Senate Study Bill 3105 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON MATHIS) A BILL FOR An Act relating to a patient’s designation and authorization of 1 a person to whom the patient’s health care information may 2 be disclosed. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5101XC (6) 86 pf/rj

S.F. _____ Section 1. NEW SECTION . 144E.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Health care” means any care, treatment, service, or 4 procedure to maintain, diagnose, or treat a patient’s physical 5 or mental condition. 6 2. “Health care provider” means a person, health care 7 facility, organization, or corporation licensed, certified, or 8 otherwise authorized or permitted by the state to administer 9 health care other than a nursing facility licensed under 10 chapter 135C or a dentist or dental hygienist licensed under 11 chapter 153. 12 3. “Patient” means an individual sixteen years of age or 13 older who presents or is presented to a health care provider 14 for health care. 15 4. “Treatment” means the broad range of emergency, 16 outpatient, intermediate, and inpatient services and care that 17 may be extended to a patient to diagnose and treat a human 18 disease, ailment, defect, abnormality, or complaint, whether 19 of physical or mental origin. 20 Sec. 2. NEW SECTION . 144E.2 Authorization of disclosure of 21 health care information to designated person. 22 1. A health care provider or the health care provider’s 23 agent shall offer to a patient, in the patient’s written 24 information form or electronic health record, the opportunity 25 for the patient to designate and authorize a family member or 26 other individual as a person with whom the health care provider 27 may discuss the patient’s health care information. 28 2. The authorization provided for in subsection 1 shall meet 29 all of the following conditions: 30 a. Satisfy the requirements relating to disclosure of 31 certain health information with a patient’s consent specified 32 in Code of Federal Regulations, Title 42, and the federal 33 Health Insurance Portability and Accountability Act of 1996, 34 Pub. L. No. 104-191. 35 -1- LSB 5101XC (6) 86 pf/rj 1/ 4

S.F. _____ b. Present the question in bold print, or by electronic 1 means: ‘Do you want to designate a family member or other 2 individual with whom the health care provider may discuss your 3 health care information? If yes, with whom?’ 4 c. Specify that the patient may revoke or modify an 5 authorization with regard to any family member or other 6 individual designated by the patient in the authorization and 7 that the revocation or modification must be in writing. 8 3. A health care provider may disclose a patient’s health 9 care information pursuant to an authorization under this 10 section unless the provider has actual knowledge that the 11 authorization has been revoked or modified. 12 4. A health care provider who in good faith discloses 13 a patient’s health care information in accordance with an 14 authorization pursuant to this section is not subject to civil 15 liability, criminal liability, or disciplinary action because 16 of the disclosure. 17 5. This section shall not be construed to do any of the 18 following: 19 a. Require a health care provider to disclose a patient’s 20 health care information if the health care provider is 21 otherwise authorized to withhold the health care information 22 or limit its disclosure. 23 b. Prevent a health care provider from disclosing a 24 patient’s health care information without written authorization 25 from the patient if the disclosure is otherwise permitted by 26 law without the patient’s specific authorization or permission. 27 c. Prohibit a health care provider from receiving health 28 care information from family members and other individuals and 29 using such health care information if relevant to the safe and 30 effective treatment of the patient. 31 d. Conflict with a durable power of attorney for health care 32 executed by the patient as provided for in chapter 144B. 33 EXPLANATION 34 The inclusion of this explanation does not constitute agreement with 35 -2- LSB 5101XC (6) 86 pf/rj 2/ 4

S.F. _____ the explanation’s substance by the members of the general assembly. 1 This bill provides a process for a health care provider or 2 the health care provider’s agent to provide the opportunity for 3 a patient to designate in the patient’s written information 4 form or electronic health record, a family member or other 5 individual the patient authorizes as a person with whom the 6 health care provider may discuss the patient’s health care 7 information. The bill requires that the authorization meet 8 federal requirements for the sharing of a patient’s health 9 information; present the question in bold print, or by 10 electronic means: ‘Do you want to designate a family member 11 or other individual with whom the health care provider may 12 discuss your health care information? If yes, with whom?’; and 13 specify that the patient may revoke or modify an authorization 14 with regard to any family member or other individual designated 15 by the patient in the authorization and that the revocation or 16 modification must be in writing. Under the bill, a health care 17 provider may disclose health care information pursuant to an 18 authorization unless the provider has actual knowledge that 19 the authorization has been revoked or modified. A health care 20 provider who in good faith discloses information in accordance 21 with an authorization is not subject to civil liability, 22 criminal liability, or disciplinary action because of the 23 disclosure. 24 The bill provides that the bill is not to be construed 25 to require a health care provider to disclose health care 26 information if the health care provider is otherwise authorized 27 to withhold or limit the disclosure of such information; 28 prevent a health care provider from disclosing a patient’s 29 health care information without written authorization from 30 the patient if the disclosure is otherwise permitted by law 31 without the patient’s specific authorization or permission; 32 prohibit a provider from receiving health care information from 33 family members or other individuals and using such health care 34 information if such health care information is relevant to the 35 -3- LSB 5101XC (6) 86 pf/rj 3/ 4

S.F. _____ safe and effective provision of health care to the patient; or 1 conflict with a patient’s durable power of attorney for health 2 care. 3 The bill defines “health care”, “health care provider”, 4 “patient”, and “treatment”, but provides that the bill does not 5 apply to a licensed nursing facility or to a licensed dentist 6 or dental hygienist. 7 -4- LSB 5101XC (6) 86 pf/rj 4/ 4