Req. No. 603 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 60th Legislature (2025) SENATE BILL 423 By: Rader AS INTRODUCED An Act relating to medical records; amending 76 O.S. 2021, Section 19, which relates to access to medical records; modifying applicability of certain provisions; eliminating certain duties of health care providers; authorizing imposition of certain fee; making certain acts unlawful; creating felony offense; providing administrative and criminal penalties; providing for civil relief; and prov iding an effective date. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. AMENDATORY 76 O.S. 2021, Section 19, is amended to read as follows: Section 19. A. 1. Any person who is or has been a patien t of a doctor, hospital or other medical institution any health care provider or health care facility, or such person ’s personal representative, shall be entitled, upon request, to obtain access to the information contained in the patient ’s medical records including any x-ray or other photograph or image, pathology slide or the patient’s medical bills. Req. No. 603 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. Disclosure of the information described in paragraph 1 of this subsection regarding a deceased patient shall require either a court order or a written re lease of an executor, administrator or personal representative appointed by the court, or if there is no such appointment, by the spouse of the patient or, if none, by any responsible member of the family of the patient. As used in this paragraph, “responsible family member” shall mean the parent, adult child, adult sibling or othe r adult relative who was actively involved in providing care to or monitoring the care of the patient as verified by the doctor, hospital or other medical institution health care provider or health care facility responsible for the care and treatment of such person. 2. Any person who is or has been a patient of a doctor, hospital or other medical institution shall be furnished copies of all medical records including any x -ray, other photograph or image, pathology slide or all medical bills pertaining to th at person’s case upon request and upon the tender of the expenses enumerated in this paragraph. The cost of each copy to such person or to the personal representative, spouse or responsible family member of such person, not including any x -ray or other photograph or image or pathology slide, shall be fifty cents ($0.50) for each page. 3. Health care providers and health care facilities may impose a reasonable, cost-based fee when patients or their personal representatives request copies of medical records ; provided, that Req. No. 603 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 the fee includes only the cost of applicable expenses listed in 42 C.F.R., Section 164.524(c)(4). 4. Requests for medical records and medical bills from attorneys, insurance companies and by way of subpoena shall be charged a base fee of Twenty Dollars ($20.00) in addition to the per page charges required pursuant to this section, plus postage or delivery fee. The base fee shall be charged regardless of whether any records related to the request are located. A fee of Fifteen Dollars ($15.00) shall be charged if a certification or an affidavit by the provider regarding the authenticity of the medical records or bills is requested. The physician, hospital or othe r medical professionals and institutions, or their business associates as the term is defined in Section 160.103 of Title 45 of the United States Code of Federal Regulations shall produce the records in digital form at the rate of thirty cents ($0.30) per page if: a. the entire request can be reproduced from an electronic health rec ord system, b. the records are specifically requested to be delivered in electronic format, and c. the records can be delivered electronically. If a provider or business associat e transmits the records electronically, no postage shall be charged but a delivery charge shall apply. In no event shall a charge for the reproduction of electronically stored and delivered medical records pursuant to this Req. No. 603 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 paragraph exceed Two Hundred Dol lars ($200.00) plus postage or delivery fee. The cost of each printed x -ray, other photograph or image to such person or to the legal representative of such person shall be Fifteen Dollars ($15.00). If the x -ray, other photograph or image is provided on a CD/DVD or other electronic media, the fee shall be Twenty Dollars ($20.00) per CD/DVD or other electronic media. The physician, hospital, or other medical professionals and institutions, or their business associates as the term is defined in Section 160.103 of Title 45 of the United States Code of Federal Regulations, shall not c harge a person who requests their own record a fee for searching, retrieving, reviewing, and preparing medical records of the person. No mailing fee shall be charged for copies provided by facsimile. All requests for medical records made pursuant to this subsection shall be subject to the fees described in this section regardless of where the copies or electronic versions of such records are actually produced . 3. 5. The provisions of paragraphs 1 and 2 of this subsection shall not apply to: a. psychological, psychiatric, mental health or substance abuse treatment records. In the case of psychological, psychiatric, mental health or substance abuse treatment records, access to in formation contained in the records shall be obtained pursuant to Section 1-109 of Title 43A of the Oklahoma Statutes . Req. No. 603 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 4. The provisions of paragraphs 1 and 2 of this subsection shall not apply to, and b. requests for medical records made by the Disability Determination Division of the State Department of Rehabilitation Services. T he fee for such requests shall be at a rate allowed by the Social Security Administration. B. 1. In cases involving a claim for personal injury or death against any practitione r of the healing arts or a licensed hospital, or a nursing facility or nursing home licensed pursuant to Section 1-1903 of Title 63 of the Oklahoma Statutes arising out of patient care, where any person has placed the physical or mental condition of that person in issue by the commencement of any action, proceeding, or suit for dama ges, or where any person has placed in issue the physical or mental condition of any other person or deceased person by or through whom the person rightfully claims, that person shall be deemed to waive any privilege granted by law concerning any communication made to a physician or health care provider with reference to any physical or mental condition or any knowledge obtained by the physician or health care provider by personal examination of the patient; provided that, before any communication, medical or hospital record, or testimony is admitted in evidence in any proceeding, it must be material and relevant to an issue therein, according to existing rules of evidence. Req. No. 603 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Psychological, psychiatric, mental health and substance abuse treatment records and information from psychological, psychiatric, mental health and substance abuse treatment practitioners may only be obtained provided the requirements of Section 1 -109 of Title 43A of the Oklahoma Statutes are met. 2. Any person who obtains any document pu rsuant to the provisions of this section shall provide copies of the document to any opposing party in the proceeding upon payment of the expense of copying the document pursuant to the provisions of this section. C. This section shall not apply to the records of an inmate in a correctional institution when the correctional institution believes the release of such information to be a threat to the safety or security of the inmate or the institution. D. 1. It shall be unlawful for any person to transmit, disclose, seek, use, or obtain any person ’s health information or records related to any medical service, procedure, or treatment that is deemed medically necessary by a physicia n, nurse, or other health care provider licensed in this state for any purpose other than treatment, payment, or health care operations as those terms are defined by the Health Insurance Portability and Accountability Act of 1996 or as authorized by the pe rson whose information is being sought, used, or disclosed. Req. No. 603 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. Violation of paragraph 1 of this subsection shall be deemed unprofessional conduct by the person’s licensure board if applicable and subject to mandatory license revocation. 3. A person found in violation of paragraph 1 of this subsection shall, upon conviction, be guilty of a felony punishable by a fine not to exceed Ten Thousand Dollars ($10,000.00) , or by imprisonment in the custody of the Department of Corrections for a term not to exceed one (1) year, or by both such fine and imprisonment. 4. If a health care provider believes a violation of paragraph 1 of this subsection has occurred or will occur in relation to a request for medical records, the health care provider may apply to a court of competent jurisdiction for relief and the court shall award appropriate relief including , but not limited to, temporary, preliminary, or permanent injunctive relief . SECTION 2. This act shall become effective November 1, 2025. 60-1-603 DC 1/7/2025 11:33:35 AM