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HF 2703

as introduced - 90th Legislature (2017 - 2018) Posted on 05/20/2017 10:08am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health; modifying provisions of the Minnesota Health Records Act;
amending Minnesota Statutes 2016, sections 72A.501, subdivision 4; 72A.502,
subdivision 6; 144.291, subdivision 2; 144.293, subdivisions 2, 3, 5, 8; 144.295,
subdivision 1.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2016, section 72A.501, subdivision 4, is amended to read:


Subd. 4.

Authorization; noninsurers.

If an authorization is submitted to an insurer,
insurance-support organization, or insurance agent by a person other than an insurer,
insurance-support organization, or insurance agent, the authorization must be dateddeleted text begin ,deleted text end new text begin andnew text end
signed by the persondeleted text begin ,deleted text end and deleted text begin obtained one year or less before the date a disclosure is soughtdeleted text end new text begin is
valid for one year, or for a period specified in the authorization, or for a period as provided
in law
new text end .

Sec. 2.

Minnesota Statutes 2016, section 72A.502, subdivision 6, is amended to read:


Subd. 6.

Other laws or order.

Personal or privileged information may be disclosed
without a written authorization if permitted or required by another new text begin state or federal new text end law or
new text begin regulation or new text end in response to a facially valid administrative or judicial order, including a
search warrant or subpoena.

Sec. 3.

Minnesota Statutes 2016, section 144.291, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For the purposes of sections 144.291 to 144.298, the following
terms have the meanings given.

(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.

(b) "Health information exchange" means a legal arrangement between health care
providers and group purchasers to enable and oversee the business and legal issues involved
in the electronic exchange of health records between the entities for the delivery of patient
care.

(c) "Health record" means any deleted text begin information, whether oral or recorded in any form or
medium, that relates to the past, present, or future physical or mental health or condition of
a patient; the provision of health care to a patient; or the past, present, or future payment
for the provision of health care to a patient
deleted text end new text begin protected health information as defined in HIPAAnew text end .

new text begin (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996,
title II, subtitle F, as amended, including federal regulations adopted under that act.
new text end

deleted text begin (d)deleted text end new text begin (e)new text end "Identifying information" means the patient's name, address, date of birth, gender,
parent's or guardian's name regardless of the age of the patient, and other nonclinical data
which can be used to uniquely identify a patient.

deleted text begin (e)deleted text end new text begin (f)new text end "Individually identifiable form" means a form in which the patient is or can be
identified as the subject of the health records.

deleted text begin (f)deleted text end new text begin (g)new text end "Medical emergency" means medically necessary care which is immediately
needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, or
prevent placing the physical or mental health of the patient in serious jeopardy.

deleted text begin (g)deleted text end new text begin (h)new text end "Patient" means a natural person who has received health care services from a
provider for treatment or examination of a medical, psychiatric, or mental condition, the
surviving spouse and parents of a deceased patient, or a person the patient appoints in writing
as a representative, including a health care agent acting according to chapter 145C, unless
the authority of the agent has been limited by the principal in the principal's health care
directive. Except for minors who have received health care services under sections 144.341
to 144.347, in the case of a minor, patient includes a parent or guardian, or a person acting
as a parent or guardian in the absence of a parent or guardian.

deleted text begin (h)deleted text end new text begin (i)new text end "Patient information service" means a service providing the following query
options: a record locator service as defined in paragraph deleted text begin (j)deleted text end new text begin (k)new text end or a master patient index or
clinical data repository as defined in section 62J.498, subdivision 1.

deleted text begin (i)deleted text end new text begin (j)new text end "Provider" means:

(1) any person who furnishes health care services and is regulated to furnish the services
under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A, 151, 153, or
153A;

(2) a home care provider licensed under section 144A.471;

(3) a health care facility licensed under this chapter or chapter 144A; and

(4) a physician assistant registered under chapter 147A.

deleted text begin (j)deleted text end new text begin (k)new text end "Record locator service" means an electronic index of patient identifying
information that directs providers in a health information exchange to the location of patient
health records held by providers and group purchasers.

deleted text begin (k)deleted text end new text begin (l)new text end "Related health care entity" means an affiliate, as defined in section 144.6521,
subdivision 3
, paragraph (b), of the provider releasing the health records.

Sec. 4.

Minnesota Statutes 2016, section 144.293, subdivision 2, is amended to read:


Subd. 2.

Patient consent to release of records.

A provider, or a person who receives
health records from a provider, may not release a patient's health records to a person deleted text begin withoutdeleted text end :

(1) new text begin without new text end a signed and dated consent from the patient or the patient's legally authorized
representative authorizing the release;

(2) new text begin unless permitted or required under HIPAA or new text end specific authorization in new text begin other applicable
federal or state
new text end law; or

(3) new text begin without new text end a representation from a provider that holds a signed and dated consent from
the patient authorizing the release.

Sec. 5.

Minnesota Statutes 2016, section 144.293, subdivision 3, is amended to read:


Subd. 3.

Release from one provider to another.

new text begin In addition to release or disclosure of
health records authorized under subdivision 2,
new text end a patient's health record, including, but not
limited to, laboratory reports, x-rays, prescriptions, and other technical information used in
assessing the patient's condition, or the pertinent portion of the record relating to a specific
condition, or a summary of the record, shall promptly be furnished to another provider upon
the written request of the patient. The written request shall specify the name of the provider
to whom the health record is to be furnished. The provider who furnishes the health record
or summary may retain a copy of the materials furnished. The patient shall be responsible
for the reasonable costs of furnishing the information.

Sec. 6.

Minnesota Statutes 2016, section 144.293, subdivision 5, is amended to read:


Subd. 5.

Exceptions to consent requirement.

(a) new text begin In addition to release or disclosure
of health records authorized under subdivision 2,
new text end this section does not prohibit the release
of health records:

(1) for a medical emergency when the provider is unable to obtain the patient's consent
due to the patient's condition or the nature of the medical emergency;

(2) to other providers deleted text begin withindeleted text end new text begin ornew text end related health care entities deleted text begin when necessarydeleted text end for the current
treatment of the patient; or

(3) to a health care facility licensed by this chapter, chapter 144A, or to the same types
of health care facilities licensed by this chapter and chapter 144A that are licensed in another
state when a patient:

(i) is returning to the health care facility and unable to provide consent; or

(ii) who resides in the health care facility, has services provided by an outside resource
under Code of Federal Regulations, title 42, section 483.75(h), and is unable to provide
consent.

(b) A provider may release a deceased patient's health care records to another provider
for the purposes of diagnosing or treating the deceased patient's surviving adult child.

Sec. 7.

Minnesota Statutes 2016, section 144.293, subdivision 8, is amended to read:


Subd. 8.

Record locator or patient information service.

(a) new text begin In addition to release or
disclosure of health records authorized under subdivision 2,
new text end a provider or group purchaser
may release patient identifying information and information about the location of the patient's
health records to a record locator or patient information service without consent from the
patient, unless the patient has elected to be excluded from the service under paragraph (d).
The Department of Health may not access the record locator or patient information service
or receive data from the service. Only a provider may have access to patient identifying
information in a record locator or patient information service. Except in the case of a medical
emergency, a provider participating in a health information exchange using a record locator
or patient information service does not have access to patient identifying information and
information about the location of the patient's health records unless the patient specifically
consents to the access. A consent does not expire but may be revoked by the patient at any
time by providing written notice of the revocation to the provider.

(b) A health information exchange maintaining a record locator or patient information
service must maintain an audit log of providers accessing information in the service that at
least contains information on:

(1) the identity of the provider accessing the information;

(2) the identity of the patient whose information was accessed by the provider; and

(3) the date the information was accessed.

(c) No group purchaser may in any way require a provider to participate in a record
locator or patient information service as a condition of payment or participation.

(d) A provider or an entity operating a record locator or patient information service must
provide a mechanism under which patients may exclude their identifying information and
information about the location of their health records from a record locator or patient
information service. At a minimum, a consent form that permits a provider to access a record
locator or patient information service must include a conspicuous check-box option that
allows a patient to exclude all of the patient's information from the service. A provider
participating in a health information exchange with a record locator or patient information
service who receives a patient's request to exclude all of the patient's information from the
service or to have a specific provider contact excluded from the service is responsible for
removing that information from the service.

Sec. 8.

Minnesota Statutes 2016, section 144.295, subdivision 1, is amended to read:


Subdivision 1.

Methods of release.

(a) deleted text begin Notwithstanding section 144.293, subdivisions
2 and 4
deleted text end new text begin In addition to release or disclosure of health records authorized under section
144.293
new text end , health records may be released to an external researcher solely for purposes of
medical or scientific research only as follows:

(1) health records generated before January 1, 1997, may be released if the patient has
not objected or does not elect to object after that date;

(2) for health records generated on or after January 1, 1997, the provider must:

(i) disclose in writing to patients currently being treated by the provider that health
records, regardless of when generated, may be released and that the patient may object, in
which case the records will not be released; and

(ii) use reasonable efforts to obtain the patient's written general authorization that
describes the release of records in item (i), which does not expire but may be revoked or
limited in writing at any time by the patient or the patient's authorized representative;

(3) the provider must advise the patient of the rights specified in clause (4); and

(4) the provider must, at the request of the patient, provide information on how the
patient may contact an external researcher to whom the health record was released and the
date it was released.

(b) Authorization may be established if an authorization is mailed at least two times to
the patient's last known address with a postage prepaid return envelope and a conspicuous
notice that the patient's medical records may be released if the patient does not object, and
at least 60 days have expired since the second notice was sent.