UT
Utah House Bill HB0239

Utah 2023 Regular Session

Utah House Bill HB0239 Compare Versions

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1-2nd Sub. H.B. 239
1+1st Sub. H.B. 239
22 LEGISLATIVE GENERAL COUNSEL
33 6 Approved for Filing: C. Williams 6
4-6 02-15-23 9:52 PM 6
4+6 02-08-23 8:49 PM 6
55 H.B. 239
6-2nd Sub. (Gray)
6+1st Sub. (Buff)
77 Representative Raymond P. Ward proposes the following substitute bill:
88 1 MEDICAL RECORD ACCESS AMENDMENTS
99 2 2023 GENERAL SESSION
1010 3 STATE OF UTAH
1111 4 Chief Sponsor: Raymond P. Ward
1212 5 Senate Sponsor: ____________
1313 6
1414 7LONG TITLE
1515 8General Description:
1616 9 This bill enacts provisions related to a patient's health information contained by hospital
1717 10systems.
1818 11Highlighted Provisions:
1919 12 This bill:
2020 13 <defines terms;
2121 14 <requires certain hospital systems to collectively select a method that allows a health
2222 15care provider to access patient information for the patient the health care provider is
23-16treating; and
24-17 <requires the Department of Health and Human Services to facilitate discussions
25-18between the hospital systems and other entities for improving patient access and
26-19patient control of medical information.
27-20Money Appropriated in this Bill:
28-21 This bill appropriates in fiscal year 2024:
29-22 <to the Department of Health and Human Services - Operations - Data, Systems, &
30-23Evaluations, as an ongoing appropriation:
31-24 Cfrom the General Fund, $300,000.
32-25Other Special Clauses:
33-*HB0239S02* 2nd Sub. (Gray) H.B. 239 02-15-23 9:52 PM
23+16treating;
24+17 <requires the Department of Health and Human Services (department) to facilitate
25+18discussions between the hospital systems; and
26+19 <allows the department to designate a health information exchange that hospital
27+20systems must adopt if the hospital systems are unable to collectively make a
28+21decision.
29+22Money Appropriated in this Bill:
30+23 This bill appropriates in fiscal year 2024:
31+24 <to the Department of Health and Human Services - Operations - Data, Systems, &
32+25Evaluations, as an ongoing appropriation:
33+*HB0239S01* 1st Sub. (Buff) H.B. 239 02-08-23 8:49 PM
3434 - 2 -
35-26 None
36-27Utah Code Sections Affected:
37-28AMENDS:
38-29 26-70-101, as enacted by Laws of Utah 2022, Chapter 327
39-30 63I-1-226, as last amended by Laws of Utah 2022, Chapters 194, 206, 224, 253, 255,
40-31347, and 451
41-32ENACTS:
42-33 26-21-36, Utah Code Annotated 1953
43-34 26-70-103, Utah Code Annotated 1953
44-35
45-36Be it enacted by the Legislature of the state of Utah:
46-37 Section 1. Section 26-21-36 is enacted to read:
47-38 26-21-36. Health care facilities within a hospital system.
48-39 (1) As used in this section:
49-40 (a) "Hospital system" means the same as that term is defined in Section 26-70-101.
50-41 (b) "Medical information" means the same as that term is defined in Section
51-4226-70-101.
52-43 (2) Beginning July 1, 2025, a health care facility that is owned or operated by a hospital
53-44system shall ensure that medical information collected by the health care facility is accessible
54-45in accordance with Section 26-70-103.
55-46 Section 2. Section 26-70-101 is amended to read:
56-47 CHAPTER 70. PATIENT HEALTH RECORD ACCESS
57-48 26-70-101. Definitions.
58-49 As used in this chapter:
59-50 (1) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
60-51Pub. L. No. 104-191, 110 Stat. 1936, as amended.
61-52 (2) "Hospital" means:
62-53 (a) a general acute hospital as defined in Section 26-21-2; and
63-54 (b) a specialty hospital as defined in Section 26-21-2.
64-55 (3) "Hospital system" means an entity that owns or operates at least five hospitals that
65-56are licensed under Chapter 21, Health Care Facility Licensing and Inspection Act. 02-15-23 9:52 PM 2nd Sub. (Gray) H.B. 239
66-- 3 -
67-57 (4) "Medical information" means one or more of the following regarding a patient:
68-58 (a) for each time the patient is hospitalized:
69-59 (i) an admission history and physical exam; or
70-60 (ii) a discharge summary;
71-61 (b) the health care provider's notes regarding:
72-62 (i) an emergency room visit;
73-63 (ii) an urgent care visit;
74-64 (iii) a primary care outpatient care visit; or
75-65 (iv) a consultation office visit;
76-66 (c) a radiology report;
77-67 (d) a lab report; or
78-68 (e) a pathology report.
79-69 [(2)] (5) "Patient" means the individual whose information is being requested.
80-70 [(3)] (6) "Personal representative" means an individual described in 45 C.F.R. Sec.
81-71164.502(g).
82-72 Section 3. Section 26-70-103 is enacted to read:
83-73 26-70-103. Patient information access by a health care provider.
84-74 (1) Beginning July 1, 2025, each hospital system shall ensure for a patient receiving
85-75care in the hospital system's hospital that the patient's medical information maintained by all of
86-76the hospital systems is accessible to a physician designated by the patient, preferably through
87-77the use of single login.
88-78 (2) (a) The department shall facilitate discussions with each hospital system and the
89-79One Utah Health Collaborative as to how to best achieve the requirement described in
90-80Subsection (1).
91-81 (b) The department shall facilitate discussions with each hospital system and the
92-82qualified networks within the state to accurately determine the costs of meeting the requirement
93-83of Subsection (1) and determine where those costs would occur.
94-84 (c) The department shall facilitate discussions with each hospital system and the
95-85qualified networks within the state to make recommendations about how to best improve a
96-86patient's ability to control how, when, and where the patient's medical information is shared.
97-87 (3) The liability protections of Subsection 26-1-37(5) apply to a hospital system's 2nd Sub. (Gray) H.B. 239 02-15-23 9:52 PM
35+26 Cfrom the General Fund, $1,500,000.
36+27Other Special Clauses:
37+28 None
38+29Utah Code Sections Affected:
39+30AMENDS:
40+31 26-70-101, as enacted by Laws of Utah 2022, Chapter 327
41+32 63I-1-226, as last amended by Laws of Utah 2022, Chapters 194, 206, 224, 253, 255,
42+33347, and 451
43+34ENACTS:
44+35 26-21-36, Utah Code Annotated 1953
45+36 26-70-103, Utah Code Annotated 1953
46+37
47+38Be it enacted by the Legislature of the state of Utah:
48+39 Section 1. Section 26-21-36 is enacted to read:
49+40 26-21-36. Health care facilities within a hospital system.
50+41 (1) As used in this section:
51+42 (a) "Hospital system" means the same as that term is defined in Section 26-70-101.
52+43 (b) "Medical information" means the same as that term is defined in Section
53+4426-70-101.
54+45 (2) Beginning July 1, 2025, a health care facility that is owned or operated by a hospital
55+46system shall ensure that medical information collected by the health care facility is accessible
56+47in accordance with Section 26-70-103.
57+48 Section 2. Section 26-70-101 is amended to read:
58+49 CHAPTER 70. PATIENT HEALTH RECORD ACCESS
59+50 26-70-101. Definitions.
60+51 As used in this chapter:
61+52 (1) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
62+53Pub. L. No. 104-191, 110 Stat. 1936, as amended.
63+54 (2) "Hospital" means:
64+55 (a) a general acute hospital as defined in Section 26-21-2; and
65+56 (b) a specialty hospital as defined in Section 26-21-2. 02-08-23 8:49 PM 1st Sub. (Buff) H.B. 239
66+- 3 - House Committee Amendments 2-9-2023 pf/cw1
67+57 (3) "Hospital system" means an entity that owns or operates at least five hospitals that
68+58are licensed under Chapter 21, Health Care Facility Licensing and Inspection Act.
69+59 (4) "Medical information" means one or more of the following regarding a patient:
70+60 (a) for each time the patient is hospitalized:
71+61 (i) an admission history and physical exam; or
72+62 (ii) a discharge summary;
73+63 (b) the health care provider's notes regarding:
74+64 (i) an emergency room visit;
75+65 (ii) an urgent care visit;
76+66 (iii) a primary care outpatient care visit; or
77+67 (iv) a consultation office visit;
78+68 (c) a radiology report;
79+69 (d) a lab report; or
80+70 (e) a pathology report.
81+71 [(2)] (5) "Patient" means the individual whose information is being requested.
82+72 [(3)] (6) "Personal representative" means an individual described in 45 C.F.R. Sec.
83+73164.502(g).
84+74 Section 3. Section 26-70-103 is enacted to read:
85+75 26-70-103. Patient information access by a health care provider.
86+76 (1)  º [Beginning July 1, 2025, each hospital system, collectively, shall ensure that a
87+77patient's medical information that is created when the patient receives care from the hospital
88+78system is accessible to a physician designated by the patient, preferably through the use of
89+79single login.] Beginning July 1, 2025, each hospital system shall ensure for a patient receiving
90+79acare in their hospital that the patient's medical information maintained by all of the hospital
91+79bsystems is accessible to a physician designated by the patient, preferably through the use of
92+79csingle login. » 
93+80 (2) The department shall facilitate discussions with each hospital system and the One
94+81Utah Health Collaborative as to how to best achieve the requirement described in Subsection
95+82(1).
96+83 (3) The liability protections of Subsection 26-1-37(5) a hospital system's compliance
97+84with Subsection (1).
98+85 (4) To better improve patient access to the patient's medical information, the
99+86department shall communicate with each hospital system and with the One Utah Health
100+87Collaborative to determine whether each hospital system, collectively, will create and adopt the 1st Sub. (Buff) H.B. 239 02-08-23 8:49 PM
98101 - 4 -
99-88compliance with Subsection (1).
100-89 (4) To better improve patient access to the patient's medical information, the
101-90department shall communicate with each hospital system and with the One Utah Health
102-91Collaborative to determine whether each hospital system, collectively, will create and adopt the
103-92same policies regarding one or all of the following:
104-93 (a) the creation of a published provider directory that contains identifying information
105-94of the providers to facilitate interfaces between systems;
106-95 (b) the establishment of technical specifications that would enable identity verification
107-96and authentication both for a patient and a health care provider; and
108-97 (c) the creation of a consensus data sharing agreement for health care providers and
109-98hospitals that is consistent with applicable federal and state laws.
110-99 (5) The department shall report to the Health and Human Services Interim Committee
111-100before November 1, 2023, and again between June 1, 2024, and November 1, 2024, regarding:
112-101 (a) any progress towards the hospital systems complying with Subsection (1);
113-102 (b) an analysis of costs as described in Subsection (2)(b);
114-103 (c) recommendations regarding the patient's control of medical information as
115-104described in Subsection (2)(c); and
116-105 (d) whether a consensus has been achieved on any of the items listed in Subsection (4).
117-106 (6) Nothing in this section requires a hospital system to pay for a system described in
118-107Subsection (1) that the hospital system does not control.
119-108 Section 4. Section 63I-1-226 is amended to read:
120-109 63I-1-226. Repeal dates: Title 26 through 26B.
121-110 (1) Section 26-1-7.5, which creates the Utah Health Advisory Council, is repealed July
122-1111, 2025.
123-112 (2) Section 26-1-40 is repealed July 1, 2022.
124-113 (3) Section 26-1-41 is repealed July 1, 2026.
125-114 (4) Section 26-1-43 is repealed December 31, 2025.
126-115 (5) Section 26-7-10 is repealed July 1, 2025.
127-116 (6) Subsection 26-7-11(5), regarding reports to the Legislature, is repealed July 1,
128-1172028.
129-118 (7) Section 26-7-14 is repealed December 31, 2027. 02-15-23 9:52 PM 2nd Sub. (Gray) H.B. 239
102+88same policies regarding one or all of the following:
103+89 (a) the creation of a published provider directory that contains identifying information
104+90of the providers to facilitate interfaces between systems;
105+91 (b) the establishment of technical specifications that would enable identity verification
106+92and authentication both for a patient and a health care provider; and
107+93 (c) the creation of a consensus data sharing agreement for health care providers and
108+94hospitals that is consistent with applicable federal and state laws.
109+95 (5) The department shall report to the Health and Human Services Interim Committee
110+96before November 1, 2023, and again between June 1, 2024, and November 1, 2024, regarding:
111+97 (a) any progress towards the hospital systems complying with Subsection (1); and
112+98 (b) whether a consensus has been achieved on any of the items listed in Subsection (4).
113+99 (6) To better improve a patient's access and control of the patient's own medical
114+100information when a patient receives care from more than one hospital system, the department
115+101shall communicate with each hospital system and with the One Utah Health Collaborative to
116+102determine which policies or projects would best improve:
117+103 (a) the accuracy of any information that the patient requests to have shared;
118+104 (b) the completeness of any information that the patient requests to have shared;
119+105 (c) the security of any information that the patient requests to have shared;
120+106 (d) the timeliness of any information that the patient requests to have shared;
121+107 (e) the ability of the patient to block any of the patient's data from being shared; or
122+108 (f) the ability of the patient to block the patient's data from any individual source from
123+109being shared.
124+110 Section 4. Section 63I-1-226 is amended to read:
125+111 63I-1-226. Repeal dates: Title 26 through 26B.
126+112 (1) Section 26-1-7.5, which creates the Utah Health Advisory Council, is repealed July
127+1131, 2025.
128+114 (2) Section 26-1-40 is repealed July 1, 2022.
129+115 (3) Section 26-1-41 is repealed July 1, 2026.
130+116 (4) Section 26-1-43 is repealed December 31, 2025.
131+117 (5) Section 26-7-10 is repealed July 1, 2025.
132+118 (6) Subsection 26-7-11(5), regarding reports to the Legislature, is repealed July 1, 02-08-23 8:49 PM 1st Sub. (Buff) H.B. 239
130133 - 5 -
131-119 (8) Section 26-8a-603 is repealed July 1, 2027.
132-120 (9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
133-1211, 2025.
134-122 (10) Subsection 26-10-6(5), which creates the Newborn Hearing Screening Committee,
135-123is repealed July 1, 2026.
136-124 (11) Section 26-10b-106, which creates the Primary Care Grant Committee, is repealed
137-125July 1, 2025.
138-126 (12) Subsection 26-15c-104(3), relating to a limitation on the number of
139-127microenterprise home kitchen permits that may be issued, is repealed July 1, 2022.
140-128 (13) Subsection 26-18-2.6(9), which addresses reimbursement for dental hygienists, is
141-129repealed July 1, 2028.
142-130 (14) Section 26-18-27 is repealed July 1, 2025.
143-131 (15) Section 26-18-28 is repealed June 30, 2027.
144-132 (16) Title 26, Chapter 18, Part 2, Drug Utilization Review Board, is repealed July 1,
145-1332027.
146-134 (17) Subsection 26-18-418(2), the language that states "and the Behavioral Health
147-135Crisis Response Commission created in Section 63C-18-202" is repealed July 1, 2023.
148-136 (18) Section 26-33a-117 is repealed December 31, 2023.
149-137 (19) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
150-138 (20) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
151-1392024.
152-140 (21) Title 26, Chapter 36c, Medicaid Expansion Hospital Assessment Act, is repealed
153-141July 1, 2024.
154-142 (22) Title 26, Chapter 36d, Hospital Provider Assessment Act, is repealed July 1, 2024.
155-143 (23) Section 26-39-201, which creates the Residential Child Care Licensing Advisory
156-144Committee, is repealed July 1, 2024.
157-145 (24) Section 26-39-405, Drinking water quality in child care centers, is repealed July 1,
158-1462027.
159-147 (25) Section 26-40-104, which creates the Utah Children's Health Insurance Program
160-148Advisory Council, is repealed July 1, 2025.
161-149 (26) Section 26-50-202, which creates the Traumatic Brain Injury Advisory 2nd Sub. (Gray) H.B. 239 02-15-23 9:52 PM
134+1192028.
135+120 (7) Section 26-7-14 is repealed December 31, 2027.
136+121 (8) Section 26-8a-603 is repealed July 1, 2027.
137+122 (9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
138+1231, 2025.
139+124 (10) Subsection 26-10-6(5), which creates the Newborn Hearing Screening Committee,
140+125is repealed July 1, 2026.
141+126 (11) Section 26-10b-106, which creates the Primary Care Grant Committee, is repealed
142+127July 1, 2025.
143+128 (12) Subsection 26-15c-104(3), relating to a limitation on the number of
144+129microenterprise home kitchen permits that may be issued, is repealed July 1, 2022.
145+130 (13) Subsection 26-18-2.6(9), which addresses reimbursement for dental hygienists, is
146+131repealed July 1, 2028.
147+132 (14) Section 26-18-27 is repealed July 1, 2025.
148+133 (15) Section 26-18-28 is repealed June 30, 2027.
149+134 (16) Title 26, Chapter 18, Part 2, Drug Utilization Review Board, is repealed July 1,
150+1352027.
151+136 (17) Subsection 26-18-418(2), the language that states "and the Behavioral Health
152+137Crisis Response Commission created in Section 63C-18-202" is repealed July 1, 2023.
153+138 (18) Section 26-33a-117 is repealed December 31, 2023.
154+139 (19) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
155+140 (20) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
156+1412024.
157+142 (21) Title 26, Chapter 36c, Medicaid Expansion Hospital Assessment Act, is repealed
158+143July 1, 2024.
159+144 (22) Title 26, Chapter 36d, Hospital Provider Assessment Act, is repealed July 1, 2024.
160+145 (23) Section 26-39-201, which creates the Residential Child Care Licensing Advisory
161+146Committee, is repealed July 1, 2024.
162+147 (24) Section 26-39-405, Drinking water quality in child care centers, is repealed July 1,
163+1482027.
164+149 (25) Section 26-40-104, which creates the Utah Children's Health Insurance Program 1st Sub. (Buff) H.B. 239 02-08-23 8:49 PM
162165 - 6 -
163-150Committee, is repealed July 1, 2025.
164-151 (27) Title 26, Chapter 54, Spinal Cord and Brain Injury Rehabilitation Fund and
165-152Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
166-153 (28) Title 26, Chapter 66, Early Childhood Utah Advisory Council, is repealed July 1,
167-1542026.
168-155 (29) Title 26, Chapter 68, COVID-19 Vaccine Restrictions Act, is repealed July 1,
169-1562024.
170-157 (30) Section 26-69-406 is repealed July 1, 2025.
171-158 (31) Section 26-70-103 is repealed July 1, 2025.
172-159 [(31)] (32) Subsection 26B-1-204(2)(i), related to the Residential Child Care Licensing
173-160Advisory Committee, is repealed July 1, 2024.
174-161 [(32)] (33) Subsection 26B-1-204(2)(k), related to the Primary Care Grant Committee,
175-162is repealed July 1, 2025.
176-163 Section 5. Appropriation.
177-164 The following sums of money are appropriated for the fiscal year beginning July 1,
178-1652023, and ending June 30, 2024. These are additions to amounts previously appropriated for
179-166fiscal year 2024. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
180-167Act, the Legislature appropriates the following sums of money from the funds or accounts
181-168indicated for the use and support of the government of the state of Utah.
182-169ITEM 1
183-170To Department of Health and Human Services - Operations
184-171 From General Fund 300,000
185-172 Schedule of Programs:
186-173 Data, Systems, & Evaluations 300,000
187-174 The Legislature intends that the Department of Health and Human Services use the
188-175appropriation, through one or more requests for proposal, to assist:
189-176 (1) the hospital systems to meet the obligations of Subsection 26-70-103(1); and
190-177 (2) in facilitating discussions and creating policies upon reaching a consensus as
191-178described in Subsection 26-70-103(4).
192-179
166+150Advisory Council, is repealed July 1, 2025.
167+151 (26) Section 26-50-202, which creates the Traumatic Brain Injury Advisory
168+152Committee, is repealed July 1, 2025.
169+153 (27) Title 26, Chapter 54, Spinal Cord and Brain Injury Rehabilitation Fund and
170+154Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
171+155 (28) Title 26, Chapter 66, Early Childhood Utah Advisory Council, is repealed July 1,
172+1562026.
173+157 (29) Title 26, Chapter 68, COVID-19 Vaccine Restrictions Act, is repealed July 1,
174+1582024.
175+159 (30) Section 26-69-406 is repealed July 1, 2025.
176+160 (31) Section 26-70-103 is repealed July 1, 2027.
177+161 [(31)] (32) Subsection 26B-1-204(2)(i), related to the Residential Child Care Licensing
178+162Advisory Committee, is repealed July 1, 2024.
179+163 [(32)] (33) Subsection 26B-1-204(2)(k), related to the Primary Care Grant Committee,
180+164is repealed July 1, 2025.
181+165 Section 5. Appropriation.
182+166 The following sums of money are appropriated for the fiscal year beginning July 1,
183+1672023, and ending June 30, 2024. These are additions to amounts previously appropriated for
184+168fiscal year 2024. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
185+169Act, the Legislature appropriates the following sums of money from the funds or accounts
186+170indicated for the use and support of the government of the state of Utah.
187+171ITEM 1
188+172To Department of Health and Human Services - Operations
189+173 From General Fund 1,500,000
190+174 Schedule of Programs:
191+175 Data, Systems, & Evaluations 1,500,000
192+176 The Legislature intends that the Department of Health and Human Services use the
193+177appropriation, through one or more requests for proposal, to:
194+178 (1) assist the hospital systems to meet the obligations of Subsection 26-70-103(1);
195+179 (2) assist in facilitating discussions and creating policies upon consensus as described
196+180in Subsection 26-70-103(5); and 02-08-23 8:49 PM 1st Sub. (Buff) H.B. 239
197+- 7 -
198+181 (3) accomplish the projects described in Subsection 26-70-103(6).