HF 1686

as introduced - 91st Legislature (2019 - 2020) Posted on 03/11/2019 05:14pm

A bill for an act
relating to health care; establishing a statutory form to provide consent for the
disclosure of health care records; amending Minnesota Statutes 2018, section
144.293, subdivision 2; proposing coding for new law in Minnesota Statutes,
chapter 144.

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

Section 1.

Minnesota Statutes 2018, 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 without:

(1) a signed and dated consent new text begin form made as provided in section 144.2975 or section
144.292, subdivision 8, new text end from the patient or the patient's legally authorized representative
authorizing the release;

(2) specific authorization in law; or

(3) a representation from a provider that holds a signed and dated consent new text begin form as
provided in section 144.2975 or 144.292, subdivision 8, new text end from the patient authorizing the
release.

Sec. 2.

new text begin [144.2975] STATUTORY CONSENT FORM FOR PATIENT DATA
DISCLOSURE.
new text end

new text begin Subdivision 1. new text end

new text begin Form. new text end

new text begin Except for disclosures and releases permitted when a patient uses
the "Minnesota Standard Consent Form to Release Health Information" prepared pursuant
to section 144.292, subdivision 8, a provider must use the following form to obtain patient
consent to disclose, release, or use health care records as provided in sections 144.291 to
144.298:
new text end

new text begin Minnesota Patient Data Consent Form.
new text end

new text begin Patient's Notice of Data Rights:
new text end

new text begin (a) Your treatment is not conditioned upon granting or refusing consent below for use,
sharing, or release of health information.
new text end

new text begin (b) To authorize more limited disclosures of health information to specific health care
providers and other third parties, or to obtain copies of your own medical records, use the
"Minnesota Standard Consent Form to Release Health Information" available through the
Minnesota Department of Health's website.
new text end

new text begin (c) Minnesota law guarantees certain patient privacy and consent rights under Minnesota
Statutes, sections 144.291 to 144.298.
new text end

new text begin (d) You may revoke or modify your consent to share health records in writing at any
time, except that a revocation or modification has no effect on any health records released
prior to the date of revocation or modification.
new text end

new text begin Patient's Medical Consent.
new text end

new text begin Please read the following carefully and check either "yes" or "no" to each item
below.
new text end

new text begin ....... Yes ....... No Obtaining Medical Records: I consent to [the above health care
provider] communicating with my current and future health care providers to obtain any
and all previous medical records necessary for my treatment as defined under the federal
Health Insurance Portability and Accountability Act (HIPAA). See attached definition.
new text end

new text begin ....... Yes ....... No Releasing Information for Treatment: I consent to [the above health
care provider] sharing information from my medical record with current and future health
care providers involved in my treatment as defined under HIPAA. See attached definition.
new text end

new text begin ....... Yes ....... No Releasing Information for Payment: I consent to [the above health
care provider] sharing my information for the purpose of billing and payment as defined
under HIPAA. See attached definition. This sharing of information includes insurers or
third parties responsible for payment of my medical bills.
new text end

new text begin ....... Yes ....... No Releasing Information for Health Care Operations: I consent to
[the above health care provider] sharing my information for health care operations as defined
under HIPAA. See attached definition. This includes information sharing for activities
unrelated to treatment for my medical condition.
new text end

new text begin ....... Yes ....... No Releasing Information for Medical or Scientific Research: I consent
to [the above health care provider] releasing my medical information for medical or scientific
research.
new text end

new text begin ....... Yes ....... No Disclosure of Presence: I authorize [the above health care provider]
to disclose my presence to any person who inquires about me using my full name. This
disclosure is limited to acknowledging my presence and a one-word description of my
condition: critical, serious, fair, or good.
new text end

new text begin Health Information Exchange.
new text end

new text begin ....... Yes ....... No Access: I authorize [the above health care provider] to use a health
information exchange (HIE), record locator service (RLS), patient information service (PIS),
clinical data repository (CDR), or master patient index (MPI) for the purpose of accessing
my patient identifying information and information about the location of my medical records.
See attached definitions.
new text end

new text begin ....... Yes ....... No Release: I authorize [the above health care provider] to release my
patient identifying information and information about where my medical records are located
to an HIE, RLS, PIS, CDR, or MPI. See attached definitions.
new text end

new text begin Consent Duration.
new text end

new text begin I understand that under Minnesota law, my consent to release my health records for
certain limited purposes listed in Minnesota Statutes, section 144.293, subdivision 6 or 8,
does not expire but may be revoked at any time. For all other purposes described above, I
authorize my consent to be valid for the following length of time:
new text end

new text begin ....... One year
new text end

new text begin ....... Three years
new text end

new text begin ....... Indefinitely (unless I revoke or modify)
new text end

new text begin PATIENT SIGNATURE
new text end

new text begin Patient Name: .......................................... Date of Birth: ......./......./.......
new text end

new text begin If patient is not signing, name and relationship to patient: ..........................................
new text end

new text begin Signature: .......................................... Date: ......./......./.......
new text end

new text begin Federal HIPAA Definitions (Code of Federal Regulations, title 45, section 164.501)
new text end

new text begin (a) "Health care operations" means any of the following activities of the covered entity
to the extent that the activities are related to covered functions:
new text end

new text begin (1) conducting quality assessment and improvement activities, including outcomes,
evaluation, and development of clinical guidelines, provided that the obtaining of
generalizable knowledge is not the primary purpose of any studies resulting from the
activities; patient safety activities, as defined in Code of Federal Regulations, title 42, section
3.20; population-based activities relating to improving health or reducing health care costs,
protocol development, case management and care coordination, contacting of health care
providers and patients with information about treatment alternatives; and related functions
that do not include treatment;
new text end

new text begin (2) reviewing the competence or qualifications of health care professionals, evaluating
practitioner and provider performance, health plan performance, conducting training programs
in which students, trainees, or practitioners in areas of health care learn under supervision
to practice or improve their skills as health care providers, training of nonhealth care
professionals, accreditation, certification, licensing, or credentialing activities;
new text end

new text begin (3) except as prohibited under Code of Federal Regulations, title 45, section
164.502(a)(5)(i), underwriting, enrollment, premium rating, and other activities related to
the creation, renewal, or replacement of a contract of health insurance or health benefits,
and ceding, securing, or placing a contract for reinsurance of risk relating to claims for
health care, including stop-loss insurance and excess of loss insurance, provided that the
requirements of Code of Federal Regulations, title 45, section 164.514(g), are met, if
applicable;
new text end

new text begin (4) conducting or arranging for medical review, legal services, and auditing functions,
including fraud and abuse detection and compliance programs;
new text end

new text begin (5) business planning and development, such as conducting cost-management and
planning-related analyses related to managing and operating the entity, including formulary
development and administration, development, or improvement of methods of payment or
coverage policies; and
new text end

new text begin (6) business management and general administrative activities of the entity, including,
but not limited to:
new text end

new text begin (i) management activities relating to implementation of and compliance with the
requirements of this subchapter;
new text end

new text begin (ii) customer service, including the provision of data analyses for policyholders, plan
sponsors, or other customers, provided that protected health information is not disclosed to
the policyholder, plan sponsor, or customer;
new text end

new text begin (iii) resolution of internal grievances;
new text end

new text begin (iv) the sale, transfer, merger, or consolidation of all or part of the covered entity with
another covered entity, or an entity that following the activity will become a covered entity
and due diligence related to the activity; and
new text end

new text begin (v) consistent with the applicable requirements of Code of Federal Regulations, title 45,
section 164.514, creating de-identified health information or a limited data set, and
fund-raising for the benefit of the covered entity.
new text end

new text begin (b) "Payment" means:
new text end

new text begin (1) the activities undertaken by:
new text end

new text begin (i) a health plan to obtain premiums or to determine or fulfill its responsibility for
coverage and provision of benefits under the health plan, except as prohibited under Code
of Federal Regulations, title 45, section 164.502(a)(5)(i); or
new text end

new text begin (ii) a health care provider or health plan to obtain or provide reimbursement for the
provision of health care; and
new text end

new text begin (2) the activities in clause (1) relate to the individual to whom health care is provided
and include, but are not limited to:
new text end

new text begin (i) determinations of eligibility or coverage (including coordination of benefits or the
determination of cost-sharing amounts), and adjudication or subrogation of health benefit
claims;
new text end

new text begin (ii) risk-adjusting amounts due based on enrollee health status and demographic
characteristics;
new text end

new text begin (iii) billing, claims management, collection activities, obtaining payment under a contract
for reinsurance (including stop-loss insurance and excess of loss insurance), and related
health care data processing;
new text end

new text begin (iv) review of health care services with respect to medical necessity, coverage under a
health plan, appropriateness of care, or justification of charges;
new text end

new text begin (v) utilization review activities, including precertification and preauthorization of services,
concurrent and retrospective review of services; and
new text end

new text begin (vi) disclosure to consumer reporting agencies of any of the following protected health
information relating to collection of premiums or reimbursement:
new text end

new text begin (A) Name and address;
new text end

new text begin (B) Date of birth;
new text end

new text begin (C) Social Security number;
new text end

new text begin (D) Payment history;
new text end

new text begin (E) Account number; and
new text end

new text begin (F) Name and address of the health care provider or health plan.
new text end

new text begin (c) "Treatment" means the provision, coordination, or management of health care and
related services by one or more health care providers, including the coordination or
management of health care by a health care provider with a third party; consultation between
health care providers relating to a patient; or the referral of a patient for health care from
one health care provider to another.
new text end

new text begin Minnesota Definitions (Minnesota Statutes, sections 62J.498 and 144.291).
new text end

new text begin (a) "Clinical data repository" means a realtime database that consolidates data from a
variety of clinical sources to present a unified view of a single patient and is used by a
state-certified health information exchange service provider to enable health information
exchange among health care providers that are not related health care entities as defined in
section 144.291, subdivision 2, paragraph (j). This does not include clinical data that are
submitted to the commissioner for public health purposes required or permitted by law,
including any rules adopted by the commissioner.
new text end

new text begin (b) "Health care provider" means a person, hospital, or health care facility, organization,
or corporation that is licensed, certified, or otherwise authorized by the laws of this state to
provide health care.
new text end

new text begin (c) "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.
new text end

new text begin (d) "Master patient index" means an electronic database that holds unique identifiers of
patients registered at a care facility and is used by a state-certified health information
exchange service provider to enable health information exchange among health care providers
that are not related health care entities as defined in section 144.291, subdivision 2, paragraph
(k). This does not include data that are submitted to the commissioner for public health
purposes required or permitted by law, including any rules adopted by the commissioner.
new text end

new text begin (e) "Patient information service" means a service providing the following query options:
a record locator service or a master patient index or clinical repository.
new text end

new text begin (f) "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.
new text end

new text begin Subd. 2. new text end

new text begin Failure to check "Yes" or "No." new text end

new text begin A failure to check "Yes" or "No" on a form
prepared pursuant to this section is presumed to be a "No" and a provider must not disclose
or release any health record under the relevant paragraph.
new text end

new text begin Subd. 3. new text end

new text begin Exceptions. new text end

new text begin (a) This section does not apply to a release of or a request for
psychotherapy notes as defined under Code of Federal Regulations, title 45, section 164.501,
as amended. Pursuant to federal law, providers must use a separate consent form.
new text end

new text begin (b) Patient records may not be shared with an insurance company if the patient pays
out-of-pocket in full and requests nondisclosure, as required in Code of Federal Regulations,
title 45, section 164.522(a)(1)(vi).
new text end