Connecticut 2024 Regular Session

Connecticut House Bill HB05411 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
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3		-	LCO 1 of 10
	3	+	LCO No. 2381 1 of 10
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5		-	General Assembly ~~Substitute~~ Bill No. 5411
	5	+	General Assembly Raised Bill No. 5411
6	6		February Session, 2024
	7	+	LCO No. 2381
	8	+
	9	+
	10	+	Referred to Committee on JUDICIARY
	11	+
	12	+
	13	+	Introduced by:
	14	+	(JUD)
	15	+
7	16
8	17
9	18
10	19		AN ACT CONCERNING REQUESTS FOR HEALTH RECORDS AND
11	20		THE FEES CHARGED FOR ACCESS TO SUCH RECORDS.
12	21		Be it enacted by the Senate and House of Representatives in General
13	22		Assembly convened:
14	23
15	24		Section 1. Section 31-294f of the general statutes is repealed and the 1
16	25		following is substituted in lieu thereof (Effective October 1, 2024): 2
17	26		(a) An injured employee shall submit [himself] to an examination by 3
18	27		a reputable practicing physician or surgeon, at any time while claiming 4
19	28		or receiving compensation, upon the reasonable request of the employer 5
20	29		or at the direction of the administrative law judge. The examination 6
21	30		shall be performed to determine the nature of the injury and the 7
22	31		incapacity resulting from the injury. The physician or surgeon shall be 8
23	32		selected by the employer from an approved list of physicians and 9
24	33		surgeons prepared by the chairperson of the Workers' Compensation 10
25	34		Commission and shall be paid by the employer. At any examination 11
26	35		requested by the employer or directed by the administrative law judge 12
27	36		under this section, the injured employee shall be allowed to have in 13
28	37		attendance any reputable practicing physician or surgeon that the 14
29		-	employee obtains and [pays for himself] is paid for by the employee. 15
	38	+	employee obtains and [pays for himself] is paid for by the employee. 15 Raised Bill No. 5411
	39	+
	40	+
	41	+
	42	+	LCO No. 2381 2 of 10
	43	+
30	44		The employee shall submit to all other physical examinations as 16
31	45		required by this chapter. The refusal of an injured employee to submit 17
32	46		[himself] to a reasonable examination under this section shall suspend 18
33		-	[his] the employee's right to compensation during such refusal. 19 Substitute Bill No. 5411
34		-
35		-
36		-	LCO 2 of 10
37		-
	47	+	[his] the employee's right to compensation during such refusal. 19
38	48		(b) All medical reports concerning any injury of an employee 20
39	49		sustained in the course of [his] the employee's employment shall be 21
40	50		furnished [within] not later than thirty days after the date of completion 22
41	51		of the reports, at the same time and in the same manner, to the employer 23
42	52		and the employee or [his] the employee's attorney. 24
43	53		(c) The administrative law judge may penalize a practicing physician, 25
44	54		surgeon or a third-party vendor acting on behalf of such physician or 26
45		-	surgeon if a medical report is not furnished ~~not later than~~ thirty days 27
46		-	~~after the~~ date of completion of the report. Penalties imposed by an 28
47		-	~~administrative~~ law judge shall include (1) issuance of written 29
48		-	~~notification of~~ noncompliance in furnishing a medical report to the 30
49		-	~~practicing~~ physician, surgeon or a third-party vendor acting on behalf 31
50		-	~~of such~~ physician or surgeon, (2) an order requiring a physician, surgeon 32
51		-	or third-party vendor to appear at a hearing to explain the reasons for 33
52		-	~~not~~ furnishing the report in a timely fashion, or (3) a fine not to exceed 34
53		-	~~five~~ hundred dollars payable to the claimant. 35
	55	+	surgeon if a medical report is not furnished within thirty days after the 27
	56	+	date of completion of the report. Penalties imposed by an administrative 28
	57	+	law judge shall include (1) issuance of written notification of 29
	58	+	noncompliance in furnishing a medical report to the practicing 30
	59	+	physician, surgeon or a third-party vendor acting on behalf of such 31
	60	+	physician or surgeon, (2) an order requiring a physician, surgeon or 32
	61	+	third-party vendor to appear at a hearing to explain the reasons for not 33
	62	+	furnishing the report in a timely fashion, or (3) a fine not to exceed five 34
	63	+	hundred dollars payable to the claimant. 35
54	64		Sec. 2. Section 20-7c of the general statutes is repealed and the 36
55	65		following is substituted in lieu thereof (Effective October 1, 2024): 37
56	66		(a) For purposes of this section, "clinical laboratory" has the same 38
57	67		meaning as provided in section 19a-490. "Clinical laboratory" does not 39
58	68		include any state laboratory established by the Department of Public 40
59	69		Health pursuant to section 19a-26 or 19a-29. 41
60	70		(b) Except as provided for in subsection (e) of this section, a provider 42
61	71		shall (1) supply to a patient upon request complete and current 43
62	72		information possessed by that provider concerning any diagnosis, 44
63	73		treatment and prognosis of the patient, and (2) notify a patient of any 45
64	74		test results in the provider's possession or requested by the provider for 46
65		-	the purposes of diagnosis, treatment or prognosis of such patient. In 47
	75	+	the purposes of diagnosis, treatment or prognosis of such patient. In 47 Raised Bill No. 5411
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	77	+
	78	+
	79	+	LCO No. 2381 3 of 10
	80	+
66	81		addition, upon the request of a patient or a provider who orders medical 48
67	82		tests on behalf of a patient, a clinical laboratory shall provide medical 49
68	83		test results relating to the patient to (A) the patient, or (B) any other 50
69		-	provider who is treating the patient for the purposes of diagnosis, 51 Substitute Bill No. 5411
70		-
71		-
72		-	LCO 3 of 10
73		-
	84	+	provider who is treating the patient for the purposes of diagnosis, 51
74	85		treatment or prognosis of such patient. 52
75	86		(c) A provider, who requests that his or her patient submit to repeated 53
76	87		medical testing at regular intervals, over a specified period of time, for 54
77	88		purposes of ascertaining a diagnosis, prognosis or recommended course 55
78	89		of treatment for such patient, may issue a single authorization that 56
79	90		allows the entity that conducts such medical testing, including, but not 57
80	91		limited to, a clinical laboratory, to directly communicate the results of 58
81	92		such testing to the patient for the period of time that such testing is 59
82	93		requested by the provider. 60
83	94		(d) (1) Upon a written request of a patient, a patient's attorney or 61
84	95		authorized representative, or pursuant to a written authorization, a 62
85	96		provider, or entity acting on behalf of a provider, except as provided in 63
86	97		section 4-194, shall furnish to the person making such request a copy of 64
87	98		the patient's health record, including but not limited to, bills, x-rays and 65
88	99		copies of laboratory reports, contact lens specifications based on 66
89	100		examinations and final contact lens fittings given within the preceding 67
90	101		three months or such longer period of time as determined by the 68
91	102		provider but no longer than six months, records of prescriptions and 69
92	103		other technical information used in assessing the patient's health 70
93	104		condition. The written request shall specify if a paper or electronic copy 71
94	105		of the record is preferred, and if an electronic copy is preferred and is 72
95	106		able to be produced, then the provider, or entity acting on behalf of the 73
96	107		provider, shall furnish the electronic copy of the requested record. (2) 74
97	108		No provider, or entity acting on behalf of the provider, shall refuse to 75
98	109		return to a patient original records or copies of records that the patient 76
99	110		has brought to the provider from another provider. When returning 77
100	111		records to a patient, a provider may retain copies of such records for the 78
101	112		provider's file, provided such provider does not charge the patient for 79
102	113		the costs incurred in copying such records. No provider, or entity acting 80
103		-	on behalf of the provider, shall charge more than [sixty-five cents per 81
104		-	page, including] the following for a paper copy of a health record: (A) 82
105		-	Seventy-five cents per page for pages one to twenty-five, (B) fifty cents 83
106		-	per page for pages twenty-six to fifty, (C) twenty-five cents per page for 84
107		-	pages fifty-one to ninety-nine, and (D) ten cents per page for page one 85 Substitute Bill No. 5411
	114	+	on behalf of the provider, shall charge more than [sixty-five cents per 81 Raised Bill No. 5411
108	115
109	116
110		-	LCO 4 of 10
111	117
112		-	hundred and each succeeding page thereafter. The fees prescribed in 86
113		-	this subdivision shall include any [research fees, handling] clerical fees 87
114		-	or related costs, and the cost of first class postage, if applicable, for 88
115		-	furnishing a health record pursuant to this subsection, except such 89
116		-	provider, or entity acting on behalf of the provider, may charge a patient 90
117		-	the amount necessary to cover the cost of materials for furnishing a copy 91
118		-	of an x-ray, provided no such charge shall be made for furnishing a 92
119		-	health record or part thereof to a patient, a patient's attorney or 93
120		-	authorized representative if the record or part thereof is necessary for 94
121		-	the purpose of supporting a claim or appeal under any provision of the 95
122		-	Social Security Act or a claim or appeal for veterans' benefits under any 96
123		-	provision of Title 38 of the United States Code or chapter 506 and the 97
124		-	request is accompanied by documentation of the claim or appeal. If an 98
125		-	electronic copy of a health record is requested and furnished, the 99
126		-	provider, or an entity acting on behalf of the provider, shall charge the 100
127		-	requestor not more than thirty-five cents per page with a maximum fee 101
128		-	of two hundred fifty dollars per record for such electronic copy. No 102
129		-	provider, or entity acting on behalf of a provider, shall charge a research 103
130		-	fee or handling fee for a paper or electronic health record unless the 104
131		-	patient, the patient's attorney or authorized representative requests that 105
132		-	the provider, or an entity acting on behalf of the provider, make 106
133		-	redactions to the requested health record. If a research fee or handling 107
134		-	fee is charged, such fee shall not exceed fifty dollars. If a patient, a 108
135		-	patient's attorney or authorized representative requests that the 109
136		-	provider, or an entity acting on behalf of a provider, furnish a health 110
137		-	record not later than seventy-two hours following the receipt of such 111
138		-	request, the provider, or entity acting on behalf of the provider, may 112
139		-	charge not more than an additional fee of fifty dollars to expedite the 113
140		-	furnishing of the health record. On and after January 1, 2025, the 114
141		-	Commissioner of Public Health shall publish on the department's 115
142		-	Internet web site, the fees prescribed for the furnishing of paper or 116
143		-	electronic copies of a health record pursuant to this subdivision. On 117
144		-	January 1, 2026, and each January first thereafter, the Commissioner of 118
145		-	Public Health shall adjust the fees prescribed in this subdivision for the 119
146		-	furnishing of paper or electronic copies of a health record, based upon 120 Substitute Bill No. 5411
	118	+	LCO No. 2381 4 of 10
	119	+
	120	+	page, including] than the following for a paper copy of a health record: 82
	121	+	(A) Seventy-five cents per page for pages one to twenty-five, (B) fifty 83
	122	+	cents per page for pages twenty-six to fifty, (C) twenty-five cents per 84
	123	+	page for pages fifty-one to ninety-nine, and (D) ten cents per page for 85
	124	+	page one hundred and each succeeding page thereafter. Such fees shall 86
	125	+	include any [research fees, handling] clerical fees or related costs, and 87
	126	+	the cost of first class postage, if applicable, for furnishing a health record 88
	127	+	pursuant to this subsection, except such provider, or entity acting on 89
	128	+	behalf of the provider, may charge a patient the amount necessary to 90
	129	+	cover the cost of materials for furnishing a copy of an x-ray, provided 91
	130	+	no such charge shall be made for furnishing a health record or part 92
	131	+	thereof to a patient, a patient's attorney or authorized representative if 93
	132	+	the record or part thereof is necessary for the purpose of supporting a 94
	133	+	claim or appeal under any provision of the Social Security Act or a claim 95
	134	+	or appeal for veterans' benefits under any provision of Title 38 of the 96
	135	+	United States Code or chapter 506 and the request is accompanied by 97
	136	+	documentation of the claim or appeal. If an electronic copy of the health 98
	137	+	record is requested and furnished, the provider, or an entity acting on 99
	138	+	behalf of the provider, shall charge the requestor not more than thirty-100
	139	+	five cents per page with a maximum fee of two hundred fifty dollars per 101
	140	+	record. No provider, or entity acting on behalf of a provider, shall 102
	141	+	charge a research fee or handling fee for a paper or electronic health 103
	142	+	record unless the patient, the patient's attorney or authorized 104
	143	+	representative requests that the provider, or an entity acting on behalf 105
	144	+	of the provider, make redactions to the requested health record. If a 106
	145	+	research fee or handling fee is charged, such fee shall not exceed fifty 107
	146	+	dollars. If a patient, a patient's attorney or authorized representative 108
	147	+	makes a request of the provider, or an entity acting on behalf of a 109
	148	+	provider, to expedite the furnishing of a health record within seventy-110
	149	+	two hours of the time of receipt of such request, a provider, or entity 111
	150	+	acting on behalf of a provider, may charge not more than an additional 112
	151	+	fee of fifty dollars to expedite the furnishing of the health record. On 113
	152	+	and after January 1, 2025, the Commissioner of Public Health shall 114
	153	+	publish on the department's Internet web site, the fees prescribed for the 115
	154	+	furnishing of paper or electronic copies of a health record pursuant to 116 Raised Bill No. 5411
147	155
148	156
149		-	LCO 5 of 10
150	157
151		-	the consumer price index calculator published by the United States 121
152		-	Bureau of Labor and Statistics. (3) A provider, or an entity acting on 122
153		-	behalf of a provider, shall furnish a health record requested pursuant to 123
154		-	this section [within] not later than thirty days after the date of receipt of 124
155		-	the request. If such provider, or an entity acting on behalf of a provider, 125
156		-	fails to furnish the health record requested to the requestor not later than 126
157		-	thirty days after the date of receipt of request, the fee charged to furnish 127
158		-	such health record shall be reduced by fifty per cent. If such provider, 128
159		-	or an entity acting on behalf of a provider, fails to furnish the health 129
160		-	record requested to the requestor not later than sixty days after the date 130
161		-	of receipt of the request, the fee charged to furnish such health record 131
162		-	shall be reduced by seventy-five per cent. If such provider, or an entity 132
163		-	acting on behalf of a provider, fails to furnish the health record 133
164		-	requested to the requestor not later than ninety days after the date of 134
165		-	receipt of the request, the fee charged to furnish such health record shall 135
166		-	be reduced by ninety per cent. Nothing in this subsection shall be 136
167		-	construed to require a provider, or an entity acting on behalf of a 137
168		-	provider, to furnish a requested health record until such time as a 138
169		-	medical authorization form that is compliant with the provisions of the 139
170		-	Health Insurance Portability and Accountability Act of 1996, P.L. 104-140
171		-	191, as amended from time to time, has been submitted to the provider, 141
172		-	or an entity acting on behalf of a provider. (4) No health care provider, 142
173		-	[who] or entity acting on behalf of the provider, that has purchased or 143
174		-	assumed the practice of a provider who is retiring or deceased, may 144
175		-	refuse to return original records or copied records to a patient who 145
176		-	decides not to seek care from the successor provider. When returning 146
177		-	records to a patient who has decided not to seek care from a successor 147
178		-	provider, such provider may not charge a patient for costs incurred in 148
179		-	copying the records of the retired or deceased provider. 149
180		-	(e) If a provider reasonably determines that the information is 150
	158	+	LCO No. 2381 5 of 10
	159	+
	160	+	this subdivision. On January 1, 2026, and each January first thereafter, 117
	161	+	the Commissioner of Public Health shall adjust the fee schedule 118
	162	+	prescribed in this subdivision for the furnishing of paper or electronic 119
	163	+	copies of a health record, based upon the consumer price index 120
	164	+	calculator published by the United States Bureau of Labor and Statistics. 121
	165	+	(3) A provider, or an entity acting on behalf of a provider, shall furnish 122
	166	+	a health record requested pursuant to this section [within] not later than 123
	167	+	thirty days after the date of receipt of the request. If such provider, or an 124
	168	+	entity acting on behalf of a provider, fails to furnish the health record 125
	169	+	requested to the requestor not later than thirty days after the date of 126
	170	+	receipt of request, the fee charged to furnish such health record shall be 127
	171	+	reduced by fifty per cent. If such provider, or an entity acting on behalf 128
	172	+	of a provider, fails to furnish the health record requested to the 129
	173	+	requestor not later than sixty days after the date of receipt of the request, 130
	174	+	the fee charged to furnish such health record shall be reduced by 131
	175	+	seventy-five per cent. If such provider, or an entity acting on behalf of a 132
	176	+	provider, fails to furnish the health record requested to the requestor not 133
	177	+	later than ninety days after the date of receipt of the request, the fee 134
	178	+	charged to furnish such health record shall be reduced by ninety per 135
	179	+	cent. Nothing in this subsection shall be construed to require a provider, 136
	180	+	or an entity acting on behalf of a provider, to furnish a requested health 137
	181	+	record until such time as a medical authorization form that is compliant 138
	182	+	with the provisions of the Health Insurance Portability and 139
	183	+	Accountability Act of 1996, P.L. 104-191, as amended from time to time, 140
	184	+	has been submitted to the provider, or an entity acting on behalf of a 141
	185	+	provider. (4) No health care provider, or entity acting on behalf of the 142
	186	+	provider, who has purchased or assumed the practice of a provider who 143
	187	+	is retiring or deceased, may refuse to return original records or copied 144
	188	+	records to a patient who decides not to seek care from the successor 145
	189	+	provider. When returning records to a patient who has decided not to 146
	190	+	seek care from a successor provider, such provider may not charge a 147
	191	+	patient for costs incurred in copying the records of the retired or 148
	192	+	deceased provider. 149
	193	+	(e) If a provider reasonably determines that the information is 150 Raised Bill No. 5411
	194	+
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	196	+
	197	+	LCO No. 2381 6 of 10
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181	199		detrimental to the physical or mental health of the patient, or is likely to 151
182	200		cause the patient to harm himself, herself or another, the provider may 152
183	201		withhold the information from the patient. The information may be 153
184		-	supplied to an appropriate third party or to another provider who may 154 Substitute Bill No. 5411
	202	+	supplied to an appropriate third party or to another provider who may 154
	203	+	release the information to the patient. If disclosure of information is 155
	204	+	refused by a provider under this subsection, any person aggrieved 156
	205	+	thereby may, within thirty days of such refusal, petition the superior 157
	206	+	court for the judicial district in which such person resides for an order 158
	207	+	requiring the provider to disclose the information. Such a proceeding 159
	208	+	shall be privileged with respect to assignment for trial. The court, after 160
	209	+	hearing and an in camera review of the information in question, shall 161
	210	+	issue the order requested unless it determines that such disclosure 162
	211	+	would be detrimental to the physical or mental health of the person or 163
	212	+	is likely to cause the person to harm himself, herself or another. 164
	213	+	(f) The provisions of this section shall not apply to any information 165
	214	+	relative to any psychiatric or psychological problems or conditions. 166
	215	+	(g) In the event that a provider abandons his or her practice, the 167
	216	+	Commissioner of Public Health may appoint a licensed health care 168
	217	+	provider to be the keeper of the records, who shall be responsible for 169
	218	+	disbursing the original records to the provider's patients, upon the 170
	219	+	request of any such patient. 171
	220	+	(h) The Commissioner of Public Health shall adopt regulations, in 172
	221	+	accordance with the provisions of chapter 54, to carry out the provisions 173
	222	+	of this section. 174
	223	+	Sec. 3. Section 19a-490b of the general statutes is repealed and the 175
	224	+	following is substituted in lieu thereof (Effective October 1, 2024): 176
	225	+	(a) Upon the written request of a patient or the patient's attorney or 177
	226	+	authorized representative, or pursuant to a written authorization, an 178
	227	+	institution licensed pursuant to this chapter, or an entity acting on 179
	228	+	behalf of such institution, shall furnish to the person making such 180
	229	+	request a copy of the patient's health record, including but not limited 181
	230	+	to, copies of bills, laboratory reports, prescriptions and other technical 182 Raised Bill No. 5411
185	231
186	232
187		-	LCO 6 of 10
188	233
189		-	release the information to the patient. If disclosure of information is 155
190		-	refused by a provider under this subsection, any person aggrieved 156
191		-	[thereby] by such disclosure may, [within] not later than thirty days 157
192		-	after the date of such refusal, petition the superior court for the judicial 158
193		-	district in which such person resides for an order requiring the provider 159
194		-	to disclose the information. Such a proceeding shall be privileged with 160
195		-	respect to assignment for trial. The court, after hearing and an in camera 161
196		-	review of the information in question, shall issue the order requested 162
197		-	unless it determines that such disclosure would be detrimental to the 163
198		-	physical or mental health of the person or is likely to cause the person 164
199		-	to harm himself, herself or another. 165
200		-	(f) The provisions of this section shall not apply to any information 166
201		-	relative to any psychiatric or psychological problems or conditions. 167
202		-	(g) In the event that a provider abandons his or her practice, the 168
203		-	Commissioner of Public Health may appoint a licensed health care 169
204		-	provider to be the keeper of the records, who shall be responsible for 170
205		-	disbursing the original records to the provider's patients, upon the 171
206		-	request of any such patient. 172
207		-	(h) The Commissioner of Public Health shall adopt regulations, in 173
208		-	accordance with the provisions of chapter 54, to carry out the provisions 174
209		-	of this section. 175
210		-	Sec. 3. Section 19a-490b of the general statutes is repealed and the 176
211		-	following is substituted in lieu thereof (Effective October 1, 2024): 177
212		-	(a) Upon the written request of a patient or the patient's attorney or 178
213		-	authorized representative, or pursuant to a written authorization, an 179
214		-	institution licensed pursuant to this chapter, or an entity acting on 180
215		-	behalf of such institution, shall furnish to the person making such 181
216		-	request a copy of the patient's health record, including but not limited 182
217		-	to, copies of bills, laboratory reports, prescriptions and other technical 183
218		-	information used in assessing the patient's health condition. The written 184
219		-	request shall specify if a paper or electronic copy of the record is 185
220		-	preferred, and if an electronic copy is preferred and is able to be 186 Substitute Bill No. 5411
	234	+	LCO No. 2381 7 of 10
	235	+
	236	+	information used in assessing the patient's health condition. The written 183
	237	+	request shall specify if a paper or electronic copy of the record is 184
	238	+	preferred, and if an electronic copy is preferred and is able to be 185
	239	+	produced, then the institution or an entity acting on behalf of the 186
	240	+	institution shall furnish the electronic copy of the requested record. In 187
	241	+	addition, an institution shall provide the patient or the patient's 188
	242	+	designated health care provider with a reasonable opportunity to 189
	243	+	examine retained tissue slides and retained pathology tissue blocks. 190
	244	+	Upon the written request of the patient, the patient's attorney or the 191
	245	+	patient's designated health care provider, an institution shall send the 192
	246	+	original retained tissue slide or original retained tissue block directly to 193
	247	+	the patient's designated licensed institution, laboratory or physician. If 194
	248	+	the original slide or block is not available or if a new section cut of the 195
	249	+	original slide or block is a fair representation of the original slide or 196
	250	+	block, then the institution may send the new section cut, which is clearly 197
	251	+	labeled as a new section cut, to the patient's designated health care 198
	252	+	provider. Any patient or the patient's attorney or authorized 199
	253	+	representative who is provided with an original retained slide, tissue 200
	254	+	block or a new section under the provisions of this subsection shall be 201
	255	+	solely responsible for safeguarding and returning the slide, block or new 202
	256	+	section to the institution. Any institution or laboratory that has released 203
	257	+	an original slide, an original tissue block or new section pursuant to the 204
	258	+	provisions of this subsection shall not be subject to any liability arising 205
	259	+	out of releasing or not retaining the slide, block or new section and no 206
	260	+	cause of action for damages shall arise against any such institution for 207
	261	+	releasing or not retaining the slide, block or new section. No such 208
	262	+	institution, or an entity acting on behalf of such institution, shall charge 209
	263	+	more than [sixty-five cents per page, including] the following for a 210
	264	+	paper copy of a health record: (A) Seventy-five cents per page for pages 211
	265	+	one to twenty-five, (B) fifty cents per page for pages twenty-six to fifty, 212
	266	+	(C) twenty-five cents per page for pages fifty-one to ninety-nine, and (D) 213
	267	+	ten cents per page for page one hundred and each succeeding page 214
	268	+	thereafter. Such fees shall include any [research fees,] clerical fees, 215
	269	+	[handling fees] or related costs, and the cost of first class postage, if 216
	270	+	applicable, for furnishing or providing access to a health record 217 Raised Bill No. 5411
221	271
222	272
223		-	LCO 7 of 10
224	273
225		-	produced, the institution or an entity acting on behalf of the institution 187
226		-	shall furnish the electronic copy of the requested record. In addition, an 188
227		-	institution shall provide the patient or the patient's designated health 189
228		-	care provider with a reasonable opportunity to examine retained tissue 190
229		-	slides and retained pathology tissue blocks. Upon the written request of 191
230		-	the patient, the patient's attorney or the patient's designated health care 192
231		-	provider, an institution shall send the original retained tissue slide or 193
232		-	original retained tissue block directly to the patient's designated 194
233		-	licensed institution, laboratory or physician. If the original slide or block 195
234		-	is not available or if a new section cut of the original slide or block is a 196
235		-	fair representation of the original slide or block, then the institution may 197
236		-	send the new section cut, [which] that is clearly labeled as a new section 198
237		-	cut, to the patient's designated health care provider. Any patient or the 199
238		-	patient's attorney or authorized representative who is provided with an 200
239		-	original retained slide, tissue block or a new section under the 201
240		-	provisions of this subsection shall be solely responsible for safeguarding 202
241		-	and returning the slide, block or new section to the institution. Any 203
242		-	institution or laboratory that has released an original slide, an original 204
243		-	tissue block or new section pursuant to the provisions of this subsection 205
244		-	shall not be subject to any liability arising out of releasing or not 206
245		-	retaining the slide, block or new section and no cause of action for 207
246		-	damages shall arise against any such institution for releasing or not 208
247		-	retaining the slide, block or new section. No such institution, or an entity 209
248		-	acting on behalf of such institution, shall charge more than [sixty-five 210
249		-	cents per page, including] the following for a paper copy of a health 211
250		-	record: (1) Seventy-five cents per page for pages one to twenty-five, (2) 212
251		-	fifty cents per page for pages twenty-six to fifty, (3) twenty-five cents 213
252		-	per page for pages fifty-one to ninety-nine, and (4) ten cents per page 214
253		-	for page one hundred and each succeeding page thereafter. The fees 215
254		-	prescribed in this subsection shall include any [research fees,] clerical 216
255		-	fees, [handling fees] or related costs, and the cost of first class postage, 217
256		-	if applicable, for furnishing or providing access to a health record 218
257		-	pursuant to this subsection, except such an institution, or entity acting 219
258		-	on behalf of the institution, may charge the amount necessary to cover 220
259		-	its cost of materials for furnishing a copy of an x-ray or for furnishing 221 Substitute Bill No. 5411
	274	+	LCO No. 2381 8 of 10
	275	+
	276	+	pursuant to this subsection, except such an institution, or entity acting 218
	277	+	on behalf of the institution, may charge the amount necessary to cover 219
	278	+	its cost of materials for furnishing a copy of an x-ray or for furnishing 220
	279	+	an original retained slide, an original tissue block or a new section cut 221
	280	+	from a retained pathology tissue block. If an electronic copy of the health 222
	281	+	record is requested and furnished, the institution, or an entity acting on 223
	282	+	behalf of the institution, shall charge the requestor not more than thirty-224
	283	+	five cents per page with a maximum fee of two hundred fifty dollars per 225
	284	+	record. No institution, or entity acting on behalf of an institution, shall 226
	285	+	charge a research fee or handling fee for a paper or electronic health 227
	286	+	record unless the patient, the patient's attorney or authorized 228
	287	+	representative, requests that the institution, or an entity acting on behalf 229
	288	+	of the institution, make redactions to the requested health record. If a 230
	289	+	research fee or handling fee is charged, such fee shall not exceed fifty 231
	290	+	dollars. If a patient, a patient's attorney or authorized representative 232
	291	+	makes a request of the institution, or an entity acting on behalf of an 233
	292	+	institution, to expedite the furnishing of a health record within seventy-234
	293	+	two hours of the time of receipt of such request, the institution, or entity 235
	294	+	acting on behalf of the institution, may charge not more than an 236
	295	+	additional fee of fifty dollars to expedite the furnishing of the health 237
	296	+	record. On and after January 1, 2025, the Commissioner of Public Health 238
	297	+	shall publish on the department's Internet web site, the fees prescribed 239
	298	+	for the furnishing of paper or electronic copies of a health record 240
	299	+	pursuant to this subsection. On January 1, 2026, and each January first 241
	300	+	thereafter, the Commissioner of Public Health shall adjust the fee 242
	301	+	schedule prescribed in this subsection for the furnishing of paper or 243
	302	+	electronic copies of a health record, based upon the consumer price 244
	303	+	index calculator published by the United States Bureau of Labor and 245
	304	+	Statistics. For purposes of this subsection, "health care provider" means 246
	305	+	an institution or laboratory licensed under this chapter or licensed in the 247
	306	+	state where located, a physician licensed under chapter 370 or licensed 248
	307	+	in the state where located or an advanced practice registered nurse 249
	308	+	licensed under chapter 378 or licensed in the state where located. 250
	309	+	(b) No institution licensed pursuant to this chapter shall charge for 251 Raised Bill No. 5411
260	310
261	311
262		-	LCO 8 of 10
263	312
264		-	an original retained slide, an original tissue block or a new section cut 222
265		-	from a retained pathology tissue block. If an electronic copy of the health 223
266		-	record is requested and furnished, the institution, or an entity acting on 224
267		-	behalf of the institution, shall charge the requestor not more than thirty-225
268		-	five cents per page with a maximum fee of two hundred fifty dollars per 226
269		-	record for such electronic copy. No institution, or entity acting on behalf 227
270		-	of an institution, shall charge a research fee or handling fee for a paper 228
271		-	or electronic health record unless the patient, the patient's attorney or 229
272		-	authorized representative, requests that the institution, or an entity 230
273		-	acting on behalf of the institution, make redactions to the requested 231
274		-	health record. If a research fee or handling fee is charged, such fee shall 232
275		-	not exceed fifty dollars. If a patient, a patient's attorney or authorized 233
276		-	representative requests that the institution, or an entity acting on behalf 234
277		-	of an institution, furnish a health record not later than seventy-two 235
278		-	hours following the receipt of such request, the institution, or entity 236
279		-	acting on behalf of the institution, may charge not more than an 237
280		-	additional fee of fifty dollars to expedite the furnishing of the health 238
281		-	record. On and after January 1, 2025, the Commissioner of Public Health 239
282		-	shall publish on the department's Internet web site, the fees prescribed 240
283		-	for the furnishing of paper or electronic copies of a health record 241
284		-	pursuant to this subsection. On January 1, 2026, and each January first 242
285		-	thereafter, the Commissioner of Public Health shall adjust the fees 243
286		-	prescribed in this subsection for the furnishing of paper or electronic 244
287		-	copies of a health record, based upon the consumer price index 245
288		-	calculator published by the United States Bureau of Labor and Statistics. 246
289		-	For purposes of this subsection, "health care provider" means an 247
290		-	institution or laboratory licensed under this chapter or licensed in the 248
291		-	state where located, a physician licensed under chapter 370 or licensed 249
292		-	in the state where located or an advanced practice registered nurse 250
293		-	licensed under chapter 378 or licensed in the state where located. 251
294		-	(b) No institution licensed pursuant to this chapter shall charge for 252
295		-	furnishing a health record or part thereof to a patient, his attorney or 253
296		-	conservator if the record or part thereof is necessary for the purpose of 254
297		-	supporting a claim or appeal under any provision of the Social Security 255 Substitute Bill No. 5411
	313	+	LCO No. 2381 9 of 10
	314	+
	315	+	furnishing a health record or part thereof to a patient, his attorney or 252
	316	+	conservator if the record or part thereof is necessary for the purpose of 253
	317	+	supporting a claim or appeal under any provision of the Social Security 254
	318	+	Act or a claim or appeal for veterans' benefits under any provision of 255
	319	+	Title 38 of the United States Code or chapter 506 and the request for the 256
	320	+	records is accompanied by documentation of the claim or appeal. An 257
	321	+	institution shall furnish the requested record [within] not later than 258
	322	+	thirty days [of] after the date of receipt of the request, unless the request 259
	323	+	was received in less than thirty days subsequent to the date the patient 260
	324	+	was discharged, in which case the institution shall furnish the requested 261
	325	+	record upon its completion. If such institution, or an entity acting on 262
	326	+	behalf of an institution, fails to furnish the health record requested to 263
	327	+	the requestor not later than thirty days after the date of receipt of the 264
	328	+	request, the fee charged to furnish such health record shall be reduced 265
	329	+	by fifty per cent. If such institution, or an entity acting on behalf of an 266
	330	+	institution, fails to furnish the health record requested to the requestor 267
	331	+	not later than sixty days after the date of receipt of the request, the fee 268
	332	+	charged to furnish such health record shall be reduced by seventy-five 269
	333	+	per cent. If such institution, or an entity acting on behalf of an 270
	334	+	institution, fails to furnish the health record requested to the requestor 271
	335	+	not later than ninety days after the date of receipt of the request, the fee 272
	336	+	charged to furnish such health record shall be reduced by ninety per 273
	337	+	cent. Nothing in this subsection shall be construed to require an 274
	338	+	institution, or an entity acting on behalf of an institution, to furnish a 275
	339	+	requested health record until such time as a medical authorization form 276
	340	+	that is compliant with the provisions of the Health Insurance Portability 277
	341	+	and Accountability Act of 1996, P.L. 104-191, as amended from time to 278
	342	+	time, has been submitted to the institution, or an entity acting on behalf 279
	343	+	of an institution. 280
	344	+	(c) Each institution licensed pursuant to this chapter shall maintain 281
	345	+	information regarding each patient's status as a veteran, as defined in 282
	346	+	subsection (a) of section 27-103. Said information shall be made 283
	347	+	available, upon request, to any duly authorized representative of the 284
	348	+	Department of Veterans Affairs. 285 Raised Bill No. 5411
298	349
299	350
300		-	LCO 9 of 10
301	351
302		-	Act or a claim or appeal for veterans' benefits under any provision of 256
303		-	Title 38 of the United States Code or chapter 506 and the request for the 257
304		-	records is accompanied by documentation of the claim or appeal. An 258
305		-	institution shall furnish the requested record [within] not later than 259
306		-	thirty days [of] after the date of receipt of the request, unless the request 260
307		-	was received in less than thirty days subsequent to the date the patient 261
308		-	was discharged, in which case the institution shall furnish the requested 262
309		-	record upon its completion. If such institution, or an entity acting on 263
310		-	behalf of an institution, fails to furnish the health record requested to 264
311		-	the requestor not later than thirty days after the date of receipt of the 265
312		-	request, the fee charged to furnish such health record shall be reduced 266
313		-	by fifty per cent. If such institution, or an entity acting on behalf of an 267
314		-	institution, fails to furnish the health record requested to the requestor 268
315		-	not later than sixty days after the date of receipt of the request, the fee 269
316		-	charged to furnish such health record shall be reduced by seventy-five 270
317		-	per cent. If such institution, or an entity acting on behalf of an 271
318		-	institution, fails to furnish the health record requested to the requestor 272
319		-	not later than ninety days after the date of receipt of the request, the fee 273
320		-	charged to furnish such health record shall be reduced by ninety per 274
321		-	cent. Nothing in this subsection shall be construed to require an 275
322		-	institution, or an entity acting on behalf of an institution, to furnish a 276
323		-	requested health record until such time as a medical authorization form 277
324		-	that is compliant with the provisions of the Health Insurance Portability 278
325		-	and Accountability Act of 1996, P.L. 104-191, as amended from time to 279
326		-	time, has been submitted to the institution, or an entity acting on behalf 280
327		-	of an institution. 281
328		-	(c) Each institution licensed pursuant to this chapter shall maintain 282
329		-	information regarding each patient's status as a veteran, as defined in 283
330		-	subsection (a) of section 27-103. Said information shall be made 284
331		-	available, upon request, to any duly authorized representative of the 285
332		-	Department of Veterans Affairs. 286
333		-	(d) No institution may deny a person the records available under 287
334		-	subsection (a) of this section because of the person's inability to pay the 288
335		-	required fees. An affidavit from such person attesting to an inability to 289 Substitute Bill No. 5411
	352	+	LCO No. 2381 10 of 10
336	353
337		-
338		-	~~LCO 10~~ of 10
339		-
340		-	pay such fees shall be presumptive evidence thereof. ~~290~~
341		-	(e) Each institution licensed pursuant to this chapter that ceases to ~~291~~
342		-	operate shall, at the time it relinquishes its license to the department, ~~292~~
343		-	provide to the department a certified document specifying: (1) The ~~293~~
344		-	location at which patient health records will be stored; (2) the procedure ~~294~~
345		-	that has been established for patients, former patients or their ~~295~~
346		-	authorized representatives to secure access to such health records; (3) ~~296~~
347		-	provisions for storage, should the storage location cease to operate or ~~297~~
348		-	change ownership; and (4) that the department is authorized to enforce ~~298~~
349		-	the certified document should the storage location cease to operate or ~~299~~
350		-	change ownership. An institution that fails to comply with the terms of ~~300~~
351		-	a certified document provided to the department in accordance with ~~301~~
352		-	this subsection shall be assessed a civil penalty not to exceed one ~~302~~
353		-	hundred dollars per day for each day of noncompliance with the terms ~~303~~
354		-	of the certified agreement. ~~304~~
	354	+	(d) No institution may deny a person the records available under 286
	355	+	subsection (a) of this section because of the person's inability to pay the 287
	356	+	required fees. An affidavit from such person attesting to an inability to 288
	357	+	pay such fees shall be presumptive evidence thereof. 289
	358	+	(e) Each institution licensed pursuant to this chapter that ceases to 290
	359	+	operate shall, at the time it relinquishes its license to the department, 291
	360	+	provide to the department a certified document specifying: (1) The 292
	361	+	location at which patient health records will be stored; (2) the procedure 293
	362	+	that has been established for patients, former patients or their 294
	363	+	authorized representatives to secure access to such health records; (3) 295
	364	+	provisions for storage, should the storage location cease to operate or 296
	365	+	change ownership; and (4) that the department is authorized to enforce 297
	366	+	the certified document should the storage location cease to operate or 298
	367	+	change ownership. An institution that fails to comply with the terms of 299
	368	+	a certified document provided to the department in accordance with 300
	369	+	this subsection shall be assessed a civil penalty not to exceed one 301
	370	+	hundred dollars per day for each day of noncompliance with the terms 302
	371	+	of the certified agreement. 303
355	372		This act shall take effect as follows and shall amend the following
356	373		sections:
357	374
358	375		Section 1 October 1, 2024 31-294f
359	376		Sec. 2 October 1, 2024 20-7c
360	377		Sec. 3 October 1, 2024 19a-490b
361	378
362		-	Statement of Legislative Commissioners:
363		-	Provisions in Sections 1(c), 2(d)(2), 2(e) and 3(a) were redrafted for
364		-	clarity and consistency with standard drafting conventions.
365		-
366		-	JUD Joint Favorable Subst. -LCO
	379	+	Statement of Purpose:
	380	+	To establish time and cost parameters relating to requests for health
	381	+	records.
	382	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	383	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	384	+	underlined.]
367	385