LCO No. 2381 1 of 10
General Assembly Raised Bill No. 5411
February Session, 2024
LCO No. 2381
Referred to Committee on JUDICIARY
Introduced by:
(JUD)
AN ACT CONCERNING REQUESTS FOR HEALTH RECORDS AND
THE FEES CHARGED FOR ACCESS TO SUCH RECORDS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 31-294f of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2024): 2
(a) An injured employee shall submit [himself] to an examination by 3
a reputable practicing physician or surgeon, at any time while claiming 4
or receiving compensation, upon the reasonable request of the employer 5
or at the direction of the administrative law judge. The examination 6
shall be performed to determine the nature of the injury and the 7
incapacity resulting from the injury. The physician or surgeon shall be 8
selected by the employer from an approved list of physicians and 9
surgeons prepared by the chairperson of the Workers' Compensation 10
Commission and shall be paid by the employer. At any examination 11
requested by the employer or directed by the administrative law judge 12
under this section, the injured employee shall be allowed to have in 13
attendance any reputable practicing physician or surgeon that the 14
employee obtains and [pays for himself] is paid for by the employee. 15 Raised Bill No. 5411
LCO No. 2381 2 of 10
The employee shall submit to all other physical examinations as 16
required by this chapter. The refusal of an injured employee to submit 17
[himself] to a reasonable examination under this section shall suspend 18
[his] the employee's right to compensation during such refusal. 19
(b) All medical reports concerning any injury of an employee 20
sustained in the course of [his] the employee's employment shall be 21
furnished [within] not later than thirty days after the date of completion 22
of the reports, at the same time and in the same manner, to the employer 23
and the employee or [his] the employee's attorney. 24
(c) The administrative law judge may penalize a practicing physician, 25
surgeon or a third-party vendor acting on behalf of such physician or 26
surgeon if a medical report is not furnished within thirty days after the 27
date of completion of the report. Penalties imposed by an administrative 28
law judge shall include (1) issuance of written notification of 29
noncompliance in furnishing a medical report to the practicing 30
physician, surgeon or a third-party vendor acting on behalf of such 31
physician or surgeon, (2) an order requiring a physician, surgeon or 32
third-party vendor to appear at a hearing to explain the reasons for not 33
furnishing the report in a timely fashion, or (3) a fine not to exceed five 34
hundred dollars payable to the claimant. 35
Sec. 2. Section 20-7c of the general statutes is repealed and the 36
following is substituted in lieu thereof (Effective October 1, 2024): 37
(a) For purposes of this section, "clinical laboratory" has the same 38
meaning as provided in section 19a-490. "Clinical laboratory" does not 39
include any state laboratory established by the Department of Public 40
Health pursuant to section 19a-26 or 19a-29. 41
(b) Except as provided for in subsection (e) of this section, a provider 42
shall (1) supply to a patient upon request complete and current 43
information possessed by that provider concerning any diagnosis, 44
treatment and prognosis of the patient, and (2) notify a patient of any 45
test results in the provider's possession or requested by the provider for 46
the purposes of diagnosis, treatment or prognosis of such patient. In 47 Raised Bill No. 5411
LCO No. 2381 3 of 10
addition, upon the request of a patient or a provider who orders medical 48
tests on behalf of a patient, a clinical laboratory shall provide medical 49
test results relating to the patient to (A) the patient, or (B) any other 50
provider who is treating the patient for the purposes of diagnosis, 51
treatment or prognosis of such patient. 52
(c) A provider, who requests that his or her patient submit to repeated 53
medical testing at regular intervals, over a specified period of time, for 54
purposes of ascertaining a diagnosis, prognosis or recommended course 55
of treatment for such patient, may issue a single authorization that 56
allows the entity that conducts such medical testing, including, but not 57
limited to, a clinical laboratory, to directly communicate the results of 58
such testing to the patient for the period of time that such testing is 59
requested by the provider. 60
(d) (1) Upon a written request of a patient, a patient's attorney or 61
authorized representative, or pursuant to a written authorization, a 62
provider, or entity acting on behalf of a provider, except as provided in 63
section 4-194, shall furnish to the person making such request a copy of 64
the patient's health record, including but not limited to, bills, x-rays and 65
copies of laboratory reports, contact lens specifications based on 66
examinations and final contact lens fittings given within the preceding 67
three months or such longer period of time as determined by the 68
provider but no longer than six months, records of prescriptions and 69
other technical information used in assessing the patient's health 70
condition. The written request shall specify if a paper or electronic copy 71
of the record is preferred, and if an electronic copy is preferred and is 72
able to be produced, then the provider, or entity acting on behalf of the 73
provider, shall furnish the electronic copy of the requested record. (2) 74
No provider, or entity acting on behalf of the provider, shall refuse to 75
return to a patient original records or copies of records that the patient 76
has brought to the provider from another provider. When returning 77
records to a patient, a provider may retain copies of such records for the 78
provider's file, provided such provider does not charge the patient for 79
the costs incurred in copying such records. No provider, or entity acting 80
on behalf of the provider, shall charge more than [sixty-five cents per 81 Raised Bill No. 5411
LCO No. 2381 4 of 10
page, including] than the following for a paper copy of a health record: 82
(A) Seventy-five cents per page for pages one to twenty-five, (B) fifty 83
cents per page for pages twenty-six to fifty, (C) twenty-five cents per 84
page for pages fifty-one to ninety-nine, and (D) ten cents per page for 85
page one hundred and each succeeding page thereafter. Such fees shall 86
include any [research fees, handling] clerical fees or related costs, and 87
the cost of first class postage, if applicable, for furnishing a health record 88
pursuant to this subsection, except such provider, or entity acting on 89
behalf of the provider, may charge a patient the amount necessary to 90
cover the cost of materials for furnishing a copy of an x-ray, provided 91
no such charge shall be made for furnishing a health record or part 92
thereof to a patient, a patient's attorney or authorized representative if 93
the record or part thereof is necessary for the purpose of supporting a 94
claim or appeal under any provision of the Social Security Act or a claim 95
or appeal for veterans' benefits under any provision of Title 38 of the 96
United States Code or chapter 506 and the request is accompanied by 97
documentation of the claim or appeal. If an electronic copy of the health 98
record is requested and furnished, the provider, or an entity acting on 99
behalf of the provider, shall charge the requestor not more than thirty-100
five cents per page with a maximum fee of two hundred fifty dollars per 101
record. No provider, or entity acting on behalf of a provider, shall 102
charge a research fee or handling fee for a paper or electronic health 103
record unless the patient, the patient's attorney or authorized 104
representative requests that the provider, or an entity acting on behalf 105
of the provider, make redactions to the requested health record. If a 106
research fee or handling fee is charged, such fee shall not exceed fifty 107
dollars. If a patient, a patient's attorney or authorized representative 108
makes a request of the provider, or an entity acting on behalf of a 109
provider, to expedite the furnishing of a health record within seventy-110
two hours of the time of receipt of such request, a provider, or entity 111
acting on behalf of a provider, may charge not more than an additional 112
fee of fifty dollars to expedite the furnishing of the health record. On 113
and after January 1, 2025, the Commissioner of Public Health shall 114
publish on the department's Internet web site, the fees prescribed for the 115
furnishing of paper or electronic copies of a health record pursuant to 116 Raised Bill No. 5411
LCO No. 2381 5 of 10
this subdivision. On January 1, 2026, and each January first thereafter, 117
the Commissioner of Public Health shall adjust the fee schedule 118
prescribed in this subdivision for the furnishing of paper or electronic 119
copies of a health record, based upon the consumer price index 120
calculator published by the United States Bureau of Labor and Statistics. 121
(3) A provider, or an entity acting on behalf of a provider, shall furnish 122
a health record requested pursuant to this section [within] not later than 123
thirty days after the date of receipt of the request. If such provider, or an 124
entity acting on behalf of a provider, fails to furnish the health record 125
requested to the requestor not later than thirty days after the date of 126
receipt of request, the fee charged to furnish such health record shall be 127
reduced by fifty per cent. If such provider, or an entity acting on behalf 128
of a provider, fails to furnish the health record requested to the 129
requestor not later than sixty days after the date of receipt of the request, 130
the fee charged to furnish such health record shall be reduced by 131
seventy-five per cent. If such provider, or an entity acting on behalf of a 132
provider, fails to furnish the health record requested to the requestor not 133
later than ninety days after the date of receipt of the request, the fee 134
charged to furnish such health record shall be reduced by ninety per 135
cent. Nothing in this subsection shall be construed to require a provider, 136
or an entity acting on behalf of a provider, to furnish a requested health 137
record until such time as a medical authorization form that is compliant 138
with the provisions of the Health Insurance Portability and 139
Accountability Act of 1996, P.L. 104-191, as amended from time to time, 140
has been submitted to the provider, or an entity acting on behalf of a 141
provider. (4) No health care provider, or entity acting on behalf of the 142
provider, who has purchased or assumed the practice of a provider who 143
is retiring or deceased, may refuse to return original records or copied 144
records to a patient who decides not to seek care from the successor 145
provider. When returning records to a patient who has decided not to 146
seek care from a successor provider, such provider may not charge a 147
patient for costs incurred in copying the records of the retired or 148
deceased provider. 149
(e) If a provider reasonably determines that the information is 150 Raised Bill No. 5411
LCO No. 2381 6 of 10
detrimental to the physical or mental health of the patient, or is likely to 151
cause the patient to harm himself, herself or another, the provider may 152
withhold the information from the patient. The information may be 153
supplied to an appropriate third party or to another provider who may 154
release the information to the patient. If disclosure of information is 155
refused by a provider under this subsection, any person aggrieved 156
thereby may, within thirty days of such refusal, petition the superior 157
court for the judicial district in which such person resides for an order 158
requiring the provider to disclose the information. Such a proceeding 159
shall be privileged with respect to assignment for trial. The court, after 160
hearing and an in camera review of the information in question, shall 161
issue the order requested unless it determines that such disclosure 162
would be detrimental to the physical or mental health of the person or 163
is likely to cause the person to harm himself, herself or another. 164
(f) The provisions of this section shall not apply to any information 165
relative to any psychiatric or psychological problems or conditions. 166
(g) In the event that a provider abandons his or her practice, the 167
Commissioner of Public Health may appoint a licensed health care 168
provider to be the keeper of the records, who shall be responsible for 169
disbursing the original records to the provider's patients, upon the 170
request of any such patient. 171
(h) The Commissioner of Public Health shall adopt regulations, in 172
accordance with the provisions of chapter 54, to carry out the provisions 173
of this section. 174
Sec. 3. Section 19a-490b of the general statutes is repealed and the 175
following is substituted in lieu thereof (Effective October 1, 2024): 176
(a) Upon the written request of a patient or the patient's attorney or 177
authorized representative, or pursuant to a written authorization, an 178
institution licensed pursuant to this chapter, or an entity acting on 179
behalf of such institution, shall furnish to the person making such 180
request a copy of the patient's health record, including but not limited 181
to, copies of bills, laboratory reports, prescriptions and other technical 182 Raised Bill No. 5411
LCO No. 2381 7 of 10
information used in assessing the patient's health condition. The written 183
request shall specify if a paper or electronic copy of the record is 184
preferred, and if an electronic copy is preferred and is able to be 185
produced, then the institution or an entity acting on behalf of the 186
institution shall furnish the electronic copy of the requested record. In 187
addition, an institution shall provide the patient or the patient's 188
designated health care provider with a reasonable opportunity to 189
examine retained tissue slides and retained pathology tissue blocks. 190
Upon the written request of the patient, the patient's attorney or the 191
patient's designated health care provider, an institution shall send the 192
original retained tissue slide or original retained tissue block directly to 193
the patient's designated licensed institution, laboratory or physician. If 194
the original slide or block is not available or if a new section cut of the 195
original slide or block is a fair representation of the original slide or 196
block, then the institution may send the new section cut, which is clearly 197
labeled as a new section cut, to the patient's designated health care 198
provider. Any patient or the patient's attorney or authorized 199
representative who is provided with an original retained slide, tissue 200
block or a new section under the provisions of this subsection shall be 201
solely responsible for safeguarding and returning the slide, block or new 202
section to the institution. Any institution or laboratory that has released 203
an original slide, an original tissue block or new section pursuant to the 204
provisions of this subsection shall not be subject to any liability arising 205
out of releasing or not retaining the slide, block or new section and no 206
cause of action for damages shall arise against any such institution for 207
releasing or not retaining the slide, block or new section. No such 208
institution, or an entity acting on behalf of such institution, shall charge 209
more than [sixty-five cents per page, including] the following for a 210
paper copy of a health record: (A) Seventy-five cents per page for pages 211
one to twenty-five, (B) fifty cents per page for pages twenty-six to fifty, 212
(C) twenty-five cents per page for pages fifty-one to ninety-nine, and (D) 213
ten cents per page for page one hundred and each succeeding page 214
thereafter. Such fees shall include any [research fees,] clerical fees, 215
[handling fees] or related costs, and the cost of first class postage, if 216
applicable, for furnishing or providing access to a health record 217 Raised Bill No. 5411
LCO No. 2381 8 of 10
pursuant to this subsection, except such an institution, or entity acting 218
on behalf of the institution, may charge the amount necessary to cover 219
its cost of materials for furnishing a copy of an x-ray or for furnishing 220
an original retained slide, an original tissue block or a new section cut 221
from a retained pathology tissue block. If an electronic copy of the health 222
record is requested and furnished, the institution, or an entity acting on 223
behalf of the institution, shall charge the requestor not more than thirty-224
five cents per page with a maximum fee of two hundred fifty dollars per 225
record. No institution, or entity acting on behalf of an institution, shall 226
charge a research fee or handling fee for a paper or electronic health 227
record unless the patient, the patient's attorney or authorized 228
representative, requests that the institution, or an entity acting on behalf 229
of the institution, make redactions to the requested health record. If a 230
research fee or handling fee is charged, such fee shall not exceed fifty 231
dollars. If a patient, a patient's attorney or authorized representative 232
makes a request of the institution, or an entity acting on behalf of an 233
institution, to expedite the furnishing of a health record within seventy-234
two hours of the time of receipt of such request, the institution, or entity 235
acting on behalf of the institution, may charge not more than an 236
additional fee of fifty dollars to expedite the furnishing of the health 237
record. On and after January 1, 2025, the Commissioner of Public Health 238
shall publish on the department's Internet web site, the fees prescribed 239
for the furnishing of paper or electronic copies of a health record 240
pursuant to this subsection. On January 1, 2026, and each January first 241
thereafter, the Commissioner of Public Health shall adjust the fee 242
schedule prescribed in this subsection for the furnishing of paper or 243
electronic copies of a health record, based upon the consumer price 244
index calculator published by the United States Bureau of Labor and 245
Statistics. For purposes of this subsection, "health care provider" means 246
an institution or laboratory licensed under this chapter or licensed in the 247
state where located, a physician licensed under chapter 370 or licensed 248
in the state where located or an advanced practice registered nurse 249
licensed under chapter 378 or licensed in the state where located. 250
(b) No institution licensed pursuant to this chapter shall charge for 251 Raised Bill No. 5411
LCO No. 2381 9 of 10
furnishing a health record or part thereof to a patient, his attorney or 252
conservator if the record or part thereof is necessary for the purpose of 253
supporting a claim or appeal under any provision of the Social Security 254
Act or a claim or appeal for veterans' benefits under any provision of 255
Title 38 of the United States Code or chapter 506 and the request for the 256
records is accompanied by documentation of the claim or appeal. An 257
institution shall furnish the requested record [within] not later than 258
thirty days [of] after the date of receipt of the request, unless the request 259
was received in less than thirty days subsequent to the date the patient 260
was discharged, in which case the institution shall furnish the requested 261
record upon its completion. If such institution, or an entity acting on 262
behalf of an institution, fails to furnish the health record requested to 263
the requestor not later than thirty days after the date of receipt of the 264
request, the fee charged to furnish such health record shall be reduced 265
by fifty per cent. If such institution, or an entity acting on behalf of an 266
institution, fails to furnish the health record requested to the requestor 267
not later than sixty days after the date of receipt of the request, the fee 268
charged to furnish such health record shall be reduced by seventy-five 269
per cent. If such institution, or an entity acting on behalf of an 270
institution, fails to furnish the health record requested to the requestor 271
not later than ninety days after the date of receipt of the request, the fee 272
charged to furnish such health record shall be reduced by ninety per 273
cent. Nothing in this subsection shall be construed to require an 274
institution, or an entity acting on behalf of an institution, to furnish a 275
requested health record until such time as a medical authorization form 276
that is compliant with the provisions of the Health Insurance Portability 277
and Accountability Act of 1996, P.L. 104-191, as amended from time to 278
time, has been submitted to the institution, or an entity acting on behalf 279
of an institution. 280
(c) Each institution licensed pursuant to this chapter shall maintain 281
information regarding each patient's status as a veteran, as defined in 282
subsection (a) of section 27-103. Said information shall be made 283
available, upon request, to any duly authorized representative of the 284
Department of Veterans Affairs. 285 Raised Bill No. 5411
LCO No. 2381 10 of 10
(d) No institution may deny a person the records available under 286
subsection (a) of this section because of the person's inability to pay the 287
required fees. An affidavit from such person attesting to an inability to 288
pay such fees shall be presumptive evidence thereof. 289
(e) Each institution licensed pursuant to this chapter that ceases to 290
operate shall, at the time it relinquishes its license to the department, 291
provide to the department a certified document specifying: (1) The 292
location at which patient health records will be stored; (2) the procedure 293
that has been established for patients, former patients or their 294
authorized representatives to secure access to such health records; (3) 295
provisions for storage, should the storage location cease to operate or 296
change ownership; and (4) that the department is authorized to enforce 297
the certified document should the storage location cease to operate or 298
change ownership. An institution that fails to comply with the terms of 299
a certified document provided to the department in accordance with 300
this subsection shall be assessed a civil penalty not to exceed one 301
hundred dollars per day for each day of noncompliance with the terms 302
of the certified agreement. 303
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2024 31-294f
Sec. 2 October 1, 2024 20-7c
Sec. 3 October 1, 2024 19a-490b
Statement of Purpose:
To establish time and cost parameters relating to requests for health
records.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]