Req. No. 13516 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 STATE OF OKLAHOMA 1st Session of the 60th Legislature (2025) COMMITTEE SUBSTITUTE FOR ENGROSSED SENATE BILL NO. 423 By: Rader of the Senate and Caldwell (Chad) of the House COMMITTEE SUBSTITUTE An Act relating to medical records; amending 7 6 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 fees; modifying certain fee limits; 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 health care provider or health care facility, or such person’s personal representative, Req. No. 13516 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 shall, as provided under 45 C.F.R., Section 164.502, 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. 2. Disclosure of the information described in paragraph 1 of this subsection regarding a deceased patient shall require eithe r 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 family 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 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 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 t o the personal representative, spouse or responsible family member of such Req. No. 13516 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 person, not including any x -ray or other photograph or image or pathology slide, shall be fifty cents ($0.50) for each page. 3. A health care provider or health care facility may i mpose a reasonable, cost-based fee when patients or their personal representatives request copies of medical records; provided, that 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 , or directed to, attorneys, insurance companies , other third parties, and by way of subpoena shall be charged a base fee of Twenty Dollars ($20.00) Twenty-three Dollars ($23.00) in addition to the a per page charges required pursuant to this section fee of: a. sixty-seven cents ($0.67) for paper copies , plus postage or delivery fee , or b. forty cents ($0.40) for electronic copies . The base fee shall be charged regardless of whether any records related to the request are locate d. 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: Req. No. 13516 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 a. the entire request can be reprodu ced 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 po stage 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 paragraph exceed Two Hundred Dollars ($200.00) Two Hundred Seventy Dollars ($270.00) 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) Twenty-three Dollars ($23.00) 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 charge a person who requests their own record a fee for searching, retrieving, reviewing, and preparing medical records of the person. No mailing fee sha ll be charged for copies provided by facsimile. All requests for medical records made pursuant to this subsection shall be subject to the Req. No. 13516 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 fees described in this section regardless of where the copies or electronic versions of such records are actually pro duced. 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 trea tment records, access to information contained in the records shall be obtained pursuant to Section 1 -109 of Title 43A of the Oklahoma Statutes. 4. The provisions of paragraphs 1 and 2 of this subsection shall not apply to, and b. requests for medical rec ords made by the Disability Determination Division of the State 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 de ath 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 condition of that person in issue by the commencement of any action, Req. No. 13516 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 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 righ tfully 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 healt h 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. 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 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. Req. No. 13516 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 SECTION 2. This act shall become effective November 1, 2025. 60-1-13516 TJ 04/15/25