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OLR Bill Analysis
sHB 5411
AN ACT CONCERNING REQUESTS FOR HEALTH RECORDS AND
THE FEES CHARGED FOR ACCESS TO SUCH RECORDS.
SUMMARY
This bill makes various changes to deadlines, fees, and penalties
related to patient health records requests. Principally, it:
1. authorizes workers’ compensation administrative law judges to
penalize physicians, or third-party vendors acting on their
behalf, who fail to submit medical reports for workers’
compensation cases within 30 days after they are completed;
2. allows an entity acting on a health care provider’s or institution’s
behalf to fulfill a patient’s written health records request instead
of the provider or institution;
3. requires providers, institutions, and entities representing them to
give patients (or their attorneys or authorized representatives)
copies of requested health records electronically, if the requestors
prefer it and they can be produced;
4. replaces current law’s patient health records fee of 65 cents per
page with fees that vary based on the record’s format (i.e., paper
or electronic) and number of pages;
5. prohibits providers, institutions, and entities representing them
from charging research or handling fees for paper or electronic
health records but allows them to charge an additional fee of up
to $50 for requests to (a) make redactions to the records or (b)
provide them within 72 hours;
6. requires the Department of Public Health (DPH) commissioner, 2024HB-05411-R000514-BA.DOCX
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starting January 1, 2025, to publish patient health records fees on
the DPH website and, starting January 1, 2026, annually adjust
the fees based on changes to the national consumer price index;
and
7. requires providers, institutions, and entities that represent them
that fail to supply patient health records within 30 days after
receiving a request to reduce the fees that they charge.
The bill also makes technical and conforming changes.
EFFECTIVE DATE: October 1, 2024
§ 1 — WORKERS’ COMPENSATION MEDICAL REPORTS
The bill authorizes workers’ compensation administrative law judges
to penalize practicing physicians, or third-party vendors acting on their
behalf, who fail to submit medical reports for workers’ compensation
cases within 30 days after they are completed as required under existing
law. Under the bill, penalties must include the following:
1. a written noncompliance notice to the physician or third-party
vendor;
2. an order requiring the physician or third-party vendor to appear
at a hearing and explain the reasons for not meeting the report
deadline; and
3. a fine of up to $500 payable to the workers’ compensation
claimant.
Existing law requires workers’ compensation claimants, when
seeking or receiving compensation, to submit to a physician evaluation
when an administrative law judge orders it, or an employer reasonably
requests it. Physicians must submit all medical reports for these
claimants within 30 days after the date they are completed to the
employer and the employee (claimant), or the employee’s attorney.
§§ 2 & 3 — ACCESS TO PATIENT HEALTH RECORDS
Records Requests 2024HB-05411-R000514-BA.DOCX
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By law, patients (or their attorneys or authorized representatives) can
generally obtain copies of their health records by asking a provider or
health care institution (e.g., hospital, outpatient clinic, or long-term care
facility) in writing. The bill requires providers and institutions to give
the health records to the requestor within 30 days after they receive the
request, instead of 30 days after it is made, as under current law.
Existing law, unchanged by the bill, requires institutions, if the request
was received less than 30 days from the patient’s discharge, to provide
the record when it is completed.
The bill also allows entities acting on a provider’s or institution’s
behalf (hereafter “entity”) to supply the health records instead of the
provider or institution.
Additionally, the bill requires the written request to specify if the
requestor prefers a paper or electronic copy of the health record. If an
electronic copy is preferred and can be produced, it requires the
provider, institution, or entity to give the requestor the electronic copy.
Under current law and the bill, a provider, institution, or entity
cannot refuse to return to a patient original or copied health records
from another provider.
The bill specifies that it does not require a provider, institution, or
entity to supply a requested health record until they receive a HIPAA-
compliant medical authorization form (presumably from the patient, or
patient’s attorney or authorized representative).
By law, health records include bills, x-rays, copies of lab report
results, prescriptions, contact lens specifications under certain
conditions, and other technical information used to assess the patient’s
health condition.
Fees
Current law allows a health care provider or institution to charge up
to 65 cents per page, including any applicable research or handling fees,
related costs, and first-class postage, to supply a patient’s health record.
The bill instead establishes fees based on the format in which the health 2024HB-05411-R000514-BA.DOCX
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record is provided as described below.
Under the bill, these fees cover clerical fees, related costs, and first-
class postage to supply the record. As under current law, patients may
also be charged an additional amount necessary to cover the cost of
material for (1) providing a copy of an x-ray or (2) furnishing an original
retained slide or tissue block or a new section cut from a retained tissue
block.
Existing law, unchanged by the bill, prohibits providers and
institutions from charging fees for health records requests that are
necessary for a documented claim or appeal for Social Security or
veterans’ benefits.
Paper Copies. For paper copies, the bill authorizes providers,
institutions, or entities to charge up to the following amounts:
1. 75 cents per page for the first 25 pages,
2. 50 cents per page for pages 26 through 50,
3. 25 cents per page for pages 51 through 99, and
4. 10 cents per page for pages 100 and beyond.
Electronic Copies. For electronic health records requests, the bill
allows providers, institutions, or entities to charge up to 35 cents per
page up to $250 per health record.
Reduction in Fees for Late Delivery. Under the bill, providers,
institutions, or entities that fail to supply health records within 30 days
after they receive the request must reduce the fees they charge as
follows:
1. by 50%, if they fail to provide the records within 30 days after
they receive the request;
2. by 75%, if they fail to do so within 60 days after they receive the
request; and 2024HB-05411-R000514-BA.DOCX
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3. by 90%, if they fail to do so within 90 days after they receive the
request.
COMMITTEE ACTION
Judiciary Committee
Joint Favorable
Yea 35 Nay 0 (04/01/2024)