House Study Bill 94 



                                       HOUSE FILE       
                                       BY  (PROPOSED COMMITTEE ON
                                            JUDICIARY BILL BY
                                            CHAIRPERSON SWAIM)


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to communications made in professional confidence
  2    concerning health care and health care records and providing
  3    for fees.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 1774HC 82
  6 rh/je/5

PAG LIN



  1  1    Section 1.  Section 622.10, subsection 3, paragraphs a, d,
  1  2 and e, Code 2007, are amended to read as follows:
  1  3    a.  In a civil action in which the condition of the
  1  4 plaintiff in whose favor the prohibition is made is an element
  1  5 or factor of the claim or defense of the adverse party or of
  1  6 any party claiming through or under the adverse party, the
  1  7 adverse party shall make a written request for records
  1  8 relating to the condition alleged upon the plaintiff's counsel
  1  9 for a legally sufficient patient's waiver under federal and
  1 10 state law.  Upon receipt of a written request, the plaintiff
  1 11 shall execute the a legally sufficient patient's waiver and
  1 12 release it to the adverse party making the request within
  1 13 sixty days of receipt of the written request.  The patient's
  1 14 waiver may require a physician or surgeon, physician
  1 15 assistant, advanced registered nurse practitioner, or mental
  1 16 health professional to do all of the following:
  1 17    (1)  Provide a complete copy of the patient's records
  1 18 including, but not limited to, any reports or diagnostic
  1 19 imaging relating to the condition alleged.
  1 20    (2)  Consult with the attorney for the adverse party prior
  1 21 to providing testimony regarding the plaintiff's medical
  1 22 history and the condition alleged and opinions regarding
  1 23 health etiology and prognosis for the condition alleged
  1 24 subject to the limitations in paragraph paragraphs "c" and
  1 25 "e".
  1 26    d.  Any physician or surgeon, physician assistant, advanced
  1 27 registered nurse practitioner, or mental health professional
  1 28 who provides records or consults with the counsel for the
  1 29 adverse any party shall be entitled to charge a reasonable fee
  1 30 for production of the records, diagnostic imaging, and
  1 31 consultation.  Any party seeking consultation shall be
  1 32 responsible for payment of all charges.  The fee fees for
  1 33 copies of any records shall be based upon actual cost of
  1 34 production be as specified in subsection 5.
  1 35    e.  Defendant's counsel shall provide a written notice to
  2  1 plaintiff's counsel in a manner consistent with the Iowa rules
  2  2 of civil procedure providing for notice of deposition at least
  2  3 ten days prior to any meeting with plaintiff's physician or
  2  4 surgeon, physician assistant, advanced registered nurse
  2  5 practitioner, or mental health professional.  Plaintiff's
  2  6 counsel has the right to be present at all such meetings, or
  2  7 participate in telephonic communication with the physician or
  2  8 surgeon, physician assistant, advanced registered nurse
  2  9 practitioner, or mental health professional and counsel for
  2 10 the defendant.  Prior to scheduling any meeting or engaging in
  2 11 any communication with the physician or surgeon, physician
  2 12 assistant, advanced registered nurse practitioner, or mental
  2 13 health professional, counsel for the defendant shall confer
  2 14 with plaintiff's counsel to determine a mutually convenient
  2 15 date and time for such meeting or telephonic communication.
  2 16 Plaintiff's counsel may seek a protective order structuring
  2 17 all communication by making application to the court at any
  2 18 time.
  2 19    Sec. 2.  Section 622.10, subsection 4, Code 2007, is
  2 20 amended to read as follows:
  2 21    4.  If an adverse party desires the oral deposition, either
  2 22 discovery or evidentiary, of a physician or surgeon, physician
  2 23 assistant, advanced registered nurse practitioner, or mental
  2 24 health professional to which the prohibition would otherwise
  2 25 apply or the stenographer or confidential clerk of a physician
  2 26 or surgeon, physician assistant, advanced registered nurse
  2 27 practitioner, or mental health professional or desires to call
  2 28 a physician or surgeon, physician assistant, advanced
  2 29 registered nurse practitioner, or mental health professional
  2 30 to which the prohibition would otherwise apply or the
  2 31 stenographer or confidential clerk of a physician or surgeon,
  2 32 physician assistant, advanced registered nurse practitioner,
  2 33 or mental health professional as a witness at the trial of the
  2 34 action, the adverse party shall file an application with the
  2 35 court for permission to do so.  The court upon hearing, which
  3  1 shall not be ex parte, shall grant permission unless the court
  3  2 finds that the evidence sought does not relate to the
  3  3 condition alleged and.  At the request of any party or at the
  3  4 request of the deponent, the court shall fix a reasonable fee
  3  5 to be paid to the a physician or surgeon, physician assistant,
  3  6 advanced registered nurse practitioner, or mental health
  3  7 professional by the party taking the deposition or calling the
  3  8 witness.
  3  9    Sec. 3.  Section 622.10, Code 2007, is amended by adding
  3 10 the following new subsection:
  3 11    NEW SUBSECTION.  4A.  At any time, upon a written request
  3 12 from a patient, a patient's representative, or an adverse
  3 13 party pursuant to subsection 3, accompanied by a legally
  3 14 sufficient patient's waiver, any physician or surgeon,
  3 15 physician assistant, advanced registered nurse practitioner,
  3 16 mental health professional, hospital, nursing home, or other
  3 17 person, entity, facility, or organization that furnishes,
  3 18 bills, or pays for health care in the normal course of
  3 19 business, shall provide copies of the requested records or
  3 20 images to the requestor within thirty days of receipt of the
  3 21 written request.  Except as provided in paragraph "e", a fee
  3 22 may be charged for the cost of producing such copies or images
  3 23 but the fee shall not exceed the following:
  3 24    a.  For printed or photocopied records, twelve cents per
  3 25 single=sided page or seventeen cents per double=sided page.
  3 26    b.  For images provided in a nonelectronic format including
  3 27 but not limited to X rays, diagnostic images, photographs, or
  3 28 other graphic image records, the actual cost of materials and
  3 29 supplies used to produce the copies of such images, or ten
  3 30 dollars per item, whichever is less.
  3 31    c.  For electronically scanned or produced records or
  3 32 images, the actual cost of the materials and supplies incurred
  3 33 in producing the physical media in which the electronic
  3 34 records or images are stored, or five dollars per physical
  3 35 media necessary to hold the data, whichever is less.
  4  1    d.  If applicable, the actual cost of postage or delivery
  4  2 charges incurred may be added to the amounts charged in
  4  3 paragraphs "a" through "c".
  4  4    e.  A patient or a patient's representative is entitled to
  4  5 a copy free of charge of the patient's complete billing or
  4  6 accounting statement showing all charges, payments,
  4  7 adjustments, and write=offs, including the dates and sources
  4  8 thereof, subject only to a charge for the actual costs of
  4  9 postage and delivery charges incurred in providing the
  4 10 statement.
  4 11    Fees charged pursuant to this subsection are not subject to
  4 12 a sales or use tax.  A physician or surgeon, physician
  4 13 assistant, advanced registered nurse practitioner, mental
  4 14 health professional, hospital, nursing home, or other person,
  4 15 entity, facility, or organization providing the records or
  4 16 images may require payment in advance if an itemized statement
  4 17 demanding such is provided to the requesting party within
  4 18 fifteen days of the request.  Upon a timely request for
  4 19 payment in advance, the time for providing the records or
  4 20 images shall be extended until the greater of thirty days from
  4 21 the date of the original request or ten days from the receipt
  4 22 of payment.
  4 23                           EXPLANATION
  4 24    This bill relates to communications made in professional
  4 25 confidence concerning health care and health care records and
  4 26 provides for fees.
  4 27    The bill provides that in a civil action in which the
  4 28 health condition of a plaintiff is an element or factor of the
  4 29 claim or defense, defendant's counsel and plaintiff's counsel
  4 30 shall determine a mutually convenient date and time for any
  4 31 meeting or telephonic communication with the physician or
  4 32 surgeon, physician assistant, advanced registered nurse
  4 33 practitioner, or mental health professional.  In addition, the
  4 34 bill provides that if an adverse party desires the oral
  4 35 deposition, either discovery or evidentiary, of a physician or
  5  1 surgeon, physician assistant, advanced registered nurse
  5  2 practitioner, or mental health professional, or the
  5  3 stenographer or confidential clerk of a physician or surgeon,
  5  4 physician assistant, advanced registered nurse practitioner,
  5  5 or mental health professional or desires to call a physician
  5  6 or surgeon, physician assistant, advanced registered nurse
  5  7 practitioner, or mental health professional, or the
  5  8 stenographer or confidential clerk of a physician or surgeon,
  5  9 physician assistant, advanced registered nurse practitioner,
  5 10 or mental health professional as a witness at the trial of the
  5 11 civil action, upon request of either party or the person being
  5 12 deposed, the court shall fix a reasonable fee to be paid to a
  5 13 physician or surgeon, physician assistant, advanced registered
  5 14 nurse practitioner, or mental health professional by the party
  5 15 taking the deposition or calling the witness.
  5 16    The bill provides that an adverse party in a civil action
  5 17 in which the health condition of a plaintiff is an element or
  5 18 factor of the claim or defense, an adverse party who requests
  5 19 records relating to the condition of the plaintiff or a
  5 20 patient or a patient's representative not involved in a civil
  5 21 action but who desires a copy of the patient's health records
  5 22 shall be charged a fee for production of the health records,
  5 23 which may include diagnostic imaging.  The fees for copies of
  5 24 any records shall be provided within 30 days of receipt of the
  5 25 written request.  The bill provides that fees charged for the
  5 26 cost of producing such copies or images shall not exceed
  5 27 certain specified costs, depending on the nature of the record
  5 28 requested.  Additional costs may include the actual cost of
  5 29 postage or delivery charges.  The bill also provides that a
  5 30 patient or a patient's representative is entitled to a copy
  5 31 free of charge of the patient's complete billing or accounting
  5 32 statement, subject only to a charge for the actual costs of
  5 33 postage and delivery charges incurred in providing the
  5 34 statement.  In addition, the person, entity, facility, or
  5 35 organization providing the records or images may require
  6  1 payment in advance and the time for providing the records or
  6  2 images shall be extended until the greater of 30 days from the
  6  3 date of the original request or 10 days from the receipt of
  6  4 payment.
  6  5 LSB 1774HC 82
  6  6 rh:rj/je/5