1.1                          A bill for an act 
  1.2             relating to health; modifying access to health 
  1.3             records; amending Minnesota Statutes 2000, section 
  1.4             144.335, subdivisions 2, 4, 5; Minnesota Statutes 2001 
  1.5             Supplement, section 144.335, subdivision 1; repealing 
  1.6             Minnesota Statutes 2000, section 144.335, subdivision 
  1.7             3. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 2001 Supplement, section 
  1.10  144.335, subdivision 1, is amended to read: 
  1.11     Subdivision 1.  [DEFINITIONS.] For the purposes of this 
  1.12  section, the following terms have the meanings given them: 
  1.13     (a) "Patient" means a natural person who has received 
  1.14  health care services from a provider for treatment or 
  1.15  examination of a medical, psychiatric, or mental condition, the 
  1.16  surviving spouse and parents of a deceased patient, or a person 
  1.17  the patient appoints in writing as a representative, including a 
  1.18  health care agent acting pursuant to chapter 145C, unless the 
  1.19  authority of the agent has been limited by the principal in the 
  1.20  principal's health care directive.  Except for minors who have 
  1.21  received health care services pursuant to sections 144.341 to 
  1.22  144.347, in the case of a minor, patient includes a parent or 
  1.23  guardian, or a person acting as a parent or guardian in the 
  1.24  absence of a parent or guardian. 
  1.25     (b) "Provider" means: 
  1.26     (1) any person who furnishes health care services and is 
  2.1   regulated to furnish the services pursuant to chapter 147, 147A, 
  2.2   147B, 147C, 147D, 148, 148B, 148C, 150A, 151, 153, or 153A, or 
  2.3   Minnesota Rules, chapter 4666; 
  2.4      (2) a home care provider licensed under section 144A.46; 
  2.5      (3) a health care facility licensed pursuant to this 
  2.6   chapter or chapter 144A; 
  2.7      (4) a physician assistant registered under chapter 147A; 
  2.8   and a health maintenance organization licensed under chapter 
  2.9   62D; 
  2.10     (5) an unlicensed mental health practitioner regulated 
  2.11  pursuant to sections 148B.60 to 148B.71.; 
  2.12     (6) a home health agency; 
  2.13     (7) ambulatory surgical or obstetrical facilities; 
  2.14     (8) intermediate care facilities; and 
  2.15     (9) other special care units, including podiatric 
  2.16  facilities, skilled nursing facilities, and kidney disease 
  2.17  treatment centers, including freestanding hemodialysis units. 
  2.18     (c) "Individually identifiable form" means a form in which 
  2.19  the patient is or can be identified as the subject of the health 
  2.20  records. 
  2.21     (d) "Record" means a patient's health record, including, 
  2.22  but not limited to, evaluations, diagnoses, prognoses, 
  2.23  laboratory reports, x-rays, prescriptions, and other technical 
  2.24  information used in assessing the patient's condition, the 
  2.25  pertinent portion of the record relating to a specific 
  2.26  condition, or a summary of the record. 
  2.27     Sec. 2.  Minnesota Statutes 2000, section 144.335, 
  2.28  subdivision 2, is amended to read: 
  2.29     Subd. 2.  [PATIENT ACCESS.] (a) Upon written request from a 
  2.30  patient, a the provider having custody and control of the 
  2.31  patient's record shall supply to furnish a patient complete and 
  2.32  current information possessed by that provider concerning any 
  2.33  diagnosis, treatment and prognosis of the patient in terms and 
  2.34  language the patient can reasonably be expected to 
  2.35  understand copy of the record according to this section. 
  2.36     (b) Except as provided in paragraph (e) (d), upon a 
  3.1   patient's written request, a provider, at a reasonable cost to 
  3.2   the patient, shall promptly furnish to the patient (1) copies of 
  3.3   the patient's health record, including but not limited to 
  3.4   laboratory reports, x-rays, prescriptions, and other technical 
  3.5   information used in assessing the patient's health condition, or 
  3.6   (2) the pertinent portion of the record relating to a condition 
  3.7   specified by the patient.  With the consent of the patient, the 
  3.8   provider may instead furnish only a summary of the record.  The 
  3.9   provider may exclude from the health record written speculations 
  3.10  about the patient's health condition, except that all 
  3.11  information necessary for the patient's informed consent must be 
  3.12  provided a record requested under paragraph (a) shall be 
  3.13  furnished to the patient, any other provider designated by the 
  3.14  patient, or any other person designated by the patient. 
  3.15     (c) If a the provider, as defined in subdivision 1, clause 
  3.16  (b)(1), reasonably determines that the information is disclosure 
  3.17  of the record to the patient will be detrimental to the physical 
  3.18  or mental health of the patient, or is likely to cause the 
  3.19  patient to inflict self harm, or to harm another, the provider 
  3.20  may withhold the information from the patient and may supply the 
  3.21  information to an appropriate third party or to another refuse 
  3.22  to furnish the record.  Upon such refusal, the patient's record 
  3.23  shall, upon written request by the patient, be furnished to any 
  3.24  other provider, as defined in subdivision 1, clause (b)(1).  The 
  3.25  other provider or third party may release the information 
  3.26  to designated by the patient. 
  3.27     (d) A provider as defined in subdivision 1, clause (b)(3), 
  3.28  shall release information upon written request unless, prior to 
  3.29  the request, a provider as defined in subdivision 1, clause 
  3.30  (b)(1), has designated and described a specific basis for 
  3.31  withholding the information as authorized by paragraph (c). 
  3.32     (e) A provider may not release a copy of a videotape of a 
  3.33  child victim or alleged victim of physical or sexual abuse 
  3.34  without a court order under section 13.03, subdivision 6, or as 
  3.35  provided in section 611A.90.  This paragraph does not limit the 
  3.36  right of a patient to view the videotape.  
  4.1      (e) This subdivision does not apply to psychiatric, 
  4.2   psychological, or other mental health records of a patient. 
  4.3      (f) A provider releasing information in good faith 
  4.4   according to this subdivision is not civilly or criminally 
  4.5   liable to the patient, guardian, parent, or any other person for 
  4.6   such release. 
  4.7      (g) Nothing in this subdivision shall be construed as 
  4.8   destroying or diminishing the privileged or confidential nature 
  4.9   of any communication recognized by law. 
  4.10     Sec. 3.  Minnesota Statutes 2000, section 144.335, 
  4.11  subdivision 4, is amended to read: 
  4.12     Subd. 4.  [ADDITIONAL PATIENT RIGHTS; CONSTRUCTION.] The 
  4.13  rights set forth in this section are in addition to the rights 
  4.14  set forth in sections 144.651 and 144.652 and any other 
  4.15  provision of law relating to the access of a patient to the 
  4.16  patient's health records.  Nothing in this section shall be 
  4.17  construed as granting to a patient any right of ownership in the 
  4.18  patient's record, as the record is owned by and is the property 
  4.19  of the provider. 
  4.20     Sec. 4.  Minnesota Statutes 2000, section 144.335, 
  4.21  subdivision 5, is amended to read: 
  4.22     Subd. 5.  [COSTS.] When a patient requests a copy of the 
  4.23  patient's record for purposes of reviewing current medical care, 
  4.24  the provider must not charge a fee.  When a provider or its 
  4.25  representative makes copies of patient records upon a patient's 
  4.26  request under this section, the provider or its representative 
  4.27  may charge the patient or the patient's representative no more 
  4.28  than 75 cents per page, plus $10 for time spent retrieving and 
  4.29  copying the records, unless other law or a rule or contract 
  4.30  provide for a lower maximum charge.  This limitation does not 
  4.31  apply to x-rays.  The provider may charge a patient no more than 
  4.32  the actual cost of reproducing X-rays, plus no more than $10 for 
  4.33  the time spent retrieving and copying the x-rays. 
  4.34     The respective maximum charges of 75 cents per page and $10 
  4.35  for time provided in this subdivision are in effect for calendar 
  4.36  year 1992 and may be adjusted annually each calendar year as 
  5.1   provided in this subdivision.  The permissible maximum charges 
  5.2   shall change each year by an amount that reflects the change, as 
  5.3   compared to the previous year, in the consumer price index for 
  5.4   all urban consumers, Minneapolis-St. Paul (CPI-U), published by 
  5.5   the department of labor.  The party requesting a patient's 
  5.6   record is responsible to the provider for the reasonable costs 
  5.7   of copying and mailing the patient's record.  The provider may 
  5.8   require payment before the record is furnished.  This 
  5.9   subdivision does not apply to records requested to make or 
  5.10  complete an application for a disability benefits program. 
  5.11     Sec. 5.  [REPEALER.] 
  5.12     Minnesota Statutes 2000, section 144.335, subdivision 3, is 
  5.13  repealed.