SENATE, No. 2820

STATE OF NEW JERSEY

215th LEGISLATURE

INTRODUCED MAY 30, 2013

 


 

Sponsored by:

Senator† JOSEPH F. VITALE

District 19 (Middlesex)

 

 

 

 

SYNOPSIS

†††† Modifies regulations concerning provision of medical records to patients and legally authorized representatives.

 

CURRENT VERSION OF TEXT

†††† As introduced.

††


An Act concerning hospital medical records and supplementing Titles 26 and 45 of the Revised Statutes.

 

†††† Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

†††† 1.††† a. †If a patient of a general, special, or psychiatric hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) or the patient's legally authorized representative requests, in writing, a copy of the patientís medical record, the hospital shall provide a legible paper or electronic reproduction of the medical record from each individual admission within the dates requested to the patient or the patient's legally authorized representative within 30 days of the request, in accordance with the following:

†††† (1)†† The fee for reproducing an individual admission record shall be $1 per page or $100 per individual admission record for the first 100 pages. †For individual admission records that contain more than 100 pages, a copying fee of $0.25 per page shall be charged for pages in excess of the first 100 pages, up to a maximum of $200 for each admission record.† In addition, a hospital or its business associate, as defined by the federal ďHealth Insurance Portability and Accountability Act,Ē Pub.L.104-191, shall charge the actual costs for delivering records in any medium, plus sales tax, if applicable.†

†††† (2)†† Delivery of an electronic reproduction of a patientís medical record shall be required only if: †(a) the entire request can be reproduced from an electronic health record system; (b) the medical record is specifically requested to be delivered in electronic format; and (c) the medical record can be delivered electronically.

†††† (3)†† In addition to per-page and delivery fees, a hospital shall apply the following charges:

†††† (a)†† a search fee of $10 per patient per request. †Although the patient may have had more than one admission, and thus more than one individual admission record is provided, only one search fee shall be charged for each request per patient. †The search fee shall apply even if no individual admission record is found as a result of the search;

†††† (b)†† a fee for the reproduction of x-rays or any other material within an individual admission record that cannot be routinely copied or duplicated on a commercial photocopy machine, which shall be equal to the actual cost of the duplication of the materials, plus an administrative fee of the lesser of $10 or 10 percent of the cost of reproduction to compensate for office personnel time spent retrieving or reproducing the materials and overhead costs; and

†††† (c)†† a fee for certification of a copy of a medical record of $10 per certification.† A patient or patientís legally authorized representative shall have the right to receive a full or certified copy of the medical record.

†††† (4)†† The fees established in subsection a. of section 1. of this act shall be charged for electronic reproductions as well as paper copies of medical records.

†††† (5)†† The hospital shall establish a policy assuring access to copies of medical records for patients who do not have the ability to pay for the copies.

†††† (6)†† The hospital shall establish a fee policy providing an incentive for the use of abstracts or summaries of medical records.

†††† (7)†† For the purposes of this subsection, "legally authorized representative" means the following:

†††† (a)†† the patientís spouse, domestic partner, or civil union partner;

†††† (b)†† the patientís immediate next of kin;

†††† (c)†† the patientís legal guardian;

†††† (d)†† the patient's attorney;

†††† (e)†† the patient's third party insurer; or

†††† (f)††† the patientís worker's compensation carrier, where access is permitted by contract or law, but limited only to that portion of the medical record that is relevant to the specific work-related incident at issue in the worker's compensation claim.

†††† b.††† Access to a copy of a patientís medical record shall be limited only to the extent necessary to protect the patient. †The patientís attending physician shall provide a verbal explanation for any denial of access to the patient or legally authorized representative, and shall document this in the medical record. †In the event that direct access to a copy by the patient is medically contraindicated, as documented by a physician in the patient's medical record, the hospital shall make the medical record available to a legally authorized representative of the patient or the patient's attending physician.

†††† c.†††† Commencing January 1, 2014, the Commissioner of Health shall annually adjust the amounts set forth in section 1 of this act based on the most recent changes in the consumer price index for medical care services reported annually by the Bureau of Labor Statistics of the United States Department of Labor.

†††† d.††† A hospital shall not assess any fees or charges to provide a copy of a patientís medical records other than those provided for in this section.

 

†††† 2.††† A person licensed to practice a health care profession regulated by the State Board of Medical Examiners shall provide copies of professional treatment records, including records from other health care providers that are part of a patientís record, to a patient or the patientís authorized representative in accordance with the following:

†††† a.†††† No later than 30 days from receipt of a request from a patient or a patientís authorized representative, the licensee shall provide an electronic copy or photocopy of the professional treatment records, billing records, or both, as requested. †The record shall include all pertinent, objective data, including test results and x-ray results, as applicable, and subjective information.

†††† b.††† Unless otherwise required by law, a licensee may elect to provide a summary of the record in lieu of providing the electronic copy or photocopy required pursuant to subsection a. of this section, so long as that summary adequately reflects the patient's history and treatment. †A licensee may charge a reasonable fee for the preparation of a summary that has been provided in lieu of the actual record, which shall not exceed the cost allowed pursuant to subsection d of this section; however, a patient or a patientís legally authorized representative shall have the right to receive a full or certified copy of the medical record.† The fee for certification shall be $10 per certification.

†††† c.†††† If, in the exercise of the licenseeís professional judgment, a licensee has reason to believe that the patient's mental or physical condition will be adversely affected upon being made aware of the subjective information contained in the professional treatment record or a summary of the record, the licensee may refuse to provide the record or summary to the patient.† The licensee shall include in the record a notice setting forth the reasons for the original refusal.† The licensee shall, however, provide a copy of the record or summary upon request to:

†††† (1)†† the patient's attorney;

†††† (2)†† another licensed health care professional;

†††† (3)†† the patient's health insurance carrier through an employee thereof; or

†††† (4)†† a governmental reimbursement program or an agent thereof, with responsibility to review utilization or quality of care.

†††† d.††† A licensee may require a record request to be in writing and may charge a fee for:

†††† (1)†† The reproduction of patient records, which shall be $1 per page or $200 for the entire record, whichever is less. †If the record requested is less than 10 pages, the licensee may charge up to $10 to cover the miscellaneous costs associated with retrieval of the record. †In addition, a licensee or the licenseeís business associate, as defined by the federal ďHealth Insurance Portability and Accountability Act,Ē Pub.L.104-191, shall charge the actual costs for delivering records in any medium, plus sales tax, if applicable.† If the licensee elects to provide a summary in lieu of the actual record, the charge for the summary shall not exceed the cost that would be charged for the actual record; and

†††† (2)†† The reproduction of x-rays or any other material within a patient record that cannot be routinely copied or duplicated on a commercial photocopy machine, which shall be no more than the actual cost of the duplication of the materials, or the fee charged to the licensee for duplication, plus an administrative fee of the lesser of $10 or 10 percent of the cost of reproduction to compensate for office personnel time spent retrieving or reproducing the materials and overhead costs.

†††† e.†††† The fees established in subsection d. of section 2 of this act shall be charged for electronic copies as well as paper copies of medical records.†

†††† f.†††† Delivery of an electronic copy of a patient record to the requestor shall be required only if:

†††† (1)†† the entire request can be reproduced from an electronic health record system;

†††† (2)†† the patient record is specifically requested to be delivered in electronic format; and

†††† (3)†† the patient record can be delivered electronically.

†††† g.†††† A licensee shall not charge a patient for a copy of the patient's record when:

†††† (1)†† the licensee has affirmatively terminated a patient from practice in accordance with the requirements of N.J.A.C.13:35-6.22; or

†††† (2)†† the licensee leaves a practice that the licensee was formerly a member of, or associated with, and the patient requests that the patientís medical care continue to be provided by that licensee.

†††† h.†††† If the patient or a subsequent treating health care professional is unable to read the treatment record, either because it is illegible or prepared in a language other than English, the licensee shall provide a transcription or translation, as applicable, at no cost to the patient.

†††† i.††††† The licensee shall not refuse to provide a professional treatment record on the grounds that the patient owes the licensee an unpaid balance if the record is needed by another health care professional for the purpose of rendering care.

†††† j.†††† Commencing January 1, 2014, the State Board of Medical Examiners shall annually adjust the amounts set forth in this section based on the most recent changes in the consumer price index for medical care services reported annually by the Bureau of Labor Statistics of the United States Department of Labor.

 

†††† 3.††† The Commissioner of Health and the State Board of Medical Examiners, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations as necessary to effectuate the purposes of this act.

 

†††† 4.††† This act shall take effect on the first day of the seventh month next following the date of enactment, except that the Commissioner of Health and the State Board of Medical Examiners may take such anticipatory administrative action in advance thereof as may be necessary for the implementation of this act.


STATEMENT

 

†††† This bill modifies the regulations concerning the provision of medical records to patients and legally authorized representatives, and codifies the modified regulations into statute.† The current regulations are codified at N.J.A.C.8:43G-15.3 and N.J.A.C.13:35-6.5.

†††† The bill revises the current regulations to make various clarifications regarding the fees charged by hospitals and health care professionals licensed by the State Board of Medical Examiners for the replication of a patientís medical record.† The bill also makes the fee amounts mandatory, where the current regulations establish maximum fees.

†††† The bill also allows the delivery of an electronic copy of a patientís medical record, instead of a written copy, in certain circumstances.† An electronic reproduction would be required if the entire request can be reproduced from an electronic health record system, the medical record is specifically requested to be delivered in electronic format, and the medical record can be delivered electronically.

†††† Finally, the bill requires all of the fees to be annually adjusted according to inflation.

†††† The bill takes effect on the first day of the seventh month following the date of enactment, but permits the Commissioner of Health and the State Board of Medical Examiners to take anticipatory administrative action as necessary for its implementation.