Florida Senate - 2019 COMMITTEE AMENDMENT
Bill No. SPB 7078
Ì6361669Î636166
LEGISLATIVE ACTION
Senate . House
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The Committee on Health Policy (Harrell) recommended the
following:
1 Senate Amendment (with title amendment)
2
3 Delete lines 111 - 671
4 and insert:
5 service provider must furnish applicable clinical records in its
6 possession.
7 (b) If a service provider maintains a system of electronic
8 health records as defined in s. 408.051, the service provider
9 shall furnish the requested records in the manner chosen by the
10 requester, which may include paper documents, electronic format,
11 access through a web-based patient portal, or submission through
12 a patient’s electronic personal health record.
13 (4) The service provider may charge a requester no more
14 than the reasonable costs of reproducing the clinical records,
15 including reasonable staff time.
16 (a) The reasonable costs of reproducing paper copies of
17 written or typed documents or reports may not exceed $1 per page
18 for the first 25 pages and 25 cents per page for all pages
19 thereafter.
20 (b) The reasonable costs of reproducing X-rays and other
21 forms of images shall be the actual costs. Actual costs shall be
22 the sum of the cost of the material and supplies used to
23 duplicate the record and the labor and overhead costs associated
24 with the duplication.
25 (c) If the nature or volume of the clinical records
26 requested to be copied requires extensive use of information
27 technology resources or extensive clerical or supervisory
28 assistance by personnel of the service provider, or both, the
29 service provider may charge, in addition to the charges imposed
30 under paragraphs (a) and (b), a special service charge, which
31 shall be reasonable and shall be based on the cost incurred for
32 such extensive use of information technology resources or the
33 labor cost of the personnel providing the service which is
34 actually incurred by the service provider or attributable to the
35 service provider for the clerical and supervisory assistance
36 required, or both.
37 (d) The charges established in this subsection apply to all
38 records furnished, whether directly from a service provider or
39 from a copy service acting on behalf of the service provider.
40 However, a patient whose records are copied or searched for the
41 purpose of continuing to receive care is not required to pay a
42 charge for copying or for the search.
43 Section 2. Subsection (1) and paragraph (e) of subsection
44 (4) of section 395.3025, Florida Statutes, are amended to read:
45 395.3025 Patient and personnel records; copies;
46 examination.—
47 (1)(a) Any licensed facility shall, upon written request,
48 and only after discharge of the patient, furnish, in a timely
49 manner as provided in paragraph (b), without delays for legal
50 review, to any person admitted therein for care and treatment or
51 treated thereat, or to any such person’s guardian, curator, or
52 personal representative, or in the absence of one of those
53 persons, to the next of kin of a decedent or the parent of a
54 minor, or to anyone designated by such person in writing, a true
55 and correct copy of all patient records, including X rays, and
56 insurance information concerning such person, which records are
57 in the possession of the licensed facility, provided the person
58 requesting such records agrees to pay a charge as provided in
59 paragraph (d).
60 (b) Within 14 working days after receiving a request made
61 in accordance with paragraph (a), a licensed facility must
62 furnish applicable patient records in its possession.
63 (c) If a licensed facility maintains a system of electronic
64 health records as defined in s. 408.051, the licensed facility
65 shall furnish the requested records in the manner chosen by the
66 requester, which may include paper documents, electronic format,
67 access through a web-based patient portal, or submission through
68 a patient’s electronic personal health record.
69 (d) The licensed facility may charge a requester no more
70 than the reasonable costs of reproducing the patient records,
71 including reasonable staff time.
72 1. The reasonable costs of reproducing paper copies of
73 written or typed documents or reports may not exceed $1 per page
74 for the first 25 pages and 25 cents per page for all pages
75 thereafter.
76 2. The reasonable costs of reproducing X-rays and other
77 forms of images shall be the actual costs. Actual costs shall be
78 the sum of the cost of the material and supplies used to
79 duplicate the record and the labor and overhead costs associated
80 with the duplication.
81 3. If the nature or volume of the patient records requested
82 to be copied requires extensive use of information technology
83 resources or extensive clerical or supervisory assistance by
84 personnel of the licensed facility, or both, the licensed
85 facility may charge, in addition to the charges imposed under
86 subparagraphs 1. and 2., a special service charge, which shall
87 be reasonable and shall be based on the cost incurred for such
88 extensive use of information technology resources or the labor
89 cost of the personnel providing the service which is actually
90 incurred by the licensed facility or attributable to the
91 licensed facility for the clerical and supervisory assistance
92 required, or both.
93 4. The charges established in this paragraph The exclusive
94 charge for copies of patient records may include sales tax and
95 actual postage, and, except for nonpaper records that are
96 subject to a charge not to exceed $2, may not exceed $1 per
97 page. A fee of up to $1 may be charged for each year of records
98 requested. These charges shall apply to all records furnished,
99 whether directly from the facility or from a copy service acting
100 providing these services on behalf of the facility. However, a
101 patient whose records are copied or searched for the purpose of
102 continuing to receive medical care is not required to pay a
103 charge for copying or for the search.
104 (e) If a person authorized to receive copies of patient
105 records under paragraph (a) requests to examine the licensed
106 facility’s original records pertaining to the patient, the
107 licensed facility shall, within 10 working days after receiving
108 such a request, provide such person with access to examine such
109 original records, microforms, or other suitable reproductions of
110 such records in its possession. A licensed facility may impose
111 any reasonable terms necessary to ensure further allow any such
112 person to examine the original records in its possession, or
113 microforms or other suitable reproductions of the records, upon
114 such reasonable terms as shall be imposed to assure that the
115 records will not be damaged, destroyed, or altered.
116 (4) Patient records are confidential and may must not be
117 disclosed without the consent of the patient or his or her legal
118 representative; however, but appropriate disclosure may be made
119 without such consent to:
120 (e) The department agency upon subpoena issued pursuant to
121 s. 456.071, but the records obtained thereby must be used solely
122 for the purpose of the department agency and the appropriate
123 professional board in its investigation, prosecution, and appeal
124 of disciplinary proceedings. If the department agency requests
125 copies of the records, the facility shall charge no more than
126 its actual copying costs, including reasonable staff time. The
127 records must be sealed and must not be available to the public
128 pursuant to s. 119.07(1) or any other statute providing access
129 to records, nor may they be available to the public as part of
130 the record of investigation for and prosecution in disciplinary
131 proceedings made available to the public by the department
132 agency or the appropriate regulatory board. However, the
133 department agency must make available, upon written request by a
134 practitioner against whom probable cause has been found, any
135 such records that form the basis of the determination of
136 probable cause.
137 Section 3. Present paragraphs (a) through (j) of subsection
138 (7) of section 397.501, Florida Statutes, are redesignated as
139 paragraphs (d) through (m), respectively, and new paragraphs
140 (a), (b), and (c) are added to that subsection, to read:
141 397.501 Rights of individuals.—Individuals receiving
142 substance abuse services from any service provider are
143 guaranteed protection of the rights specified in this section,
144 unless otherwise expressly provided, and service providers must
145 ensure the protection of such rights.
146 (7) RIGHT TO ACCESS TO AND CONFIDENTIALITY OF INDIVIDUAL
147 RECORDS.—
148 (a)1. Within 14 working days after receiving a written
149 request from an individual or an individual’s legal
150 representative, a service provider shall furnish a true and
151 correct copy of all records pertaining to that individual in the
152 possession of the service provider.
153 2. For the purpose of this subsection, the term “legal
154 representative” means an individual’s legal guardian or, if the
155 individual is younger than 18 years old, the individual’s parent
156 or legal guardian.
157 3. If a service provider maintains a system of electronic
158 health records as defined in s. 408.051, the service provider
159 shall furnish the requested records in the manner chosen by the
160 requester, which may include paper documents, electronic format,
161 access through a web-based patient portal, or submission through
162 an individual’s electronic personal health record.
163 (b) A service provider may charge the requester no more
164 than the reasonable costs of reproducing the records, including
165 reasonable staff time.
166 1. The reasonable costs of reproducing paper copies of
167 written or typed documents or reports may not exceed $1 per page
168 for the first 25 pages and 25 cents per page for all pages
169 thereafter.
170 2. The reasonable costs of reproducing X-rays and such
171 other kinds of records shall be the actual costs. Actual costs
172 are the sum of the cost of the material and supplies used to
173 duplicate the records and the labor and overhead costs
174 associated with the duplication.
175 3. If the nature or volume of the records requested to be
176 copied requires extensive use of information technology
177 resources or extensive clerical or supervisory assistance by
178 personnel of the service provider, or both, the service provider
179 may charge, in addition to the charges imposed under
180 subparagraphs 1. and 2., a special service charge, which shall
181 be reasonable and shall be based on the cost incurred for such
182 extensive use of information technology resources or the labor
183 cost of the personnel providing the service which is actually
184 incurred by the service provider or attributable to the service
185 provider for the clerical and supervisory assistance required,
186 or both.
187 4. The charges established in this paragraph apply to all
188 records furnished, whether directly from a service provider or
189 from a copy service acting on behalf of the service provider.
190 However, an individual whose records are copied or searched for
191 the purpose of continuing to receive care is not required to pay
192 a charge for copying or for the search.
193 (c) Within 10 working days after receiving a request from
194 an individual or an individual’s legal representative to examine
195 the service provider’s original records pertaining to that
196 individual, a service provider shall provide access to examine
197 such original records, microforms, or other suitable
198 reproductions of such records in its possession. A service
199 provider may impose any reasonable terms necessary to ensure
200 that the records will not be damaged, destroyed, or altered.
201 Section 4. Subsection (4) of section 400.145, Florida
202 Statutes, is amended to read:
203 400.145 Copies of records of care and treatment of
204 resident.—
205 (4)(a) Within 14 working days after receiving a request
206 made in accordance with subsections (1)-(3), a nursing home
207 facility must furnish applicable resident records in its
208 possession in accordance with this subsection.
209 (b) If a nursing home facility maintains a system of
210 electronic health records as defined in s. 408.051, the facility
211 shall furnish the requested records in the manner chosen by the
212 requester, which may include paper documents, electronic format,
213 or access through a web-based portal.
214 (c) The nursing home facility may charge a requester no
215 more than the reasonable costs of reproducing the records,
216 including reasonable staff time.
217 1. The reasonable costs of reproducing paper copies of
218 written or typed documents or reports may not exceed $1 per page
219 for the first 25 pages and 25 cents per page for all pages
220 thereafter.
221 2. The reasonable costs of reproducing X-rays and other
222 forms of images shall be the actual costs. Actual costs shall be
223 the sum of the cost of the material and supplies used to
224 duplicate the record and the labor and overhead costs associated
225 with the duplication.
226 3. If the nature or volume of the records requested to be
227 copied requires extensive use of information technology
228 resources or extensive clerical or supervisory assistance by
229 personnel of the nursing home facility, or both, the facility
230 may charge, in addition to the charges imposed under
231 subparagraphs 1. and 2., a special service charge, which shall
232 be reasonable and shall be based on the cost incurred for such
233 extensive use of information technology resources or the labor
234 cost of the personnel providing the service which is actually
235 incurred by the facility or attributable to the facility for the
236 clerical and supervisory assistance required, or both.
237 4. The charges established in this paragraph apply to all
238 records furnished, whether directly from a nursing home facility
239 or from a copy service acting on behalf of the facility.
240 However, a resident whose records are copied or searched for the
241 purpose of continuing to receive care is not required to pay a
242 charge for copying or for the search
243 (d) Within 10 working days after receiving a request from a
244 person who is authorized to act on behalf of a resident to
245 examine the nursing home facility’s original records pertaining
246 to the resident, the facility shall provide access to examine
247 such original records, microforms, or other suitable
248 reproductions of such records in its possession. A facility may
249 impose any reasonable terms necessary A nursing home facility
250 may charge a reasonable fee for the copying of resident records.
251 Such fee may not exceed $1 per page for the first 25 pages and
252 25 cents per page for each additional page. The facility shall
253 allow a person who is authorized to act on behalf of the
254 resident to examine the original records, microfilms, or other
255 suitable reproductions of the records in its possession upon any
256 reasonable terms imposed by the facility to ensure that the
257 records are not damaged, destroyed, or altered.
258 Section 5. Subsections (6) and (17) of section 456.057,
259 Florida Statutes, are amended to read:
260 456.057 Ownership and control of patient records; report or
261 copies of records to be furnished; disclosure of information.—
262 (6)(a) Any health care practitioner licensed by the
263 department or a board within the department who makes a physical
264 or mental examination of, or administers treatment or dispenses
265 legend drugs to, any person shall, upon written request of such
266 person or the person’s legal representative, furnish, within 14
267 working days after such request in a timely manner, without
268 delays for legal review, copies of all reports and records
269 relating to such examination or treatment, including X-rays X
270 rays and insurance information. If the health care practitioner
271 maintains a system of electronic health records as defined in s.
272 408.051, the health care practitioner shall furnish the
273 requested records in the manner chosen by the requester, which
274 may include paper documents, electronic format, access through a
275 web-based patient portal, or submission through a patient’s
276 electronic personal health record.
277 (b) Within 10 working days after receiving a written
278 request by a patient or the patient’s legal representative to
279 examine the health care practitioner’s original reports and
280 records pertaining to the patient, a health care practitioner
281 must provide access to examine such original reports and
282 records, or microforms or other suitable reproductions of the
283 reports and records in the health care practitioner’s
284 possession. The health care practitioner may impose any
285 reasonable terms necessary to ensure that the reports and
286 records will not be damaged, destroyed, or altered.
287 (c) For the purposes of this subsection, the term “legal
288 representative” means a patient’s legal guardian or, if the
289 patient is younger than 18 years old, the patient’s parent or
290 legal guardian.
291 (d) However, When a patient’s psychiatric, chapter 490
292 psychological, or chapter 491 psychotherapeutic records are
293 requested by the patient or the patient’s legal representative,
294 the health care practitioner may provide a report of examination
295 and treatment in lieu of copies of records. Upon a patient’s
296 written request, complete copies of the patient’s psychiatric
297 records shall be provided directly to a subsequent treating
298 psychiatrist. The furnishing of such report or copies may shall
299 not be conditioned upon payment of a fee for services rendered.
300 (17) A licensed health care practitioner may charge the
301 requester no more than the reasonable costs of reproducing the
302 reports and records, including reasonable staff time.
303 (a) The reasonable costs of reproducing paper copies of
304 written or typed documents or reports may not exceed $1 per page
305 for the first 25 pages and 25 cents per page for all pages
306 thereafter.
307 (b) The reasonable costs of reproducing X-rays and such
308 other kinds of records shall be the actual costs. Actual costs
309 are the sum of the cost of the material and supplies used to
310 duplicate the record and the labor and overhead costs associated
311 with the duplication.
312 (c) If the nature or volume of the records requested to be
313 copied requires extensive use of information technology
314 resources or extensive clerical or supervisory assistance by
315 personnel of the health care practitioner, or both, the health
316 care practitioner may charge, in addition to the charges imposed
317 under paragraphs (a) and (b), a special service charge, which
318 shall be reasonable and shall be based on the cost incurred for
319 such extensive use of information technology resources or the
320 labor cost of the personnel providing the service which is
321 actually incurred by the health care practitioner or
322 attributable to the health care practitioner for the clerical
323 and supervisory assistance required, or both.
324 (d) The charges established in this subsection apply to all
325 reports and records furnished, whether directly from a health
326 care practitioner or from a copy service providing such services
327 on behalf of the health care practitioner. However, a patient
328 whose reports and records are copied or searched for the purpose
329 of continuing to receive medical care is not required to pay a
330 charge for copying or for the search A health care practitioner
331 or records owner furnishing copies of reports or records or
332 making the reports or records available for digital scanning
333 pursuant to this section shall charge no more than the actual
334 cost of copying, including reasonable staff time, or the amount
335 specified in administrative rule by the appropriate board, or
336 the department when there is no board.
337
338 ================= T I T L E A M E N D M E N T ================
339 And the title is amended as follows:
340 Delete lines 10 - 56
341 and insert:
342 records; providing for a special service charge under
343 specified conditions; amending s. 395.3025, F.S.;
344 requiring a licensed facility to furnish and provide
345 access to patient records within a specified timeframe
346 after receiving a request for such records; providing
347 a conditional requirement that such records be
348 furnished in the manner chosen by the requester;
349 authorizing the licensed facility to charge a
350 reasonable cost associated with reproducing such
351 records; providing for a special service charge under
352 specified conditions; revising provisions relating to
353 the appropriate disclosure of patient records without
354 consent; amending s. 397.501, F.S.; requiring a
355 service provider to furnish and provide access to
356 records within a specified timeframe after receiving a
357 request from an individual or an individual’s legal
358 representative; defining the term “legal
359 representative”; providing a conditional requirement
360 that such records be furnished in the manner chosen by
361 the requester; authorizing the service provider to
362 charge a reasonable cost associated with reproducing
363 such records; providing for a special service charge
364 under specified conditions; amending s. 400.145, F.S.;
365 requiring a nursing home facility to furnish and
366 provide access to records within a specified timeframe
367 after receiving a request; providing a conditional
368 requirement that such records be furnished in the
369 manner chosen by the requester; authorizing the
370 nursing home facility to charge a reasonable cost
371 associated with reproducing such records; providing
372 for a special service charge under specified
373 conditions; amending s. 456.057, F.S.; requiring
374 certain licensed health care practitioners to furnish
375 and provide access to copies of reports and records
376 within a specified timeframe after receiving a request
377 from a patient or a patient’s legal representative;
378 authorizing such licensed health care practitioners to
379 impose reasonable terms necessary to preserve such
380 reports and records; defining the term “legal
381 representative”; authorizing such licensed health care
382 practitioners to charge a reasonable cost associated
383 with reproducing such reports and records; providing
384 for a special service charge under specified
385 conditions; amending s. 395.1012, F.S.; requiring a