FIRSTREGULARSESSION
HOUSEBILLNO.1001
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEANDERSON.
2393H.01I JOSEPHENGLER,ChiefClerk
ANACT
Torepealsection191.227,RSMo,andtoenactinlieuthereofonenewsectionrelatingto
medicalrecords.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Section191.227,RSMo,isrepealedandonenewsectionenactedinlieu
2thereof,tobeknownassection191.227,toreadasfollows:
191.227.1.Allphysicians,chiropractors,hospitals,dentists,andotherdulylicensed
2practitionersinthisstate,hereincalled"providers",shall,uponwrittenrequestofapatient,or
3guardianorlegallyauthorizedrepresentativeofapatient,furnishacopyofhisorherrecord
4ofthatpatient'shealthhistoryandtreatmentrenderedtothepersonsubmittingawritten
5request,exceptthatsuchrightshallbelimitedtoaccessconsistentwiththepatient'scondition
6andsoundtherapeutictreatmentasdeterminedbytheprovider.BeginningAugust28,1994,
7suchrecordshallbefurnishedwithinareasonabletimeofthereceiptoftherequesttherefor
8anduponpaymentofafeeasprovidedinthissection.
9 2.Healthcareprovidersmayconditionthefurnishingofthepatient'shealthcare
10recordstothepatient,thepatient'sauthorizedrepresentativeoranyotherpersonorentity
11authorizedbylawtoobtainorreproducesuchrecordsuponpaymentofafeefor:
12 (1)(a)Searchandretrieval,inanamountnotmorethantwenty-fourdollarsand
13eighty-fivecentspluscopyingintheamountoffifty-sevencentsperpageforthecostof
14suppliesandlaborplus,ifthehealthcareproviderhascontractedforoff-siterecordsstorage
15andmanagement,anyadditionallaborcostsofoutsidestorageretrieval,nottoexceedtwenty-
16threedollarsandtwenty-sixcents,asadjustedannuallypursuanttosubsection6ofthis
17section;or
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18 (b)Therecordsshallbefurnishedelectronicallyuponpaymentofthesearch,
19retrieval,andcopyingfeessetunderthissectionatthetimeoftherequestoronehundred
20eightdollarsandeighty-eightcentstotal,whicheverisless,ifsuchperson:
21 a.Requestshealthrecordstobedeliveredelectronicallyinaformatofthehealthcare
22provider'schoice;
23 b.Thehealthcareproviderstoressuchrecordscompletelyinanelectronichealth
24record;and
25 c.Thehealthcareprovideriscapableofprovidingtherequestedrecordsand
26affidavit,ifrequested,inanelectronicformat;
27 (2)Postage,toincludepackaginganddeliverycost;
28 (3)Notaryfee,nottoexceedtwodollars,ifrequested.
29
30SuchfeeshallbethefeeineffectonFebruary1,2018,increasedordecreasedannuallyunder
31thissection.
32 3.Forpurposesofsubsections1and2ofthissection,"acopyofhisorherrecordof
33thatpatient'shealthhistoryandtreatmentrendered"or"thepatient'shealthcarerecords"
34includesastatementorrecordthatnosuchhealthhistoryortreatmentrecordresponsivetothe
35requestexists.
36 4.Notwithstandingprovisionsofthissectiontothecontrary,providersmaycharge
37forthereasonablecostofallduplicationsofhealthcarerecordmaterialorinformationwhich
38cannotroutinelybecopiedorduplicatedonastandardcommercialphotocopymachine.
39 5.Thetransferofthepatient'srecorddoneingoodfaithshallnotrendertheprovider
40liabletothepatientoranyotherpersonforanyconsequenceswhichresultedormayresult
41fromdisclosureofthepatient'srecordasrequiredbythissection.
42 6.EffectiveFebruaryfirstofeachyear,thefeeslistedinsubsection2ofthissection
43shallbeincreasedordecreasedannuallybasedontheannualpercentagechangeinthe
44unadjusted,U.S.cityaverage,annualaverageinflationrateofthemedicalcarecomponentof
45theConsumerPriceIndexforAllUrbanConsumers(CPI-U).Thecurrentreferencebaseof
46theindex,aspublishedbytheBureauofLaborStatisticsoftheUnitedStatesDepartmentof
47Labor,shallbeusedasthereferencebase.Forpurposesofthissubsection,theannualaverage
48inflationrateshallbebasedonatwelve-monthcalendaryearbeginninginJanuaryandending
49inDecemberofeachprecedingcalendaryear.Thedepartmentofhealthandseniorservices
50shallreporttheannualadjustmentandtheadjustedfeesauthorizedinthissectiononthe
51department'sinternetwebsitebyFebruaryfirstofeachyear.
52 7.Ahealthcareprovidermaydiscloseadeceasedpatient'shealthcarerecordsor
53paymentrecordstotheexecutororadministratorofthedeceasedperson'sestate,orpursuant
54toavalid,unrevokedpowerofattorneyforhealthcarethatspecificallydirectsthatthe
HB1001 2 55deceasedperson'shealthcarerecordsbereleasedtotheagentafterdeath.Ifanexecutor,
56administrator,oragenthasnotbeenappointed,thedeceasedpriortodeathdidnotspecifically
57objecttodisclosureofhisorherrecordsinwriting,andsuchdisclosureisnotinconsistent
58withanypriorexpressedpreferenceofthedeceasedthatisknowntothehealthcareprovider,
59adeceasedpatient'shealthcarerecordsmaybereleaseduponwrittenrequestofapersonwho
60isdeemedasthepersonalrepresentativeofthedeceasedpersonunderthissubsection.
61Priorityshallbegiventothedeceasedpatient'sspouseandtherecordsshallbereleasedonthe
62affidavitofthesurvivingspousethatheorsheisthesurvivingspouse.Ifthereisnosurviving
63spouse,thehealthcarerecordsmaybereleasedtooneofthefollowingpersons:
64 (1)Theactingtrusteeofatrustcreatedbythedeceasedpatienteitheraloneorwith
65thedeceasedpatient'sspouse;
66 (2)Anadultchildofthedeceasedpatientontheaffidavitoftheadultchildthatheor
67sheistheadultchildofthedeceased;
68 (3)Aparentofthedeceasedpatientontheaffidavitoftheparentthatheorsheisthe
69parentofthedeceased;
70 (4)Anadultbrotherorsisterofthedeceasedpatientontheaffidavitoftheadult
71brotherorsisterthatheorsheistheadultbrotherorsisterofthedeceased;
72 (5)Aguardianorconservatorofthedeceasedpatientatthetimeofthepatient'sdeath
73ontheaffidavitoftheguardianorconservatorthatheorsheistheguardianorconservatorof
74thedeceased;or
75 (6)Aguardianadlitemofthedeceased'sminorchildbasedontheaffidavitofthe
76guardianthatheorsheistheguardianadlitemoftheminorchildofthedeceased.
77 8.Notwithstandinganyprovisionsofthissectiontothecontrary,ahealthcare
78providerorhealthcarefacilityshallnotchargeafeeformedicalormentalhealth
79recordsrequestedbyapatient,formerpatient,orattorneyorotherauthorized
80representativeofapatientorformerpatientforuseinsupportinganapplicationfor
81benefitsunder:
82 (1)Chapter287;
83 (2)42U.S.C.Section401etseq.;
84 (3)42U.S.C.Section1382etseq.;
85 (4)42U.S.C.Section1395etseq.;
86 (5)38U.S.C.Section1101etseq.;or
87 (6)38U.S.C.Section1501etseq.
88
HB1001 3 89Thehealthcareproviderorhealthcarefacilitymayprovidetherecordsintheformthat
90ismostcost-effective,providedthatrecordsprovidedelectronicallyshallbeproducedin
91auniversallyaccessibleformat.
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HB1001 4