AND THE RULES 183
ADOPTED UNDER THOSE CHAPTERS; 184
(2) THE INDUSTRIAL COMMISSION, IN ACCORDANCE WITH CHAPTERS 186
4121. AND 4123. OF THE REVISED CODE AND THE RULES ADOPTED UNDER 187
5
THOSE CHAPTERS;
(3) THE DEPARTMENT OF JOB AND FAMILY SERVICES, IN 189
ACCORDANCE WITH CHAPTER 5101. OF THE REVISED CODE AND THE RULES 190
ADOPTED UNDER THOSE CHAPTERS;
(4) A PATIENT OR PATIENT'S REPRESENTATIVE IF THE MEDICAL 193
RECORD IS NECESSARY TO SUPPORT A CLAIM UNDER TITLE II OR TITLE 195
XVI OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 197
U.S.C.A. 401 AND 1381, AS AMENDED, AND THE REQUEST IS ACCOMPANIED 198
BY DOCUMENTATION THAT A CLAIM HAS BEEN FILED.
(D) DIVISION (C) OF THIS SECTION SHALL NOT BE CONSTRUED TO 201
SUPERSEDE ANY RULE OF THE BUREAU OF WORKERS' COMPENSATION, THE
INDUSTRIAL COMMISSION, OR THE DEPARTMENT OF JOB AND FAMILY 202
SERVICES.
(E) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY MAY 205
ENTER INTO A CONTRACT WITH A PATIENT, A PATIENT'S REPRESENTATIVE, 206
OR AN INSURER FOR THE COPYING OF MEDICAL RECORDS AT A FEE OTHER 207
THAN AS PROVIDED IN DIVISION (B) OF THIS SECTION. 208
(F) THIS SECTION DOES NOT APPLY TO EITHER OF THE 210
FOLLOWING:
(1) COPIES OF MEDICAL RECORDS PROVIDED TO INSURERS 212
AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE 213
BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 214
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 215
UNDER CHAPTER 1751. OF THE REVISED CODE;
(2) MEDICAL RECORDS THE COPYING OF WHICH IS COVERED BY 218
SECTION 173.20 OF THE REVISED CODE OR BY 42 C.F.R. 483.10. 219
(G) NOTHING IN THIS SECTION REQUIRES OR PRECLUDES THE 222
DISTRIBUTION OF MEDICAL RECORDS AT ANY PARTICULAR COST OR FEE TO
INSURERS AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO 224
THE BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 225
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 226
UNDER CHAPTER 1751. OF THE REVISED CODE.
Sec. 3701.742. IF THE DATE SPECIFIED IN SECTION 3701.741 228
OF THE REVISED CODE IS AMENDED TO REFLECT A DATE THAT OCCURS 229
6
AFTER DECEMBER 31, 2004, THEN NOT LATER THAN JANUARY 31, 2005, 230
THE AMOUNTS SPECIFIED IN DIVISION (B) OF SECTION 3701.741 OF THE 231
REVISED CODE AND, NOT LATER THAN THE FIRST DAY OF JANUARY OF EACH 232
YEAR THEREAFTER, ANY AMOUNTS COMPUTED BY ADJUSTMENTS MADE UNDER 233
THIS SECTION, SHALL BE INCREASED OR DECREASED BY THE AVERAGE 234
PERCENTAGE OF INCREASE OR DECREASE IN THE CONSUMER PRICE INDEX 235
FOR ALL URBAN CONSUMERS (UNITED STATES CITY AVERAGE, ALL ITEMS), 236
PREPARED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF 237
LABOR STATISTICS, FOR THE TWELVE-CALENDAR-MONTH PERIOD PRIOR TO 238
THE IMMEDIATELY PRECEDING FIRST DAY OF JANUARY OVER THE 239
IMMEDIATELY PRECEDING TWELVE-CALENDAR-MONTH PERIOD, AS REPORTED 240
BY THE BUREAU. THE DIRECTOR OF HEALTH SHALL MAKE THIS
DETERMINATION AND ADJUST THE AMOUNTS ACCORDINGLY. THE DIRECTOR 241
SHALL PROVIDE A LIST OF THE ADJUSTED AMOUNTS TO ANY PARTY UPON 242
REQUEST.
Section 2. That existing section 3701.74 of the Revised 244
Code is hereby repealed. 245