1.1                          A bill for an act 
  1.2             relating to health; modifying provisions for access to 
  1.3             health records; amending Minnesota Statutes 2000, 
  1.4             section 144.335, subdivision 3a. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  Minnesota Statutes 2000, section 144.335, 
  1.7   subdivision 3a, is amended to read: 
  1.8      Subd. 3a.  [PATIENT CONSENT TO RELEASE OF RECORDS; 
  1.9   LIABILITY.] (a) A provider, or a person who receives health 
  1.10  records from a provider, may not release a patient's health 
  1.11  records to a person without a signed and dated consent from the 
  1.12  patient or the patient's legally authorized representative 
  1.13  authorizing the release, unless the release is specifically 
  1.14  authorized by law.  Except as provided in paragraph (c) or (d), 
  1.15  a consent is valid for one year or for a lesser period specified 
  1.16  in the consent or for a different period provided by law.  
  1.17     (b) This subdivision does not prohibit the release of 
  1.18  health records: 
  1.19     (1) for a medical emergency when the provider is unable to 
  1.20  obtain the patient's consent due to the patient's condition or 
  1.21  the nature of the medical emergency; or 
  1.22     (2) to other providers within related health care entities 
  1.23  when necessary for the current treatment of the patient. 
  1.24     (c) Notwithstanding paragraph (a), if a patient explicitly 
  1.25  gives informed consent to the release of health records for the 
  2.1   purposes and pursuant to the restrictions in clauses (1) and 
  2.2   (2), the consent does not expire after one year for: 
  2.3      (1) the release of health records to a provider who is 
  2.4   being advised or consulted with in connection with the current 
  2.5   treatment of the patient; 
  2.6      (2) the release of health records to an accident and health 
  2.7   insurer, health service plan corporation, health maintenance 
  2.8   organization, or third-party administrator for purposes of 
  2.9   payment of claims, fraud investigation, or quality of care 
  2.10  review and studies, provided that: 
  2.11     (i) the use or release of the records complies with 
  2.12  sections 72A.49 to 72A.505; 
  2.13     (ii) further use or release of the records in individually 
  2.14  identifiable form to a person other than the patient without the 
  2.15  patient's consent is prohibited; and 
  2.16     (iii) the recipient establishes adequate safeguards to 
  2.17  protect the records from unauthorized disclosure, including a 
  2.18  procedure for removal or destruction of information that 
  2.19  identifies the patient. 
  2.20     (d) Notwithstanding paragraph (a), health records may be 
  2.21  released to an external researcher solely for purposes of 
  2.22  medical or scientific research only as follows: 
  2.23     (1) health records generated before January 1, 1997, may be 
  2.24  released if the patient has not objected or does not elect to 
  2.25  object after that date; 
  2.26     (2) for health records generated on or after January 1, 
  2.27  1997, and used for medical or scientific research before 
  2.28  compliance with Code of Federal Regulations, title 45, part 164, 
  2.29  is required, the provider must: 
  2.30     (i) disclose in writing to patients currently being treated 
  2.31  by the provider that health records, regardless of when 
  2.32  generated, may be released and that the patient may object, in 
  2.33  which case the records will not be released; and 
  2.34     (ii) use reasonable efforts to obtain the patient's written 
  2.35  general authorization that describes the release of records in 
  2.36  item (i), which does not expire but may be revoked or limited in 
  3.1   writing at any time by the patient or the patient's authorized 
  3.2   representative; 
  3.3      (3) authorization may be established if an authorization is 
  3.4   mailed at least two times to the patient's last known address 
  3.5   with a postage prepaid return envelope and a conspicuous notice 
  3.6   that the patient's medical records may be released if the 
  3.7   patient does not object, and at least 60 days have expired since 
  3.8   the second notice was sent; and the provider must advise the 
  3.9   patient of the rights specified in clause (4); and 
  3.10     (4) the provider must, at the request of the patient, 
  3.11  provide information on how the patient may contact an external 
  3.12  researcher to whom the health record was released and the date 
  3.13  it was released.  
  3.14     In making a release for research purposes the provider 
  3.15  shall make a reasonable effort to determine that: 
  3.16     (i) the use or disclosure does not violate any limitations 
  3.17  under which the record was collected; 
  3.18     (ii) the use or disclosure in individually identifiable 
  3.19  form is necessary to accomplish the research or statistical 
  3.20  purpose for which the use or disclosure is to be made; 
  3.21     (iii) the recipient has established and maintains adequate 
  3.22  safeguards to protect the records from unauthorized disclosure, 
  3.23  including a procedure for removal or destruction of information 
  3.24  that identifies the patient; and 
  3.25     (iv) further use or release of the records in individually 
  3.26  identifiable form to a person other than the patient without the 
  3.27  patient's consent is prohibited; and 
  3.28     (5) after compliance with Code of Federal Regulations, 
  3.29  title 45, part 164, is required, health records may not be used, 
  3.30  disclosed, or released by a provider for medical or scientific 
  3.31  research without consent according to paragraph (a), except as 
  3.32  permitted by the Health Insurance Portability and Accountability 
  3.33  Act of 1996, Public Law Number 104-191, and Code of Federal 
  3.34  Regulations, title 45, section 164.512, paragraph (i). 
  3.35     (e) A person who negligently or intentionally releases a 
  3.36  health record in violation of this subdivision, or who forges a 
  4.1   signature on a consent form, or who obtains under false 
  4.2   pretenses the consent form or health records of another person, 
  4.3   or who, without the person's consent, alters a consent form, is 
  4.4   liable to the patient for compensatory damages caused by an 
  4.5   unauthorized release, plus costs and reasonable attorney's fees. 
  4.6      (f) Upon the written request of a spouse, parent, child, or 
  4.7   sibling of a patient being evaluated for or diagnosed with 
  4.8   mental illness, a provider shall inquire of a patient whether 
  4.9   the patient wishes to authorize a specific individual to receive 
  4.10  information regarding the patient's current and proposed course 
  4.11  of treatment.  If the patient so authorizes, the provider shall 
  4.12  communicate to the designated individual the patient's current 
  4.13  and proposed course of treatment.  Paragraph (a) applies to 
  4.14  consents given under this paragraph. 
  4.15     (g) In cases where a provider releases health records 
  4.16  without patient consent as authorized by law, the release must 
  4.17  be documented in the patient's health record.