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PAG LIN
1 1 Section 1. NEW SECTION. 135.29A HEALTH CARE PROVIDER
1 2 RECORDS – DUPLICATION FOR PROVISION TO PATIENT.
1 3 1. As used in this section, unless the context otherwise
1 4 requires:
1 5 a. "Health care provider" or "provider" means a person
1 6 licensed to practice medical surgery pursuant to chapter 148,
1 7 physical therapy pursuant to chapter 148A, occupational
1 8 therapy pursuant to chapter 148B, acupuncture pursuant to
1 9 chapter 148E, podiatry pursuant to chapter 149, osteopathy
1 10 pursuant to chapter 150, osteopathic medicine and surgery
1 11 pursuant to chapter 150A, chiropractic pursuant to chapter
1 12 151, nursing pursuant to chapter 152, dietetics pursuant to
1 13 chapter 152A, respiratory care pursuant to chapter 152B,
1 14 message therapy pursuant to chapter 152C, dentistry pursuant
1 15 to chapter 153, optometry pursuant to chapter 154, psychology
1 16 pursuant to chapter 154B, social work pursuant to chapter
1 17 154C, behavioral science pursuant to chapter 154D, or licensed
1 18 as a physician assistant pursuant to chapter 148C, a hospital
1 19 licensed pursuant to chapter 135B, and a health care facility
1 20 licensed pursuant to chapter 135C.
1 21 b. "Health record" includes but is not limited to
1 22 evaluations, diagnoses, prognoses, treatment, history, charts,
1 23 pictures, laboratory reports, X rays, prescriptions, and other
1 24 technical information used in assessing a patient's condition.
1 25 c. "Individually identifiable form" means a form in which
1 26 the patient is or can be identified as the subject of the
1 27 health records.
1 28 d. "Patient" means a natural person who has received
1 29 health care services from a health care provider for treatment
1 30 or examination of a medical, psychiatric, or mental condition,
1 31 the surviving spouse or parents of a deceased patient, or a
1 32 person the patient designates, in writing, as a
1 33 representative.
1 34 2. a. Upon request, a provider shall supply to a patient
1 35 complete and current information possessed by that provider
2 1 concerning any diagnosis, treatment, and prognosis of the
2 2 patient in terms and language the patient can reasonably be
2 3 expected to understand.
2 4 b. Except as provided in paragraph "e", upon a patient's
2 5 written request, a provider, at a reasonable cost to the
2 6 patient, shall promptly furnish to the patient any of the
2 7 following:
2 8 (1) Copies of the patient's health record, including but
2 9 not limited to laboratory reports, X rays, prescriptions, and
2 10 other technical information used in assessing the patient's
2 11 health condition.
2 12 (2) The pertinent portion of the patient's health record
2 13 relating to a condition specified by the patient.
2 14 With the consent of the patient, the provider may instead
2 15 furnish only a summary of the health record or pertinent
2 16 portion of the health record. The provider may exclude from
2 17 the health record written speculations about the patient's
2 18 health condition, except that all information necessary for
2 19 the patient's informed consent shall be provided.
2 20 c. If a provider reasonably determines that any
2 21 information in the health record is detrimental to the
2 22 physical or mental health of the patient, or is likely to
2 23 cause the patient to inflict self-harm, or to harm another,
2 24 the provider may withhold the information from the patient and
2 25 may supply the information to an appropriate third party or to
2 26 another provider. The other provider or third party may
2 27 release the information to the patient.
2 28 d. A provider who is a health care facility or hospital
2 29 shall release information upon written request of a patient
2 30 unless, prior to the request, a provider who is not a health
2 31 care facility or hospital has designated and described a
2 32 specific basis for withholding the information as authorized
2 33 in paragraph "c".
2 34 e. A provider shall not release a copy of a videotape of a
2 35 child victim or alleged victim of physical or sexual abuse
3 1 without a court order. This paragraph does not limit the
3 2 right of the patient to view the videotape.
3 3 3. A patient's health record, including but not limited to
3 4 laboratory reports, X rays, prescriptions, and other technical
3 5 information used in assessing the patient's condition, or the
3 6 pertinent portion of the health record relating to a specific
3 7 condition, or a summary of the health record, shall promptly
3 8 be furnished to another provider upon the written request of
3 9 the patient. The written request shall specify the name of
3 10 the provider to whom the health record is to be furnished.
3 11 The provider who furnishes the health record or summary may
3 12 retain a copy of the materials furnished. The patient shall
3 13 be responsible for the reasonable costs of furnishing the
3 14 information.
3 15 4. a. A provider, or a person who receives health records
3 16 from a provider, shall not release a patient's health records
3 17 to a person without a signed and dated consent from the
3 18 patient or the patient's legally authorized representative
3 19 authorizing the release, unless the release is specifically
3 20 authorized by law. Except as provided in paragraph "c" or
3 21 "d", a consent is valid for one year or for a lesser period
3 22 specified in the consent or for a different period provided by
3 23 law.
3 24 b. This subsection does not prohibit the release of health
3 25 records:
3 26 (1) For a medical emergency when the provider is unable to
3 27 obtain the patient's consent due to the patient's condition or
3 28 the nature of the medical emergency.
3 29 (2) To other providers within related health care entities
3 30 when necessary for the current treatment of the patient.
3 31 c. Notwithstanding paragraph "a", if a patient explicitly
3 32 gives informed consent to the release of health records for
3 33 the purposes of and pursuant to the restrictions in
3 34 subparagraph (1) or (2), the consent does not expire after one
3 35 year for either of the following:
4 1 (1) The release of health records to a provider who is
4 2 being advised or consulted with in connection with the current
4 3 treatment of the patient.
4 4 (2) The release of health records to an accident and
4 5 health insurer, health service plan corporation, health
4 6 maintenance organization, or third-party administrator for
4 7 purposes of payment of claims, fraud investigation, or quality
4 8 of care review and studies, provided that:
4 9 (a) Further use or release of the records in individually
4 10 identifiable form to a person other than the patient without
4 11 the patient's consent is prohibited.
4 12 (b) The recipient establishes adequate safeguards to
4 13 protect the records from unauthorized disclosure, including a
4 14 procedure for removal or destruction of information that
4 15 identifies the patient.
4 16 d. Notwithstanding paragraph "a", health records may be
4 17 released to a researcher solely for purposes of medical or
4 18 scientific research only as follows:
4 19 (1) Health records generated before January 1, 1999, may
4 20 be released if the patient has not objected or does not elect
4 21 to object after that date.
4 22 (2) For health records generated on or after January 1,
4 23 1999, the provider shall:
4 24 (a) Disclose in writing to patients currently being
4 25 treated by the provider that health records, regardless of
4 26 when generated, may be released for research purposes and that
4 27 the patient may object, in which case the records will not be
4 28 released.
4 29 (b) Obtain the patient's written general authorization
4 30 that describes the release of records in subparagraph
4 31 subdivision (a), which does not expire but may be revoked or
4 32 limited in writing at any time by the patient.
4 33 (3) At the request of the patient, a health care provider
4 34 shall provide information on how the patient may contact an
4 35 external researcher to whom the health record was released and
5 1 the date it was released.
5 2 (4) In making a release for research purposes, the
5 3 provider shall make a reasonable effort to determine that:
5 4 (a) The use or disclosure does not violate any limitations
5 5 under which the record was collected.
5 6 (b) The use or disclosure in individually identifiable
5 7 form is necessary to accomplish the research or statistical
5 8 purpose for which the use or disclosure is to be made.
5 9 (c) The recipient has established and maintains adequate
5 10 safeguards to protect the records from unauthorized
5 11 disclosure, including a procedure for removal or destruction
5 12 of information that identifies the patient.
5 13 (d) Further use or release of the records in individually
5 14 identifiable form to a person other than the patient without
5 15 the patient's consent is prohibited.
5 16 e. A person who negligently or intentionally releases a
5 17 health record in violation of this subsection, or who forges a
5 18 signature on a consent form, or who obtains under false
5 19 pretenses the consent form or health records of another
5 20 person, or who, without the patient's consent, alters a
5 21 consent form, is liable to the patient for compensatory
5 22 damages caused by an unauthorized release, plus costs and
5 23 reasonable attorney's fees.
5 24 f. Upon the written request of a spouse, parent, child, or
5 25 sibling of a patient being evaluated for or diagnosed with
5 26 mental illness, a provider shall inquire of a patient whether
5 27 the patient wishes to authorize a specific individual to
5 28 receive information regarding the patient's current and
5 29 proposed course of treatment. If the patient so consents, the
5 30 provider shall communicate to the designated individual the
5 31 patient's current and proposed course of treatment. Paragraph
5 32 "a" applies to consent provided under this paragraph.
5 33 g. If a provider releases health records without patient
5 34 consent as authorized by law, the release shall be documented
5 35 in the patient's health record.
6 1 5. Subsection 3 does not apply to the release of health
6 2 records to the director of public health or the health data
6 3 commission, provided that the director encrypts the patient
6 4 identifier upon receipt of the data.
6 5 6. This section applies to the subject and provider of an
6 6 independent medical examination requested by or paid for by a
6 7 third party. Notwithstanding subsection 3, a provider may
6 8 release health records created as part of an independent
6 9 medical examination to the third party who requested or paid
6 10 for the examination.
6 11 7. The department shall adopt rules prescribing uniform
6 12 fees, based upon the actual cost of duplication, that a
6 13 provider may charge for duplication of health records
6 14 requested by a patient under this section. The rules adopted
6 15 may provide for an additional fee based upon the actual costs
6 16 for postage or other means of delivery and may provide for an
6 17 annual increase based upon the annual rate of inflation for
6 18 the preceding calendar year as determined by the consumer
6 19 price index published by the bureau of labor statistics of the
6 20 United States department of labor.
6 21 8. A provider shall provide to patients, in a clear and
6 22 conspicuous manner, a written notice concerning practices and
6 23 rights with respect to access to health records. The notice
6 24 shall include an explanation of all of the following:
6 25 a. Disclosures of health records that may be made without
6 26 the written consent of the patient, including the type of
6 27 records and to whom the health records may be disclosed.
6 28 b. The right of the patient to have access to and obtain
6 29 copies of the patient's health records and other information
6 30 about the patient that is maintained by the provider.
6 31 The notice requirements of this paragraph are satisfied if
6 32 the notice is displayed prominently in the provider's place of
6 33 business. The director of public health shall develop the
6 34 notice required in this subsection.
6 35 9. A violation of this section is grounds for disciplinary
7 1 action against a provider by the appropriate licensing board
7 2 or agency.
7 3 EXPLANATION
7 4 This bill requires a health care provider to allow a
7 5 patient access to the patient's health record and upon written
7 6 request of the patient, copies of the health record at a
7 7 reasonable cost. The bill provides that if the health care
7 8 provider reasonably determines that the information is
7 9 detrimental to the physical or mental health of the patient,
7 10 or is likely to cause the patient to harm the patient or
7 11 another person, the health care provider may withhold the
7 12 record and instead provide the record to a third party or
7 13 another provider upon the request of the patient. The bill
7 14 requires the Iowa department of public health to adopt rules
7 15 to establish uniform fees which may be charged for duplication
7 16 of the records. The bill also provides for limitations on the
7 17 release of patient health records, the use of information in
7 18 the health records, and disciplinary action against a provider
7 19 who violates the bill.
7 20 LSB 3011XS 77
7 21 pf/jl/8
Text: SF02063 Text: SF02065 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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