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