House File 2019
HOUSE FILE
BY SWAIM
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to access to patient medical records, copying
2 costs, and related matters.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 5036HH 80
5 jr/gg/14
PAG LIN
1 1 Section 1. NEW SECTION. 135D.1 ACCESS TO HEALTH CARE
1 2 RECORDS.
1 3 1. DEFINITIONS. As used in this section, unless the
1 4 context otherwise requires:
1 5 a. "Authorization" means a written or printed document
1 6 signed by a patient or a patient's authorized representative
1 7 containing:
1 8 (1) A description of the health care records a health care
1 9 provider is authorized to produce.
1 10 (2) The patient's name, address, and date of birth.
1 11 (3) A designation of the person or entity authorized to
1 12 obtain copies of the health care records.
1 13 (4) A date or event upon which the authorization expires.
1 14 (5) If signed by a patient's authorized representative,
1 15 the authorized representative's name, address, telephone
1 16 number, and relationship or legal capacity in regard to the
1 17 patient.
1 18 (6) A statement setting forth the right of the person
1 19 signing the authorization to revoke it in writing.
1 20 b. "Authorized representative" means the person designated
1 21 in writing by the patient to obtain the health care records of
1 22 the patient or the person otherwise authorized by law to
1 23 obtain the health care records of the patient.
1 24 c. "Health care provider" means either of the following:
1 25 (1) A person licensed or certified under chapter 148,
1 26 148A, 148B, 148C, 148D, 148E, 149, 150, 150A, 151, 152, 152A,
1 27 152B, 152C, 152D, 152E, 153, 154, 154A, 154B, 154C, or 155A to
1 28 provide in this state professional health care service to an
1 29 individual during that individual's medical care, treatment,
1 30 or confinement.
1 31 (2) An institutional health facility as defined in section
1 32 135.61.
1 33 2. a. A health care provider shall furnish copies of a
1 34 patient's health care records to a patient, a patient's
1 35 authorized representative, or any other person authorized by
2 1 law to obtain or reproduce such records, within thirty days of
2 2 the receipt of the authorization, or the health care provider
2 3 shall notify the patient or the patient's authorized
2 4 representative of the reasons why copies are not available.
2 5 b. A health care provider may withhold copies of health
2 6 care records if the health care provider reasonably believes
2 7 that providing copies of the requested records will cause
2 8 substantial harm to the patient or another person.
2 9 c. A health care provider may condition the furnishing of
2 10 the patient's health care records to the patient, the
2 11 patient's authorized representative, or any other person or
2 12 entity authorized by law to obtain or reproduce such records,
2 13 upon the payment of charges not to exceed a fifteen dollar fee
2 14 for the cost of supplies and labor; and for copies of health
2 15 care records routinely duplicated on a standard photocopy
2 16 machine, fifty cents per page for the first two hundred fifty
2 17 pages and thirty=five cents per page for additional pages. A
2 18 health care provider may charge for the reasonable cost of all
2 19 duplications of health care record information that cannot be
2 20 routinely duplicated on a standard photocopy machine.
2 21 3. a. A health care provider, patient, authorized
2 22 representative, or any other entity authorized by law to
2 23 obtain or reproduce health care records may bring a judicial
2 24 claim or action to enforce the provisions of this section.
2 25 b. An action pursuant to this subsection shall include an
2 26 allegation that the party bringing the action has in good
2 27 faith conferred or attempted to confer with the other party
2 28 concerning the matter in dispute without court action.
2 29 c. Upon a showing that the failure to comply with this
2 30 section was without just cause or excuse, the court shall
2 31 award the costs of the action to the prevailing party and
2 32 order the records produced without cost or expense to the
2 33 prevailing party.
2 34 4. a. The Iowa department of public health shall adopt
2 35 and enforce rules consistent with this chapter that require
3 1 licensees of the department to furnish health care records to
3 2 patients or to their authorized representatives. To the
3 3 extent that the department determines that an administrative
3 4 disciplinary remedy is appropriate for violation of such
3 5 rules, that remedy is separate from and in addition to any
3 6 remedy provided under this chapter.
3 7 b. The examining boards provided for in sections 147.12
3 8 and 147.13 shall adopt and enforce rules consistent with this
3 9 chapter that require licensed or certified persons under
3 10 chapters 148, 148A, 148B, 148C, 148D, 148E, 149, 150, 150A,
3 11 151, 152, 152A, 152B, 152C, 152D, 152E, 153, 154, 154A, 154B,
3 12 154C, and 155A to furnish health care records to patients or
3 13 to their authorized representatives. To the extent that an
3 14 examining board determines that an administrative disciplinary
3 15 remedy is appropriate for violation of such rules, that remedy
3 16 is separate from and in addition to any remedy provided under
3 17 this chapter.
3 18 c. The EMS advisory council established in section 147A.2
3 19 may recommend to the Iowa department of public health rules
3 20 consistent with this chapter that require licensed or
3 21 certified persons under chapter 147A to furnish health care
3 22 records to patients or to their authorized representatives.
3 23 5. a. This chapter shall take precedence with regard to
3 24 the calculation of fees for copies of medical records over all
3 25 other contrary or conflicting provisions of law.
3 26 b. This chapter shall not take precedence with regard to
3 27 provisions of law that are more protective of a patient's
3 28 medical records and a patient's right to privacy and
3 29 confidentiality, including but not limited to chapters 141A
3 30 and 228.
3 31 Sec. 2. Section 622.10, subsection 3, paragraph d, Code
3 32 2003, is amended to read as follows:
3 33 d. Any physician or surgeon, physician assistant, advanced
3 34 registered nurse practitioner, or mental health professional
3 35 who provides records or consults with the counsel for the
4 1 adverse party shall be entitled to charge a reasonable fee for
4 2 production of the records, diagnostic imaging, and
4 3 consultation. Any party seeking consultation shall be
4 4 responsible for payment of all charges. The fee for copies of
4 5 any records shall be based upon actual cost of production
4 6 calculated according to section 135D.1.
4 7 EXPLANATION
4 8 This bill creates new Code chapter 135D regulating access
4 9 to medical records and costs for copies of the medical
4 10 records.
4 11 The bill provides that copies of a patient's health care
4 12 records shall be furnished within 30 days of receipt of
4 13 authorization to a patient or other person authorized to
4 14 obtain or reproduce the records, or the health care provider
4 15 shall explain why copies are not available. A health care
4 16 provider may withhold records if the provider reasonably
4 17 believes the records will cause substantial harm to the
4 18 patient or another person.
4 19 Copy costs are set by statute. Supplies and labor are not
4 20 to exceed $15. Photocopies are 50 cents per page for the
4 21 first 250 pages and 35 cents per additional page. Other types
4 22 of records that cannot be photocopied may be duplicated at a
4 23 reasonable fee.
4 24 The bill provides definitions for the terms
4 25 "authorization", "authorized representative", and "health care
4 26 provider". The bill also allows the Iowa department of public
4 27 health and the various health licensing boards to set separate
4 28 administrative penalties for violations of the new chapter.
4 29 The bill provides that Code section 135D.1 takes precedence
4 30 over all provisions of law with regard to copying costs for
4 31 medical records, but not with regard to confidentiality,
4 32 privacy, or other patient protection issues, including but not
4 33 limited to those provisions in Code chapters 141A and 228,
4 34 relating to medical information about HIV and mental health,
4 35 respectively.
5 1 A corresponding amendment is made to Code section 622.10
5 2 relating to copy costs during discovery in medical cases. The
5 3 language is changed to provide that copy costs will be
5 4 calculated according to new Code section 135D.1.
5 5 LSB 5036HH 80
5 6 jr/gg/14