As Passed by the Senate 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
SENATORS CUPP-BLESSING-DRAKE-SPADA-HERINGTON-ESPY 14
_________________________________________________________________ 16
A B I L L
To amend section 3701.74 and to enact sections 18
3701.741 and 3701.742 of the Revised Code 19
relative to the fees health care providers and
medical records companies may charge for 20
providing copies of medical records. 21
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 23
Section 1. That section 3701.74 be amended and sections 25
3701.741 and 3701.742 of the Revised Code be enacted to read as 26
follows:
Sec. 3701.74. (A) As used in this section AND SECTION 35
3701.741 OF THE REVISED CODE: 36
(1) "Hospital" means any institution registered as a 38
hospital with the department of health pursuant to section 39
3701.07 of the Revised Code CHIROPRACTOR" MEANS AN INDIVIDUAL 40
LICENSED UNDER CHAPTER 4734. OF THE REVISED CODE TO PRACTICE 41
CHIROPRACTIC.
(2) "HEALTH CARE PROVIDER" HAS THE SAME MEANING AS IN 43
SECTION 3729.01 OF THE REVISED CODE. 44
(3) "Medical record" means DATA IN any document or 46
2
combination of documents FORM that pertains to a patient's 48
medical history, diagnosis, prognosis, or medical condition and 49
that is generated and maintained BY A HEALTH CARE PROVIDER in the 51
process of the patient's health care treatment at a hospital. 52
(3) "Finalized medical record" means a medical record that 55
is complete according to a hospital's bylaws.
(4) "MEDICAL RECORDS COMPANY" MEANS A PERSON WHO STORES, 57
LOCATES, OR COPIES MEDICAL RECORDS FOR A HEALTH CARE PROVIDER, OR 59
IS COMPENSATED FOR DOING SO BY A HEALTH CARE PROVIDER, AND
CHARGES A FEE FOR PROVIDING MEDICAL RECORDS TO A PATIENT OR 61
PATIENT'S REPRESENTATIVE.
(5) "Patient" means any EITHER OF THE FOLLOWING: 63
(a) AN individual who received health care treatment at a 66
hospital FROM A HEALTH CARE PROVIDER;
(b) A GUARDIAN, AS DEFINED IN SECTION 1337.11 OF THE 69
REVISED CODE, OF AN INDIVIDUAL DESCRIBED IN DIVISION (A)(5)(a) OF 70
THIS SECTION.
(6) "PATIENT'S REPRESENTATIVE" MEANS A PERSON TO WHOM A 72
PATIENT HAS GIVEN WRITTEN AUTHORIZATION TO ACT ON THE PATIENT'S 73
BEHALF REGARDING THE PATIENT'S MEDICAL RECORDS, EXCEPT THAT IF 74
THE PATIENT IS DECEASED, "PATIENT'S REPRESENTATIVE" MEANS THE 75
EXECUTOR OR ADMINISTRATOR OF THE PATIENT'S ESTATE OR THE PERSON 76
RESPONSIBLE FOR THE PATIENT'S ESTATE IF IT IS NOT TO BE PROBATED. 77
"PATIENT'S REPRESENTATIVE" DOES NOT INCLUDE AN INSURER AUTHORIZED 78
UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE BUSINESS OF
SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR A HEALTH 79
INSURING CORPORATION HOLDING A CERTIFICATE OF AUTHORITY UNDER 80
CHAPTER 1751. OF THE REVISED CODE.
(7) "PHYSICIAN" MEANS A PERSON AUTHORIZED UNDER CHAPTER 82
4731. OF THE REVISED CODE TO PRACTICE MEDICINE AND SURGERY, 83
OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY. 84
(B) A hospital shall prepare a finalized medical record 86
for each patient who receives health care treatment at the 87
hospital, within a reasonable time after treatment. 88
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(C) A patient OR PATIENT'S REPRESENTATIVE who wishes to 90
examine or obtain a copy of part or all of a finalized medical 92
record covering a prior inpatient stay or outpatient treatment 93
shall submit to the hospital HEALTH CARE PROVIDER a signed, 95
written request SIGNED BY THE PATIENT dated not more than sixty 96
days before the date on which it is submitted. The patient OR 98
PATIENT'S REPRESENTATIVE who wishes to obtain a copy of the 100
record shall indicate in the request whether the copy is to be 101
sent to the patient's residence, PHYSICIAN OR CHIROPRACTOR, OR 102
REPRESENTATIVE, or held for the patient at the hospital OFFICE OF 103
THE HEALTH CARE PROVIDER. Within a reasonable time after 104
receiving a request that meets the requirements of this division 105
and includes sufficient information to identify the record 106
requested, the hospital A HEALTH CARE PROVIDER THAT HAS THE 108
PATIENT'S MEDICAL RECORDS shall permit the patient to examine the 109
record during regular business hours WITHOUT CHARGE or, ON 110
REQUEST, shall provide a copy of the record in accordance with 113
the request SECTION 3701.741 OF THE REVISED CODE, except that if 114
a physician OR CHIROPRACTOR who has treated the patient 115
determines for clearly stated treatment reasons that disclosure 117
of the requested record is likely to have an adverse effect on 118
the patient, the hospital HEALTH CARE PROVIDER shall provide the 120
record to a physician OR CHIROPRACTOR designated by the patient. 122
The hospital HEALTH CARE PROVIDER shall take reasonable steps to 123
establish the identity of the patient examining, PERSON MAKING 124
THE REQUEST TO EXAMINE or requesting OBTAIN a copy of, the 126
patient's record.
(D)(C) If a hospital HEALTH CARE PROVIDER fails to furnish 129
a finalized medical record as required by division (C)(B) of this 130
section, the patient OR PATIENT'S REPRESENTATIVE who requested 132
the record may bring a civil action to enforce the patient's 133
right of access to the record.
(E)(D)(1) This section does not apply to medical records 136
whose release is covered by SECTION 173.20 OR 3721.13 OF THE 137
4
REVISED CODE, BY Chapter 1347. or 5122. of the Revised Code or, 139
by 42 C.F.R. part 2, "Confidentiality of Alcohol and Drug Abuse 140
Patient Records.," Nothing OR BY 42 C.F.R. 483.10. 142
(2) NOTHING in this section is intended to supersede the 145
confidentiality provisions of sections 2305.24 to 2305.251 of the 146
Revised Code.
Sec. 3701.741. (A) THROUGH DECEMBER 31, 2004, EACH HEALTH 149
CARE PROVIDER AND MEDICAL RECORDS COMPANY SHALL PROVIDE COPIES OF 150
MEDICAL RECORDS IN ACCORDANCE WITH THIS SECTION. 151
(B) EXCEPT AS PROVIDED IN DIVISIONS (C) AND (E) OF THIS 154
SECTION, A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY THAT 155
RECEIVES A REQUEST FOR A COPY OF A PATIENT'S MEDICAL RECORD MAY 156
CHARGE NOT MORE THAN THE AMOUNTS SET FORTH IN THIS SECTION.
TOTAL COSTS FOR COPIES AND ALL SERVICES RELATED TO THOSE COPIES 157
SHALL NOT EXCEED THE SUM OF THE FOLLOWING: 158
(1) AN INITIAL FEE OF FIFTEEN DOLLARS, WHICH SHALL 160
COMPENSATE FOR THE RECORDS SEARCH; 161
(2) WITH RESPECT TO DATA RECORDED ON PAPER, THE FOLLOWING 164
AMOUNTS:
(a) ONE DOLLAR PER PAGE FOR THE FIRST TEN PAGES; 166
(b) FIFTY CENTS PER PAGE FOR PAGES ELEVEN THROUGH FIFTY; 168
(c) TWENTY CENTS PER PAGE FOR PAGES FIFTY-ONE AND HIGHER. 170
(3) WITH RESPECT TO DATA RECORDED OTHER THAN ON PAPER, THE 172
ACTUAL COST OF MAKING THE COPY; 173
(4) THE ACTUAL COST OF ANY RELATED POSTAGE INCURRED BY THE 175
HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY. 176
(C) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY 178
SHALL PROVIDE ONE COPY WITHOUT CHARGE TO THE FOLLOWING: 179
(1) THE BUREAU OF WORKERS' COMPENSATION, IN ACCORDANCE 181
WITH CHAPTERS 4121. AND 4123. OF THE REVISED CODE AND THE RULES 182
ADOPTED UNDER THOSE CHAPTERS; 183
(2) THE INDUSTRIAL COMMISSION, IN ACCORDANCE WITH CHAPTERS 185
4121. AND 4123. OF THE REVISED CODE AND THE RULES ADOPTED UNDER 186
THOSE CHAPTERS;
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(3) THE DEPARTMENT OF JOB AND FAMILY SERVICES, IN 188
ACCORDANCE WITH CHAPTER 5101. OF THE REVISED CODE AND THE RULES 189
ADOPTED UNDER THOSE CHAPTERS;
(4) A PATIENT OR PATIENT'S REPRESENTATIVE IF THE MEDICAL 192
RECORD IS NECESSARY TO SUPPORT A CLAIM UNDER TITLE II OR TITLE 194
XVI OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 196
U.S.C.A. 401 AND 1381, AS AMENDED, AND THE REQUEST IS ACCOMPANIED 197
BY DOCUMENTATION THAT A CLAIM HAS BEEN FILED.
(D) DIVISION (C) OF THIS SECTION SHALL NOT BE CONSTRUED TO 200
SUPERSEDE ANY RULE OF THE BUREAU OF WORKERS' COMPENSATION, THE
INDUSTRIAL COMMISSION, OR THE DEPARTMENT OF JOB AND FAMILY 201
SERVICES.
(E) A HEALTH CARE PROVIDER OR MEDICAL RECORDS COMPANY MAY 204
ENTER INTO A CONTRACT WITH A PATIENT, A PATIENT'S REPRESENTATIVE, 205
OR AN INSURER FOR THE COPYING OF MEDICAL RECORDS AT A FEE OTHER 206
THAN AS PROVIDED IN DIVISION (B) OF THIS SECTION. 207
(F) THIS SECTION DOES NOT APPLY TO EITHER OF THE 209
FOLLOWING:
(1) COPIES OF MEDICAL RECORDS PROVIDED TO INSURERS 211
AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO THE 212
BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 213
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 214
UNDER CHAPTER 1751. OF THE REVISED CODE;
(2) MEDICAL RECORDS THE COPYING OF WHICH IS COVERED BY 217
SECTION 173.20 OF THE REVISED CODE OR BY 42 C.F.R. 483.10. 218
(G) NOTHING IN THIS SECTION REQUIRES OR PRECLUDES THE 221
DISTRIBUTION OF MEDICAL RECORDS AT ANY PARTICULAR COST OR FEE TO
INSURERS AUTHORIZED UNDER TITLE XXXIX OF THE REVISED CODE TO DO 223
THE BUSINESS OF SICKNESS AND ACCIDENT INSURANCE IN THIS STATE OR 224
HEALTH INSURING CORPORATIONS HOLDING A CERTIFICATE OF AUTHORITY 225
UNDER CHAPTER 1751. OF THE REVISED CODE.
Sec. 3701.742. IF THE DATE SPECIFIED IN SECTION 3701.741 227
OF THE REVISED CODE IS AMENDED TO REFLECT A DATE THAT OCCURS 228
AFTER DECEMBER 31, 2004, THEN NOT LATER THAN JANUARY 31, 2005, 229
6
THE AMOUNTS SPECIFIED IN DIVISION (B) OF SECTION 3701.741 OF THE 230
REVISED CODE AND, NOT LATER THAN THE FIRST DAY OF JANUARY OF EACH 231
YEAR THEREAFTER, ANY AMOUNTS COMPUTED BY ADJUSTMENTS MADE UNDER 232
THIS SECTION, SHALL BE INCREASED OR DECREASED BY THE AVERAGE 233
PERCENTAGE OF INCREASE OR DECREASE IN THE CONSUMER PRICE INDEX 234
FOR ALL URBAN CONSUMERS (UNITED STATES CITY AVERAGE, ALL ITEMS), 235
PREPARED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF 236
LABOR STATISTICS, FOR THE TWELVE-CALENDAR-MONTH PERIOD PRIOR TO 237
THE IMMEDIATELY PRECEDING FIRST DAY OF JANUARY OVER THE 238
IMMEDIATELY PRECEDING TWELVE-CALENDAR-MONTH PERIOD, AS REPORTED 239
BY THE BUREAU. THE DIRECTOR OF HEALTH SHALL MAKE THIS
DETERMINATION AND ADJUST THE AMOUNTS ACCORDINGLY. THE DIRECTOR 240
SHALL PROVIDE A LIST OF THE ADJUSTED AMOUNTS TO ANY PARTY UPON 241
REQUEST.
Section 2. That existing section 3701.74 of the Revised 243
Code is hereby repealed. 244