| 1 | 1 | | FIRSTREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.1001 |
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| 3 | 3 | | 103RDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEANDERSON. |
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| 5 | 5 | | 2393H.01I JOSEPHENGLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Torepealsection191.227,RSMo,andtoenactinlieuthereofonenewsectionrelatingto |
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| 8 | 8 | | medicalrecords. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Section191.227,RSMo,isrepealedandonenewsectionenactedinlieu |
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| 11 | 11 | | 2thereof,tobeknownassection191.227,toreadasfollows: |
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| 12 | 12 | | 191.227.1.Allphysicians,chiropractors,hospitals,dentists,andotherdulylicensed |
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| 13 | 13 | | 2practitionersinthisstate,hereincalled"providers",shall,uponwrittenrequestofapatient,or |
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| 14 | 14 | | 3guardianorlegallyauthorizedrepresentativeofapatient,furnishacopyofhisorherrecord |
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| 15 | 15 | | 4ofthatpatient'shealthhistoryandtreatmentrenderedtothepersonsubmittingawritten |
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| 16 | 16 | | 5request,exceptthatsuchrightshallbelimitedtoaccessconsistentwiththepatient'scondition |
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| 17 | 17 | | 6andsoundtherapeutictreatmentasdeterminedbytheprovider.BeginningAugust28,1994, |
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| 18 | 18 | | 7suchrecordshallbefurnishedwithinareasonabletimeofthereceiptoftherequesttherefor |
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| 19 | 19 | | 8anduponpaymentofafeeasprovidedinthissection. |
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| 20 | 20 | | 9 2.Healthcareprovidersmayconditionthefurnishingofthepatient'shealthcare |
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| 21 | 21 | | 10recordstothepatient,thepatient'sauthorizedrepresentativeoranyotherpersonorentity |
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| 22 | 22 | | 11authorizedbylawtoobtainorreproducesuchrecordsuponpaymentofafeefor: |
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| 23 | 23 | | 12 (1)(a)Searchandretrieval,inanamountnotmorethantwenty-fourdollarsand |
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| 24 | 24 | | 13eighty-fivecentspluscopyingintheamountoffifty-sevencentsperpageforthecostof |
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| 25 | 25 | | 14suppliesandlaborplus,ifthehealthcareproviderhascontractedforoff-siterecordsstorage |
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| 26 | 26 | | 15andmanagement,anyadditionallaborcostsofoutsidestorageretrieval,nottoexceedtwenty- |
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| 27 | 27 | | 16threedollarsandtwenty-sixcents,asadjustedannuallypursuanttosubsection6ofthis |
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| 28 | 28 | | 17section;or |
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| 29 | 29 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 30 | 30 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18 (b)Therecordsshallbefurnishedelectronicallyuponpaymentofthesearch, |
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| 31 | 31 | | 19retrieval,andcopyingfeessetunderthissectionatthetimeoftherequestoronehundred |
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| 32 | 32 | | 20eightdollarsandeighty-eightcentstotal,whicheverisless,ifsuchperson: |
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| 33 | 33 | | 21 a.Requestshealthrecordstobedeliveredelectronicallyinaformatofthehealthcare |
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| 34 | 34 | | 22provider'schoice; |
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| 35 | 35 | | 23 b.Thehealthcareproviderstoressuchrecordscompletelyinanelectronichealth |
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| 36 | 36 | | 24record;and |
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| 37 | 37 | | 25 c.Thehealthcareprovideriscapableofprovidingtherequestedrecordsand |
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| 38 | 38 | | 26affidavit,ifrequested,inanelectronicformat; |
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| 39 | 39 | | 27 (2)Postage,toincludepackaginganddeliverycost; |
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| 40 | 40 | | 28 (3)Notaryfee,nottoexceedtwodollars,ifrequested. |
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| 41 | 41 | | 29 |
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| 42 | 42 | | 30SuchfeeshallbethefeeineffectonFebruary1,2018,increasedordecreasedannuallyunder |
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| 43 | 43 | | 31thissection. |
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| 44 | 44 | | 32 3.Forpurposesofsubsections1and2ofthissection,"acopyofhisorherrecordof |
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| 45 | 45 | | 33thatpatient'shealthhistoryandtreatmentrendered"or"thepatient'shealthcarerecords" |
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| 46 | 46 | | 34includesastatementorrecordthatnosuchhealthhistoryortreatmentrecordresponsivetothe |
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| 47 | 47 | | 35requestexists. |
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| 48 | 48 | | 36 4.Notwithstandingprovisionsofthissectiontothecontrary,providersmaycharge |
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| 49 | 49 | | 37forthereasonablecostofallduplicationsofhealthcarerecordmaterialorinformationwhich |
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| 50 | 50 | | 38cannotroutinelybecopiedorduplicatedonastandardcommercialphotocopymachine. |
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| 51 | 51 | | 39 5.Thetransferofthepatient'srecorddoneingoodfaithshallnotrendertheprovider |
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| 52 | 52 | | 40liabletothepatientoranyotherpersonforanyconsequenceswhichresultedormayresult |
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| 53 | 53 | | 41fromdisclosureofthepatient'srecordasrequiredbythissection. |
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| 54 | 54 | | 42 6.EffectiveFebruaryfirstofeachyear,thefeeslistedinsubsection2ofthissection |
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| 55 | 55 | | 43shallbeincreasedordecreasedannuallybasedontheannualpercentagechangeinthe |
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| 56 | 56 | | 44unadjusted,U.S.cityaverage,annualaverageinflationrateofthemedicalcarecomponentof |
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| 57 | 57 | | 45theConsumerPriceIndexforAllUrbanConsumers(CPI-U).Thecurrentreferencebaseof |
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| 58 | 58 | | 46theindex,aspublishedbytheBureauofLaborStatisticsoftheUnitedStatesDepartmentof |
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| 59 | 59 | | 47Labor,shallbeusedasthereferencebase.Forpurposesofthissubsection,theannualaverage |
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| 60 | 60 | | 48inflationrateshallbebasedonatwelve-monthcalendaryearbeginninginJanuaryandending |
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| 61 | 61 | | 49inDecemberofeachprecedingcalendaryear.Thedepartmentofhealthandseniorservices |
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| 62 | 62 | | 50shallreporttheannualadjustmentandtheadjustedfeesauthorizedinthissectiononthe |
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| 63 | 63 | | 51department'sinternetwebsitebyFebruaryfirstofeachyear. |
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| 64 | 64 | | 52 7.Ahealthcareprovidermaydiscloseadeceasedpatient'shealthcarerecordsor |
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| 65 | 65 | | 53paymentrecordstotheexecutororadministratorofthedeceasedperson'sestate,orpursuant |
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| 66 | 66 | | 54toavalid,unrevokedpowerofattorneyforhealthcarethatspecificallydirectsthatthe |
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| 67 | 67 | | HB1001 2 55deceasedperson'shealthcarerecordsbereleasedtotheagentafterdeath.Ifanexecutor, |
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| 68 | 68 | | 56administrator,oragenthasnotbeenappointed,thedeceasedpriortodeathdidnotspecifically |
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| 69 | 69 | | 57objecttodisclosureofhisorherrecordsinwriting,andsuchdisclosureisnotinconsistent |
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| 70 | 70 | | 58withanypriorexpressedpreferenceofthedeceasedthatisknowntothehealthcareprovider, |
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| 71 | 71 | | 59adeceasedpatient'shealthcarerecordsmaybereleaseduponwrittenrequestofapersonwho |
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| 72 | 72 | | 60isdeemedasthepersonalrepresentativeofthedeceasedpersonunderthissubsection. |
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| 73 | 73 | | 61Priorityshallbegiventothedeceasedpatient'sspouseandtherecordsshallbereleasedonthe |
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| 74 | 74 | | 62affidavitofthesurvivingspousethatheorsheisthesurvivingspouse.Ifthereisnosurviving |
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| 75 | 75 | | 63spouse,thehealthcarerecordsmaybereleasedtooneofthefollowingpersons: |
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| 76 | 76 | | 64 (1)Theactingtrusteeofatrustcreatedbythedeceasedpatienteitheraloneorwith |
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| 77 | 77 | | 65thedeceasedpatient'sspouse; |
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| 78 | 78 | | 66 (2)Anadultchildofthedeceasedpatientontheaffidavitoftheadultchildthatheor |
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| 79 | 79 | | 67sheistheadultchildofthedeceased; |
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| 80 | 80 | | 68 (3)Aparentofthedeceasedpatientontheaffidavitoftheparentthatheorsheisthe |
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| 81 | 81 | | 69parentofthedeceased; |
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| 82 | 82 | | 70 (4)Anadultbrotherorsisterofthedeceasedpatientontheaffidavitoftheadult |
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| 83 | 83 | | 71brotherorsisterthatheorsheistheadultbrotherorsisterofthedeceased; |
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| 84 | 84 | | 72 (5)Aguardianorconservatorofthedeceasedpatientatthetimeofthepatient'sdeath |
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| 85 | 85 | | 73ontheaffidavitoftheguardianorconservatorthatheorsheistheguardianorconservatorof |
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| 86 | 86 | | 74thedeceased;or |
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| 87 | 87 | | 75 (6)Aguardianadlitemofthedeceased'sminorchildbasedontheaffidavitofthe |
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| 88 | 88 | | 76guardianthatheorsheistheguardianadlitemoftheminorchildofthedeceased. |
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| 89 | 89 | | 77 8.Notwithstandinganyprovisionsofthissectiontothecontrary,ahealthcare |
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| 90 | 90 | | 78providerorhealthcarefacilityshallnotchargeafeeformedicalormentalhealth |
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| 91 | 91 | | 79recordsrequestedbyapatient,formerpatient,orattorneyorotherauthorized |
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| 92 | 92 | | 80representativeofapatientorformerpatientforuseinsupportinganapplicationfor |
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| 93 | 93 | | 81benefitsunder: |
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| 94 | 94 | | 82 (1)Chapter287; |
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| 95 | 95 | | 83 (2)42U.S.C.Section401etseq.; |
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| 96 | 96 | | 84 (3)42U.S.C.Section1382etseq.; |
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| 97 | 97 | | 85 (4)42U.S.C.Section1395etseq.; |
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| 98 | 98 | | 86 (5)38U.S.C.Section1101etseq.;or |
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| 99 | 99 | | 87 (6)38U.S.C.Section1501etseq. |
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| 100 | 100 | | 88 |
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| 101 | 101 | | HB1001 3 89Thehealthcareproviderorhealthcarefacilitymayprovidetherecordsintheformthat |
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| 102 | 102 | | 90ismostcost-effective,providedthatrecordsprovidedelectronicallyshallbeproducedin |
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| 103 | 103 | | 91auniversallyaccessibleformat. |
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| 104 | 104 | | âś” |
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| 105 | 105 | | HB1001 4 |
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