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SENATE FLOOR VERSION
February 10, 2025
AS AMENDED
SENATE BILL NO. 423 By: Rader of the Senate
and
Caldwell (Chad) of the
House
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 misdemeanor
offense; providing administrative and criminal
penalties; providing for civil relief; and providing
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 patient 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.
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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 release 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 other 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 insti tution
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 inclu ding any x-ray, other photograph or image,
pathology slide or all medical bills pertaining to that 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
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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 rega rdless of whether
any records related to the reque st 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 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 produce the records in digital
form at the rate of thirty cents ($0.30) per page if:
a. the entire request c an be reproduced from an
electronic health record 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 associate 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
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paragraph exceed Two Hundred Dollars ($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 defi ned in
Section 160.103 of Title 45 of the United S tates Code of Federal
Regulations, shall not charge 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 c harged 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 information
contained in the records shall be obtained pursuant to
Section 1-109 of Title 43A of the Oklahoma Statutes .
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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 S tate Department of
Rehabilitation Services. The 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 practitioner 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 c ondition
of that person in issue by the commenceme nt of any action,
proceeding, or suit for damages, 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 cl aims,
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 pr ovider by
personal examination of the patient; pro vided 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.
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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 m et.
2. Any person who obtains any document pursuant 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 neces sary by a physician, 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 person whose information is being
sought, used, or disclosed.
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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 misdemeanor
punishable by a fine not to exceed One Thousand Dollars ($1,000.00) .
4. If a health care provider believes a violation of paragraph
1 of this subsection has occurred or will occur in relat ion 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.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
February 10, 2025 - DO PASS AS AMENDED