Bill Text: NY S05243 | 2019-2020 | General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relates to the provision of patient health information and medical records; expands the definition of medical records to include all health related records; prohibits fees for providing certain records.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-01-08 - REFERRED TO HEALTH [S05243 Detail]
Download: New_York-2019-S05243-Introduced.html
Bill Title: Relates to the provision of patient health information and medical records; expands the definition of medical records to include all health related records; prohibits fees for providing certain records.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-01-08 - REFERRED TO HEALTH [S05243 Detail]
Download: New_York-2019-S05243-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 5243 2019-2020 Regular Sessions IN SENATE April 18, 2019 ___________ Introduced by Sen. SERRANO -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law and the mental hygiene law, in relation to patient health information and medical records The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 17 of the public health law, as amended by chapter 2 165 of the laws of 1991, the first undesignated paragraph as amended by 3 chapter 322 of the laws of 2017, is amended to read as follows: 4 § 17. Release of [medical] health records to a designated health care 5 provider. 1. Upon the written request of any competent patient, parent 6 or guardian of an infant, a guardian appointed pursuant to article 7 eighty-one of the mental hygiene law, or conservator of a conservatee, 8 [an examining, consulting or treating physician or hospital must] a 9 health care provider who has provided professional health care services 10 pertaining to a patient shall release and deliver, exclusive of non- 11 clinical personal notes of the [said physician or hospital] health care 12 provider, copies of all [x-rays, medical] requested health records[and13test records including all laboratory tests] regarding that patient to 14 any other designated [physician or hospital provided, however, that] 15 health care provider. However, such records concerning the treatment of 16 an infant patient for venereal disease or the performance of an abortion 17 operation upon such infant patient shall not be released or in any 18 manner be made available to the parent or guardian of such infant, and 19 provided, further, that original mammograms, rather than copies thereof, 20 shall be released and delivered. Where a health care provider maintains 21 a health record in electronic form, it may provide the record under this 22 section in a reasonably usable electronic form, and shall provide it in 23 such form if requested by the person making the request. [Either the24physician or hospital] EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD03429-02-9S. 5243 2 1 2. A health care provider incurring the expense of providing copies of 2 [x-rays, medical] health records [and test records including all labora-3tory tests] pursuant to the provisions of this section may impose a 4 reasonable charge to be paid by the person requesting the release and 5 deliverance of such records as reimbursement [for such] not to exceed 6 the health care provider's actual expenses, provided, however, that the 7 [physician or hospital] health care provider may not impose a charge for 8 copying an original mammogram when the original has been released or 9 delivered to any competent patient, parent or guardian of an infant, a 10 guardian appointed pursuant to article eighty-one of the mental hygiene 11 law, or a conservator of a conservatee and provided, further, that any 12 charge for delivering an original mammogram pursuant to this section 13 shall not exceed the documented actual costs associated therewith[.14However, the reasonable charge] which for paper copies shall not exceed 15 seventy-five cents per page. A release of records under this section 16 shall not be denied solely because of inability to pay. 17 3. Where a health care provider provides health care professional 18 services as an employee of or under contract with another health care 19 provider, compliance with this section shall be the responsibility of 20 the health care provider that employs or contracts for the services of 21 the other health care provider, unless the terms of the employment or 22 contract explicitly provide otherwise. If a health care provider 23 receives a request under this section and compliance is the responsibil- 24 ity of a different health care provider under this subdivision, the 25 health care provider receiving the request shall immediately inform the 26 requesting party to which health care provider the request should be 27 directed. No charge may be imposed under this section for providing, 28 releasing, or delivering [medical] health records or copies of [medical] 29 health records where requested for the purpose of supporting an applica- 30 tion, claim or appeal for any government benefit or program, provided 31 that, where a provider maintains medical records in electronic form, it 32 shall provide the copy in either electronic or paper form, as required 33 by the government benefit or program, or at the patient's request. 34 4. For the purposes of this section the [term "laboratory tests" shall35include] following terms shall have the following meanings: 36 (a) "Health record" includes any patient information as defined in 37 section eighteen of this title, X-rays and other images, and records of 38 laboratory tests including but not [be] limited to tests and examina- 39 tions administered in clinical laboratories or blood banks as those 40 terms are defined in section five hundred seventy-one of this chapter. 41 (b) "Health care provider" and "health care practitioner" have the 42 same meanings as defined in section eighteen of this title. 43 (c) "Professional health care services" means the services of a health 44 care provider examining, assessing, treating or consulting in relation 45 to a patient or patient's condition, within the scope of practice of a 46 health care practitioner. 47 § 2. Paragraphs (c), (d) and (e) of subdivision 1 of section 18 of the 48 public health law, paragraphs (c) and (d) as added by chapter 497 of the 49 laws of 1986, paragraph (e) as amended by chapter 2 of the laws of 1990, 50 and the closing paragraph of paragraph (e) as amended by chapter 576 of 51 the laws of 1998, are amended and a new paragraph (j) is added to read 52 as follows: 53 (c) "Health care facility" or "facility" means a hospital as defined 54 in article twenty-eight of this chapter, a home care services agency as 55 defined in article thirty-six of this chapter, a hospice as defined in 56 article forty of this chapter, a health maintenance organization asS. 5243 3 1 defined in article forty-four of this chapter, [and] a shared health 2 facility as defined in article forty-seven of this chapter; or an entity 3 that provides the health care professional services of a health care 4 provider by employing or contracting for the health care professional 5 services of a health care provider. 6 (d) "Health care practitioner" or "practitioner" means a person 7 licensed under article one hundred thirty-one (medicine), one hundred 8 thirty-one-B (physician assistants), one hundred thirty-one-C (special- 9 ist assistant), one hundred thirty-two (chiropractic), one hundred thir- 10 ty-three (dentistry and dental hygiene), one hundred thirty-four 11 (licensed perfusionists), one hundred thirty-six (physical therapy and 12 physical therapy assistants), one hundred thirty-seven (pharmacy), one 13 hundred thirty-nine (nursing), one hundred forty (professional midwifery 14 practice), one hundred forty-one (podiatry), one hundred forty-three 15 (optometry), one hundred forty-four (ophthalmic dispensing), one hundred 16 fifty-three (psychology), one hundred fifty-four (social work), one 17 hundred fifty-five (massage therapy), one hundred fifty-six [or] (occu- 18 pational therapy), one hundred fifty-seven (dietetics and nutrition), 19 one hundred fifty-nine (speech-language pathologists or audiologists), 20 one hundred sixty (acupuncture), one hundred sixty-two (athletic train- 21 ers), one hundred sixty-three (mental health practitioners), one hundred 22 sixty-four (respiratory therapists and respiratory therapy technicians), 23 one hundred sixty-five (clinical laboratory technology practice), one 24 hundred sixty-six (medical physics practice), or one hundred sixty-seven 25 (applied behavior analysis) of the education law [or a person certified26under section twenty-five hundred sixty of this chapter]. 27 (e) (i) "Patient information" or "information" means: any information 28 or health record concerning or relating to the examination, health 29 assessment including, but not limited to, a health assessment for insur- 30 ance and employment purposes [or], consulting in relation to treatment 31 of providing drugs or devices, or providing professional health care 32 services pertaining to an identifiable subject maintained or possessed 33 by a health care [facility or health care practitioner who] provider 34 which has provided or is providing services [for assessment of a health35condition including, but not limited to, a health assessment for insur-36ance and employment purposes or has treated or is treating such subject,37except (i)]. It shall include X-rays and other images, and records of 38 laboratory tests including but not limited to tests and examinations 39 administered in clinical laboratories or blood banks as those terms are 40 defined in section five hundred seventy-one of this chapter. It shall 41 include records of charges to, and payments received from, the patient 42 or identifiable subject or any other party on behalf of the patient or 43 identifiable subject, for any such services, drugs or devices. 44 (ii) "Patient information" or "information" shall not include (A) 45 information and clinical records subject to the provisions of section 46 [23.05 or] 33.13 of the mental hygiene law[, (ii)]; (B) non-clinical 47 personal notes and observations of a health care practitioner, provided 48 that such personal notes and observations are maintained by the practi- 49 tioner and not disclosed by the practitioner to any other person after 50 January first, nineteen hundred eighty-seven[, (iii)]; (C) information 51 maintained by a practitioner, concerning or relating to the prior exam- 52 ination or treatment of a subject received from another practitioner, 53 provided however, that such information may be requested by the subject 54 directly from such other practitioner in accordance with the provisions 55 of this section, and provided further that this clause does not apply to 56 any referral, order, authorization, or prescription received from theS. 5243 4 1 other practitioner; and [(iv)] (D) data disclosed to a practitioner in 2 confidence by other persons on the basis of an express condition that 3 such data would never be disclosed to the subject or other persons, 4 provided that such data has never been disclosed to any other person. If 5 at any time such personal notes and observations or such data is 6 disclosed, it shall be considered patient information for purposes of 7 this section. For purposes of this subdivision, "disclosure to any other 8 person" shall not include disclosures made to practitioners as part of a 9 consultation or referral during the treatment of the subject, to persons 10 reviewing information or records in the ordinary course of ensuring that 11 a provider is in compliance with applicable quality of care, licensure 12 or accreditation standards, to an employee or official of a federal, 13 state or local agency for the sole purpose of conducting an audit in the 14 course of his or her official duties, to the statewide planning and 15 research cooperative system, to other persons pursuant to a court order, 16 to governmental agencies, insurance companies licensed pursuant to the 17 insurance law and other third parties requiring information necessary 18 for payments to be made to or on behalf of patients, to qualified 19 researchers, to the [state board for professional medical conduct] 20 department of health or the department of education when such [board] 21 department requests such information in the exercise of its statutory 22 function, to an insurance carrier insuring, or an attorney consulted by, 23 a health care provider, or to a health maintenance organization certi- 24 fied pursuant to article forty-four of this chapter or licensed pursuant 25 to the insurance law, or to the committee or a court pursuant to the 26 provisions of this section. 27 (iii) For purposes of this subdivision treatment of a subject shall 28 not include diagnostic services, except mammography, performed by a 29 practitioner at the request of another health care practitioner 30 provided, however, that such information, and mammograms, may be 31 requested by the subject directly from the practitioner at whose request 32 such diagnostic services were performed, in accordance with the 33 provisions of this section. 34 (j) "Professional health care services" means the services of a health 35 care provider examining, assessing, treating or consulting in relation 36 to an identifiable subject of an identifiable subject's condition, with- 37 in the scope of practice of a health care practitioner. 38 § 3. Paragraphs (d) and (e) of subdivision 2 of section 18 of the 39 public health law, paragraph (d) as amended by chapter 576 of the laws 40 of 1998 and paragraph (e) as amended by chapter 322 of the laws of 2017, 41 are amended and a new paragraph (j) is added to read as follows: 42 (d) Subject to the provisions of subdivision three of this section, 43 upon the written request of any qualified person, a health care provider 44 shall furnish to such person, within a reasonable time, a copy of any 45 patient information requested, and original mammograms requested, which 46 the person is authorized to inspect pursuant to this subdivision. Where 47 a health care provider maintains the patient information in electronic 48 form, it may provide the patient information under this section in a 49 reasonably usable electronic form, and shall provide it in such form if 50 requested by the person making the request. 51 (e) The provider may impose a reasonable charge for all inspections 52 and copies, not exceeding the reasonable and actual costs incurred by 53 such provider, provided, however, that a provider may not impose a 54 charge for copying an original mammogram when the original has been 55 furnished to any qualified person and provided, further, that any charge 56 for furnishing an original mammogram pursuant to this section shall notS. 5243 5 1 exceed the documented costs associated therewith[. However, the reason-2able charge], which for paper copies shall not exceed seventy-five cents 3 per page. A qualified person shall not be denied access to patient 4 information solely because of inability to pay. No charge may be imposed 5 under this section for providing, releasing, or delivering patient 6 information or copies of patient information where requested for the 7 purpose of supporting an application, claim or appeal for any government 8 benefit or program, provided that, where a provider maintains patient 9 information in electronic form, it shall provide the copy in either 10 electronic or paper form, as required by the government benefit or 11 program, or at the patient's request. 12 (j) Where a health care provider provides health care professional 13 services as an employee of or under contract with another health care 14 provider, compliance with this section shall be the responsibility of 15 the health care provider that employs or contracts for the services of 16 the other health care provider, unless the terms of the employment or 17 contract explicitly provide otherwise. If a health care provider 18 receives a request under this section and compliance is the responsibil- 19 ity of a different health care provider under this subdivision, the 20 health care provider receiving the request shall immediately inform the 21 requesting party to which health care provider the request should be 22 directed. 23 § 4. Paragraphs 1, 3 and 4 of subdivision (a) of section 33.16 of the 24 mental hygiene law, paragraphs 1 and 4 as amended by chapter 226 of the 25 laws of 1991, and paragraph 3 as amended by chapter 37 of the laws of 26 2011, are amended to read as follows: 27 1. "Clinical record" means any information concerning or relating to 28 the examination or treatment of, consulting in relation to treatment of, 29 providing drugs or devices, or providing professional mental or behav- 30 ioral health care services pertaining to an identifiable patient or 31 client maintained or possessed by a facility which has treated or is 32 treating such patient or client, except data disclosed to a practitioner 33 in confidence by other persons on the basis of an express condition that 34 such data would never be disclosed to the patient or client or other 35 persons, provided that such data has never been disclosed by the practi- 36 tioner or a facility to any other person. If at any time such data is 37 disclosed, it shall be considered clinical records for the purposes of 38 this section. For purposes of this subdivision, "disclosure to any 39 other person" shall not include disclosures made pursuant to section 40 33.13 of this article, to practitioners as part of a consultation or 41 referral during the treatment of the patient or client, to the statewide 42 planning and research cooperative system, or to the committee or a court 43 pursuant to the provisions of this section or to an insurance carrier 44 insuring, or an attorney consulted by, a facility. Clinical record 45 shall include X-rays and other images, and records of laboratory tests 46 including but not limited to tests and examinations administered in 47 clinical laboratories or blood banks as those terms are defined in 48 section five hundred seventy-one of the public health law. It shall 49 include records of charges to, and payments received from, the patient 50 or identifiable subject or any other party on behalf of the patient or 51 identifiable subject, for any such services, drugs or devices. 52 3. "Facility" means a facility as defined in section 1.03 of this 53 chapter, a program requiring approval for operation pursuant to article 54 thirty-two of this chapter, institutions offering training in psychoth- 55 erapy, psychoanalysis and related areas chartered pursuant to section 56 two hundred sixteen of the education law, or, notwithstanding sectionS. 5243 6 1 1.03 of this chapter, any provider of services for persons with mental 2 illness or developmental disabilities which is operated by, under 3 contract with, receives funding from, or is otherwise approved to render 4 services by, a director of community services pursuant to article 5 forty-one of this chapter or one or both of the offices, including any 6 such provider which is exempt from the requirement for an operating 7 certificate under article sixteen or article thirty-one of this chapter; 8 or an entity that provides mental or behavioral health professional 9 services by employing or contracting for the professional services of a 10 mental health practitioner. 11 4. "Mental health practitioner" or "practitioner" means a person 12 employed by or rendering a service at a facility maintaining the clin- 13 ical record who is licensed under article one hundred thirty-one of the 14 education law (medicine) who practices psychiatry or a person licensed 15 under article one hundred thirty-nine (nursing), one hundred fifty-three 16 [or] (psychology), one hundred fifty-four (social work), one hundred 17 sixty-three (mental health practitioners), or one hundred sixty-seven 18 (applied behavior analysis) of the education law or any other person not 19 prohibited by law from providing mental health or developmental disabil- 20 ities services. 21 § 5. Paragraphs 5 and 6 of subdivision (b) of section 33.16 of the 22 mental hygiene law, paragraph 5 as amended by chapter 233 of the laws of 23 1991, and paragraph 6 as amended by chapter 322 of the laws of 2017, are 24 amended to read as follows: 25 5. Subject to the provisions of this subdivision and subdivision (c) 26 of this section, upon the written request of any qualified person, a 27 facility shall furnish to such person, within a reasonable time, a copy 28 of any clinical record requested which the person is authorized to 29 inspect pursuant to this subdivision. Where a facility maintains a 30 clinical record in electronic form, it may provide the record under this 31 section in a reasonably usable electronic form, and shall provide it in 32 such form if requested by the qualified person making the request. 33 6. The facility may impose a reasonable charge for all inspections and 34 copies, not exceeding the documented actual costs incurred by such 35 provider[. However, the reasonable charge], which for paper copies shall 36 not exceed seventy-five cents per page. A qualified person shall not be 37 denied access to the clinical record solely because of inability to pay. 38 No charge may be imposed under this section for providing, releasing, or 39 delivering clinical records or copies of clinical records where 40 requested for the purpose of supporting an application, claim or appeal 41 for any government benefit or program, provided that, where a provider 42 maintains clinical records in electronic form, it shall provide the copy 43 in either electronic or paper form, as required by the government bene- 44 fit or program, or at the patient's request. 45 § 6. Section 33.16 of the mental hygiene law is amended by adding a 46 new subdivision (l) to read as follows: 47 (l) This section shall not be construed to supplant or diminish a 48 right or benefit that any patient, qualified person or person acting on 49 behalf of a patient under section seventeen or eighteen of the public 50 health law has under either of such sections of the public health law. 51 § 7. This act shall take effect on the first of January next succeed- 52 ing the date on which it shall have become a law.
