EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
FIRST REGULAR SESSION
SENATE BILL NO. 806
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR BERNSKOETTER.
3179S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 191.227, RSMo, and to enact in lieu thereof one new section relating to medical
records.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 191.227, RSMo, is repealed and one new 1
section enacted in lieu thereof, to be known as section 191.227, 2
to read as follows:3
191.227. 1. All physicians, chiropractors, hospitals, 1
dentists, and other duly licensed practitioners in this 2
state, herein called "providers", shall, upon written 3
request of a patient, or guardian or legally authorized 4
representative of a patient, furnish a copy of his or her 5
record of that patient's health history and treatment 6
rendered to the person submitting a written request, except 7
that such right shall be limited to access consistent with 8
the patient's condition and sound therapeutic treatment as 9
determined by the prov ider. Beginning August 28, [1994] 10
2025, such record shall be furnished within [a reasonable 11
time] twenty-four hours of the receipt of the request 12
therefor and upon payment of a fee as provided in this 13
section. 14
2. Health care providers may condit ion the furnishing 15
of the patient's health care records to the patient, the 16
patient's authorized representative or any other person or 17 SB 806 2
entity authorized by law to obtain or reproduce such records 18
upon payment of a fee for: 19
(1) (a) Search and retrieval, in an amount not more 20
than twenty-four dollars and eighty -five cents plus copying 21
in the amount of fifty -seven cents per page for the cost of 22
supplies and labor plus, if the health care provider has 23
contracted for off-site records storage and m anagement, any 24
additional labor costs of outside storage retrieval, not to 25
exceed twenty-three dollars and twenty -six cents, as 26
adjusted annually pursuant to subsection 6 of this section; 27
or 28
(b) The records shall be furnished electronically upon 29
payment of the search, retrieval, and copying fees set under 30
this section at the time of the request or one hundred eight 31
dollars and eighty-eight cents total, whichever is less, if 32
such person: 33
a. Requests health records to be delivered 34
electronically in a format of the health care provider's 35
choice; 36
b. The health care provider stores such records 37
completely in an electronic health record; and 38
c. The health care provider is capable of providing 39
the requested records and affidavit, if requested, in an 40
electronic format; 41
(2) Postage, to include packaging and delivery cost; 42
(3) Notary fee, not to exceed two dollars, if 43
requested. 44
Such fee shall be the fee in effect on February 1, 2018, 45
increased or decreased annually un der this section. 46
3. For purposes of subsections 1 and 2 of this 47
section, "a copy of his or her record of that patient's 48 SB 806 3
health history and treatment rendered" or "the patient's 49
health care records" includes a statement or record that no 50
such health history or treatment record responsive to the 51
request exists. 52
4. Notwithstanding provisions of this section to the 53
contrary, providers may charge for the reasonable cost of 54
all duplications of health care record material or 55
information which cannot routinely be copied or duplicated 56
on a standard commercial photocopy machine. 57
5. The transfer of the patient's record done in good 58
faith shall not render the provider liable to the patient or 59
any other person for any consequences which resu lted or may 60
result from disclosure of the patient's record as required 61
by this section. 62
6. Effective February first of each year, the fees 63
listed in subsection 2 of this section shall be increased or 64
decreased annually based on the annual percent age change in 65
the unadjusted, U.S. city average, annual average inflation 66
rate of the medical care component of the Consumer Price 67
Index for All Urban Consumers (CPI -U). The current 68
reference base of the index, as published by the Bureau of 69
Labor Statistics of the United States Department of Labor, 70
shall be used as the reference base. For purposes of this 71
subsection, the annual average inflation rate shall be based 72
on a twelve-month calendar year beginning in January and 73
ending in December of eac h preceding calendar year. The 74
department of health and senior services shall report the 75
annual adjustment and the adjusted fees authorized in this 76
section on the department's internet website by February 77
first of each year. 78
7. A health care provider may disclose a deceased 79
patient's health care records or payment records to the 80 SB 806 4
executor or administrator of the deceased person's estate, 81
or pursuant to a valid, unrevoked power of attorney for 82
health care that specifically directs that the dece ased 83
person's health care records be released to the agent after 84
death. If an executor, administrator, or agent has not been 85
appointed, the deceased prior to death did not specifically 86
object to disclosure of his or her records in writing, and 87
such disclosure is not inconsistent with any prior expressed 88
preference of the deceased that is known to the health care 89
provider, a deceased patient's health care records may be 90
released upon written request of a person who is deemed as 91
the personal represe ntative of the deceased person under 92
this subsection. Priority shall be given to the deceased 93
patient's spouse and the records shall be released on the 94
affidavit of the surviving spouse that he or she is the 95
surviving spouse. If there is no surviving spouse, the 96
health care records may be released to one of the following 97
persons: 98
(1) The acting trustee of a trust created by the 99
deceased patient either alone or with the deceased patient's 100
spouse; 101
(2) An adult child of the deceased patie nt on the 102
affidavit of the adult child that he or she is the adult 103
child of the deceased; 104
(3) A parent of the deceased patient on the affidavit 105
of the parent that he or she is the parent of the deceased; 106
(4) An adult brother or sister of the deceased patient 107
on the affidavit of the adult brother or sister that he or 108
she is the adult brother or sister of the deceased; 109
(5) A guardian or conservator of the deceased patient 110
at the time of the patient's death on the affidavit of the 111 SB 806 5
guardian or conservator that he or she is the guardian or 112
conservator of the deceased; or 113
(6) A guardian ad litem of the deceased's minor child 114
based on the affidavit of the guardian that he or she is the 115
guardian ad litem of the minor child of the de ceased. 116