Senate File 2155 - Introduced



                                       SENATE FILE       
                                       BY  COMMITTEE ON JUDICIARY

                                       (SUCCESSOR TO SF 522)
                                       (SUCCESSOR TO SSB 1097)


    Passed Senate,  Date               Passed House, 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, patient access to the patient's
  3    medical file, and health care records and providing for fees.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 6482SZ 82
  6 rh/rj/5

PAG LIN



  1  1    Section 1.  Section 622.10, subsection 3, paragraphs a, d,
  1  2 and e, Code Supplement 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 attorney for a legally sufficient patient's waiver under
  1 10 federal and state law.  Upon receipt of a written request, the
  1 11 plaintiff shall execute the a legally sufficient patient's
  1 12 waiver and release it to the adverse party making the request
  1 13 within sixty days of receipt of the written request.  The
  1 14 patient's 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 attorney for
  1 29 the adverse any party shall be entitled to charge a reasonable
  1 30 fee 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 4A.
  1 35    e.  Defendant's counsel shall provide a written notice to
  2  1 plaintiff's counsel attorney in a manner consistent with the
  2  2 Iowa rules of civil procedure providing for notice of
  2  3 deposition at least ten days prior to any meeting with
  2  4 plaintiff's physician or surgeon, physician assistant,
  2  5 advanced registered nurse practitioner, or mental health
  2  6 professional.  Plaintiff's counsel attorney has the right to
  2  7 be present at all such meetings, or participate in telephonic
  2  8 communication with the physician or surgeon, physician
  2  9 assistant, advanced registered nurse practitioner, or mental
  2 10 health professional and counsel attorney for the defendant.
  2 11 Prior to scheduling any meeting or engaging in any
  2 12 communication with the physician or surgeon, physician
  2 13 assistant, advanced registered nurse practitioner, or mental
  2 14 health professional, attorney for the defendant shall confer
  2 15 with plaintiff's attorney to determine a mutually convenient
  2 16 date and time for such meeting or telephonic communication.
  2 17 Plaintiff's counsel attorney may seek a protective order
  2 18 structuring all communication by making application to the
  2 19 court at any time.
  2 20    Sec. 2.  Section 622.10, subsection 4, Code Supplement
  2 21 2007, is amended to read as follows:
  2 22    4.  If an adverse party desires the oral deposition, either
  2 23 discovery or evidentiary, of a physician or surgeon, physician
  2 24 assistant, advanced registered nurse practitioner, or mental
  2 25 health professional to which the prohibition would otherwise
  2 26 apply or the stenographer or confidential clerk of a physician
  2 27 or surgeon, physician assistant, advanced registered nurse
  2 28 practitioner, or mental health professional or desires to call
  2 29 a physician or surgeon, physician assistant, advanced
  2 30 registered nurse practitioner, or mental health professional
  2 31 to which the prohibition would otherwise apply or the
  2 32 stenographer or confidential clerk of a physician or surgeon,
  2 33 physician assistant, advanced registered nurse practitioner,
  2 34 or mental health professional as a witness at the trial of the
  2 35 action, the adverse party shall file an application with the
  3  1 court for permission to do so.  The court upon hearing, which
  3  2 shall not be ex parte, shall grant permission unless the court
  3  3 finds that the evidence sought does not relate to the
  3  4 condition alleged and.  At the request of any party or at the
  3  5 request of the deponent, the court shall fix a reasonable fee
  3  6 to be paid to the a physician or surgeon, physician assistant,
  3  7 advanced registered nurse practitioner, or mental health
  3  8 professional by the party taking the deposition or calling the
  3  9 witness.
  3 10    Sec. 3.  Section 622.10, Code Supplement 2007, is amended
  3 11 by adding the following new subsection:
  3 12    NEW SUBSECTION.  4A.  At any time, upon a written request
  3 13 from a patient, a patient's legal representative or attorney,
  3 14 or an adverse party pursuant to subsection 3, any provider
  3 15 shall provide copies of the requested records or images to the
  3 16 requester within thirty days of receipt of the written
  3 17 request.  The written request shall be accompanied by a
  3 18 legally sufficient patient's waiver unless the request is made
  3 19 by the patient or the patient's legal representative or
  3 20 attorney.  The provider shall also produce copies of patient
  3 21 records or images contained in the provider's files generated
  3 22 by another provider.
  3 23    a.  The fee charged for the cost of producing the requested
  3 24 records or images shall be based upon the actual cost of
  3 25 production.  If the written request and accompanying patient's
  3 26 waiver, if required, authorizes the release of all of the
  3 27 patient's records for the requested time period, including
  3 28 records relating to the patient's mental health, substance
  3 29 abuse, and acquired immune deficiency syndrome=related
  3 30 conditions, the amount charged shall not exceed the rates
  3 31 established by the workers' compensation commissioner for
  3 32 copies of records in workers' compensation cases.  In
  3 33 addition, a retrieval fee of up to twenty=five dollars per
  3 34 request may be charged for up to two requests.  If requested,
  3 35 the provider shall include an affidavit certifying that the
  4  1 records or images produced are true and accurate copies of the
  4  2 originals for an additional fee not to exceed ten dollars.
  4  3    b.  A patient or a patient's legal representative or a
  4  4 patient's attorney is entitled to one copy free of charge of
  4  5 the patient's complete billing statement, subject only to a
  4  6 charge for the actual costs of postage or delivery charges
  4  7 incurred in providing the statement.  If requested, the
  4  8 provider or custodian of the record shall include an affidavit
  4  9 certifying the billing statements produced to be true and
  4 10 accurate copies of the originals for an additional fee not to
  4 11 exceed ten dollars.
  4 12    c.  Fees charged pursuant to this subsection are not
  4 13 subject to a sales or use tax.  A provider providing the
  4 14 records or images may require payment in advance if an
  4 15 itemized statement demanding such is provided to the
  4 16 requesting party within fifteen days of the request.  Upon a
  4 17 timely request for payment in advance, the time for providing
  4 18 the records or images shall be extended until the greater of
  4 19 thirty days from the date of the original request or ten days
  4 20 from the receipt of payment.
  4 21    d.  If a provider does not provide to the requester all
  4 22 records or images encompassed by the request or does not allow
  4 23 a patient access to all of the patient's medical records
  4 24 encompassed by the patient's request to examine the patient's
  4 25 records, the provider shall give written notice to the
  4 26 requester or the patient that providing the requested records
  4 27 or images would be a violation of the federal Health Insurance
  4 28 Portability and Accountability Act of 1996, Pub. L.  No.
  4 29 104=191.
  4 30    e.  As used in this subsection:
  4 31    (1)  "Records" and "images" include electronic media and
  4 32 data containing a patient's health or billing information and
  4 33 "copies" includes patient records or images provided in
  4 34 electronic form, regardless of the form of the originals.  If
  4 35 consented to by the requesting party, records and images
  5  1 produced pursuant to this subsection may be produced on
  5  2 electronic media.
  5  3    (2)  "Provider" means any physician or surgeon, physician
  5  4 assistant, advanced registered nurse practitioner, mental
  5  5 health professional, hospital, nursing home, or other person,
  5  6 entity, facility, or organization that furnishes, bills, or is
  5  7 paid for health care in the normal course of business.
  5  8                           EXPLANATION
  5  9    This bill relates to communications made in professional
  5 10 confidence concerning health care and health care records and
  5 11 provides for fees.
  5 12    The bill provides that in a civil action in which the
  5 13 health condition of a plaintiff is an element or factor of the
  5 14 claim or defense, defendant's attorney and plaintiff's
  5 15 attorney shall determine a mutually convenient date and time
  5 16 for any meeting or telephonic communication with the physician
  5 17 or surgeon, physician assistant, advanced registered nurse
  5 18 practitioner, or mental health professional.  In addition, the
  5 19 bill provides that if an adverse party desires the oral
  5 20 deposition, either discovery or evidentiary, of a physician or
  5 21 surgeon, physician assistant, advanced registered nurse
  5 22 practitioner, or mental health professional, or the
  5 23 stenographer or confidential clerk of a physician or surgeon,
  5 24 physician assistant, advanced registered nurse practitioner,
  5 25 or mental health professional or desires to call a physician
  5 26 or surgeon, physician assistant, advanced registered nurse
  5 27 practitioner, or mental health professional, or the
  5 28 stenographer or confidential clerk of a physician or surgeon,
  5 29 physician assistant, advanced registered nurse practitioner,
  5 30 or mental health professional as a witness at the trial of the
  5 31 civil action, upon request of either party or the person being
  5 32 deposed, the court shall fix a reasonable fee to be paid to a
  5 33 physician or surgeon, physician assistant, advanced registered
  5 34 nurse practitioner, or mental health professional by the party
  5 35 taking the deposition or calling the witness.
  6  1    The bill provides that at any time, upon a written request
  6  2 from a patient, a patient's legal representative or attorney,
  6  3 or an adverse party, any provider shall provide copies of the
  6  4 requested records or images to the requester within 30 days of
  6  5 receipt of the written request.  The written request shall
  6  6 include a legally sufficient patient's waiver unless the
  6  7 request is made by the patient or the patient's
  6  8 representative.
  6  9    The bill provides that the fee charged for the cost of
  6 10 producing the requested records or images shall be based upon
  6 11 the actual cost of production.  If the written request and
  6 12 accompanying patient's waiver, if required, authorizes the
  6 13 release of all of the patient's records for the requested time
  6 14 period, the amount charged shall not exceed the rates
  6 15 established by the workers' compensation commissioner for
  6 16 copies of records in workers' compensation cases.  In
  6 17 addition, a retrieval fee of up to $25 per request may be
  6 18 charged for up to two requests and, if requested, the provider
  6 19 shall include an affidavit certifying that the records or
  6 20 images produced are true and accurate copies of the originals
  6 21 for an additional fee not to exceed $10.
  6 22    The bill provides that a patient or a patient's legal
  6 23 representative or a patient's attorney is entitled to one copy
  6 24 free of charge of the patient's complete billing statement,
  6 25 subject only to a charge for the actual costs of postage or
  6 26 delivery charges incurred in providing the statement.  If
  6 27 requested, the provider or custodian of the record shall
  6 28 include an affidavit certifying the billing statements
  6 29 produced to be true and accurate copies of the originals for
  6 30 an additional fee not to exceed $10.
  6 31    The bill provides that fees charged pursuant to the bill
  6 32 are not subject to a sales or use tax.  A provider providing
  6 33 the records or images may require payment in advance if an
  6 34 itemized statement demanding such is provided to the
  6 35 requesting party within 15 days of the request.  Upon a timely
  7  1 request for payment in advance, the time for providing the
  7  2 records or images shall be extended until the greater of 30
  7  3 days from the date of the original request or 10 days from the
  7  4 receipt of payment.
  7  5    The bill provides that if a provider does not provide to
  7  6 the requester all records or images encompassed by the request
  7  7 or does not allow a patient access to all of the patient's
  7  8 medical records encompassed by the patient's request to
  7  9 examine the patient's records, the provider shall give written
  7 10 notice to the requester or the patient that providing the
  7 11 requested records or images would be a violation of the
  7 12 federal law.
  7 13    The bill defines "records" and "images" to include
  7 14 electronic media and data containing a patient's health or
  7 15 billing information and "copies" includes patient records or
  7 16 images provided in electronic form, regardless of the form of
  7 17 the originals and "provider" means any physician or surgeon,
  7 18 physician assistant, advanced registered nurse practitioner,
  7 19 mental health professional, hospital, nursing home, or other
  7 20 person, entity, facility, or organization that furnishes,
  7 21 bills, or is paid for health care in the normal course of
  7 22 business.
  7 23 LSB 6482SZ 82
  7 24 rh/rj/5