Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. SB 7078
       
       
       
       
       
       
                                Ì195108+Î195108                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/10/2019           .                                
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       Appropriations Subcommittee on Health and Human Services
       (Harrell) recommended the following:
       
    1         Senate Amendment 
    2  
    3         Delete lines 119 - 407
    4  and insert:
    5         (a)The reasonable costs of reproducing copies of written
    6  or typed documents or reports, in any format or medium, may not
    7  exceed $1 per page for the first 25 pages and 25 cents per page
    8  for all pages thereafter.
    9         (b)The reasonable costs of reproducing X-rays and other
   10  forms of images shall be the actual costs. Actual costs shall be
   11  the sum of the cost of the material and supplies used to
   12  duplicate the record and the labor and overhead costs associated
   13  with the duplication.
   14         (c) If the nature or volume of the clinical records
   15  requested to be copied requires extensive use of information
   16  technology resources or extensive clerical or supervisory
   17  assistance by personnel of the service provider, or both, the
   18  service provider may charge, in addition to the charges imposed
   19  under paragraphs (a) and (b), a special service charge, which
   20  shall be reasonable and shall be based on the cost incurred for
   21  such extensive use of information technology resources or the
   22  labor cost of the personnel providing the service which is
   23  actually incurred by the service provider or attributable to the
   24  service provider for the clerical and supervisory assistance
   25  required, or both.
   26         (d) The charges established in this subsection apply to all
   27  records furnished, whether directly from a service provider or
   28  from a copy service acting on behalf of the service provider.
   29  However, a patient whose records are copied or searched for the
   30  purpose of continuing to receive care is not required to pay a
   31  charge for copying or for the search.
   32         Section 2. Subsection (1) and paragraph (e) of subsection
   33  (4) of section 395.3025, Florida Statutes, are amended to read:
   34         395.3025 Patient and personnel records; copies;
   35  examination.—
   36         (1)(a) Any licensed facility shall, upon written request,
   37  and only after discharge of the patient, furnish, in a timely
   38  manner as provided in paragraph (b), without delays for legal
   39  review, to any person admitted therein for care and treatment or
   40  treated thereat, or to any such person’s guardian, curator, or
   41  personal representative, or in the absence of one of those
   42  persons, to the next of kin of a decedent or the parent of a
   43  minor, or to anyone designated by such person in writing, a true
   44  and correct copy of all patient records, including X rays, and
   45  insurance information concerning such person, which records are
   46  in the possession of the licensed facility, provided the person
   47  requesting such records agrees to pay a charge as provided in
   48  paragraph (d).
   49         (b)Within 14 working days after receiving a request made
   50  in accordance with paragraph (a), a licensed facility must
   51  furnish applicable patient records in its possession.
   52         (c)If a licensed facility maintains a system of electronic
   53  health records as defined in s. 408.051, the licensed facility
   54  shall furnish the requested records in the manner chosen by the
   55  requester, which may include paper documents, electronic format,
   56  access through a web-based patient portal, or submission through
   57  a patient’s electronic personal health record.
   58         (d)The licensed facility may charge a requester no more
   59  than the reasonable costs of reproducing the patient records,
   60  including reasonable staff time.
   61         1.The reasonable costs of reproducing copies of written or
   62  typed documents or reports, in any format or medium, may not
   63  exceed $1 per page for the first 25 pages and 25 cents per page
   64  for all pages thereafter.
   65         2.The reasonable costs of reproducing X-rays and other
   66  forms of images shall be the actual costs. Actual costs shall be
   67  the sum of the cost of the material and supplies used to
   68  duplicate the record and the labor and overhead costs associated
   69  with the duplication.
   70         3. If the nature or volume of the patient records requested
   71  to be copied requires extensive use of information technology
   72  resources or extensive clerical or supervisory assistance by
   73  personnel of the licensed facility, or both, the licensed
   74  facility may charge, in addition to the charges imposed under
   75  subparagraphs 1. and 2., a special service charge, which shall
   76  be reasonable and shall be based on the cost incurred for such
   77  extensive use of information technology resources or the labor
   78  cost of the personnel providing the service which is actually
   79  incurred by the licensed facility or attributable to the
   80  licensed facility for the clerical and supervisory assistance
   81  required, or both.
   82         4. The charges established in this paragraph The exclusive
   83  charge for copies of patient records may include sales tax and
   84  actual postage, and, except for nonpaper records that are
   85  subject to a charge not to exceed $2, may not exceed $1 per
   86  page. A fee of up to $1 may be charged for each year of records
   87  requested. These charges shall apply to all records furnished,
   88  whether directly from the facility or from a copy service acting
   89  providing these services on behalf of the facility. However, a
   90  patient whose records are copied or searched for the purpose of
   91  continuing to receive medical care is not required to pay a
   92  charge for copying or for the search.
   93         (e) If a person authorized to receive copies of patient
   94  records under paragraph (a) requests to examine the licensed
   95  facility’s original records pertaining to the patient, the
   96  licensed facility shall, within 10 working days after receiving
   97  such a request, provide such person with access to examine such
   98  original records, microforms, or other suitable reproductions of
   99  such records in its possession. A licensed facility may impose
  100  any reasonable terms necessary to ensure further allow any such
  101  person to examine the original records in its possession, or
  102  microforms or other suitable reproductions of the records, upon
  103  such reasonable terms as shall be imposed to assure that the
  104  records will not be damaged, destroyed, or altered.
  105         (4) Patient records are confidential and may must not be
  106  disclosed without the consent of the patient or his or her legal
  107  representative; however, but appropriate disclosure may be made
  108  without such consent to:
  109         (e) The department agency upon subpoena issued pursuant to
  110  s. 456.071, but the records obtained thereby must be used solely
  111  for the purpose of the department agency and the appropriate
  112  professional board in its investigation, prosecution, and appeal
  113  of disciplinary proceedings. If the department agency requests
  114  copies of the records, the facility shall charge no more than
  115  its actual copying costs, including reasonable staff time. The
  116  records must be sealed and must not be available to the public
  117  pursuant to s. 119.07(1) or any other statute providing access
  118  to records, nor may they be available to the public as part of
  119  the record of investigation for and prosecution in disciplinary
  120  proceedings made available to the public by the department
  121  agency or the appropriate regulatory board. However, the
  122  department agency must make available, upon written request by a
  123  practitioner against whom probable cause has been found, any
  124  such records that form the basis of the determination of
  125  probable cause.
  126         Section 3. Present paragraphs (a) through (j) of subsection
  127  (7) of section 397.501, Florida Statutes, are redesignated as
  128  paragraphs (d) through (m), respectively, and new paragraphs
  129  (a), (b), and (c) are added to that subsection, to read:
  130         397.501 Rights of individuals.—Individuals receiving
  131  substance abuse services from any service provider are
  132  guaranteed protection of the rights specified in this section,
  133  unless otherwise expressly provided, and service providers must
  134  ensure the protection of such rights.
  135         (7) RIGHT TO ACCESS TO AND CONFIDENTIALITY OF INDIVIDUAL
  136  RECORDS.—
  137         (a)1.Within 14 working days after receiving a written
  138  request from an individual or an individual’s legal
  139  representative, a service provider shall furnish a true and
  140  correct copy of all records pertaining to that individual in the
  141  possession of the service provider.
  142         2. For the purpose of this subsection, the term “legal
  143  representative” means an individual’s legal guardian or, if the
  144  individual is younger than 18 years old, the individual’s parent
  145  or legal guardian.
  146         3. If a service provider maintains a system of electronic
  147  health records as defined in s. 408.051, the service provider
  148  shall furnish the requested records in the manner chosen by the
  149  requester, which may include paper documents, electronic format,
  150  access through a web-based patient portal, or submission through
  151  an individual’s electronic personal health record.
  152         (b)A service provider may charge the requester no more
  153  than the reasonable costs of reproducing the records, including
  154  reasonable staff time.
  155         1.The reasonable costs of reproducing copies of written or
  156  typed documents or reports, in any format or medium, may not
  157  exceed $1 per page for the first 25 pages and 25 cents per page
  158  for all pages thereafter.
  159         2.The reasonable costs of reproducing X-rays and such
  160  other kinds of records shall be the actual costs. Actual costs
  161  are the sum of the cost of the material and supplies used to
  162  duplicate the records and the labor and overhead costs
  163  associated with the duplication.
  164         3.If the nature or volume of the records requested to be
  165  copied requires extensive use of information technology
  166  resources or extensive clerical or supervisory assistance by
  167  personnel of the service provider, or both, the service provider
  168  may charge, in addition to the charges imposed under
  169  subparagraphs 1. and 2., a special service charge, which shall
  170  be reasonable and shall be based on the cost incurred for such
  171  extensive use of information technology resources or the labor
  172  cost of the personnel providing the service which is actually
  173  incurred by the service provider or attributable to the service
  174  provider for the clerical and supervisory assistance required,
  175  or both.
  176         4. The charges established in this paragraph apply to all
  177  records furnished, whether directly from a service provider or
  178  from a copy service acting on behalf of the service provider.
  179  However, an individual whose records are copied or searched for
  180  the purpose of continuing to receive care is not required to pay
  181  a charge for copying or for the search.
  182         (c)Within 10 working days after receiving a request from
  183  an individual or an individual’s legal representative to examine
  184  the service provider’s original records pertaining to that
  185  individual, a service provider shall provide access to examine
  186  such original records, microforms, or other suitable
  187  reproductions of such records in its possession. A service
  188  provider may impose any reasonable terms necessary to ensure
  189  that the records will not be damaged, destroyed, or altered.
  190         Section 4. Subsections (1) and (4) of section 400.145,
  191  Florida Statutes, are amended to read:
  192         400.145 Copies of records of care and treatment of
  193  resident.—
  194         (1) Upon receipt of a written request that complies with
  195  the federal Health Insurance Portability and Accountability Act
  196  of 1996 (HIPAA) and this section, a nursing home facility shall
  197  furnish to a competent resident, or to a representative of that
  198  resident who is authorized to make requests for the resident’s
  199  records under HIPAA or subsection (2), copies of the resident’s
  200  paper and electronic records that are in possession of the
  201  facility. Such records must include any medical records and
  202  records concerning the care and treatment of the resident
  203  performed by the facility, except for progress notes and
  204  consultation report sections of a psychiatric nature. The
  205  facility shall provide copies of the requested records according
  206  to the timeframe requirements of 42 C.F.R. s. 483.10(g)(2)(ii)
  207  for within 14 working days after receipt of a request relating
  208  to a current resident or within 30 working days after receipt of
  209  a request relating to a former resident.
  210         (4)(a) After receiving a request made in accordance with
  211  subsections (1)-(3), a nursing home facility must furnish
  212  applicable records in its possession in accordance with the
  213  timeframe requirements of subsection (1) and the provisions of
  214  this subsection.
  215         (b)If a nursing home facility maintains a system of
  216  electronic health records as defined in s. 408.051, the facility
  217  shall furnish the requested records in the manner chosen by the
  218  requester, which may include paper documents, electronic format,
  219  or access through a web-based portal.
  220         (c)The nursing home facility may charge a requester no
  221  more than the reasonable costs of reproducing the records,
  222  including reasonable staff time.
  223         1.The reasonable costs of reproducing copies of written or
  224  typed documents or reports, in any format or medium, may not
  225  exceed $1 per page for the first 25 pages and 25 cents per page
  226  for all pages thereafter.
  227         2.The reasonable costs of reproducing X-rays and other
  228  forms of images shall be the actual costs. Actual costs shall be
  229  the sum of the cost of the material and supplies used to
  230  duplicate the record and the labor and overhead costs associated
  231  with the duplication.
  232         3. If the nature or volume of the records requested to be
  233  copied requires extensive use of information technology
  234  resources or extensive clerical or supervisory assistance by
  235  personnel of the nursing home facility, or both, the facility
  236  may charge, in addition to the charges imposed under
  237  subparagraphs 1. and 2., a special service charge, which shall
  238  be reasonable and shall be based on the cost incurred for such
  239  extensive use of information technology resources or the labor
  240  cost of the personnel providing the service which is actually
  241  incurred by the facility or attributable to the facility for the
  242  clerical and supervisory assistance required, or both.
  243         4. The charges established in this paragraph apply to all
  244  records furnished, whether directly from a nursing home facility
  245  or from a copy service acting on behalf of the facility.
  246  However, a resident whose records are copied or searched for the
  247  purpose of continuing to receive care is not required to pay a
  248  charge for copying or for the search
  249         (d)Within 10 working days after receiving a request from a
  250  person who is authorized to act on behalf of a resident to
  251  examine the nursing home facility’s original records pertaining
  252  to the resident, the facility shall provide access to examine
  253  such original records, microforms, or other suitable
  254  reproductions of such records in its possession. A facility may
  255  impose any reasonable terms necessary A nursing home facility
  256  may charge a reasonable fee for the copying of resident records.
  257  Such fee may not exceed $1 per page for the first 25 pages and
  258  25 cents per page for each additional page. The facility shall
  259  allow a person who is authorized to act on behalf of the
  260  resident to examine the original records, microfilms, or other
  261  suitable reproductions of the records in its possession upon any
  262  reasonable terms imposed by the facility to ensure that the
  263  records are not damaged, destroyed, or altered.
  264         Section 5. Subsections (6) and (17) of section 456.057,
  265  Florida Statutes, are amended to read:
  266         456.057 Ownership and control of patient records; report or
  267  copies of records to be furnished; disclosure of information.—
  268         (6)(a) Any health care practitioner licensed by the
  269  department or a board within the department who makes a physical
  270  or mental examination of, or administers treatment or dispenses
  271  legend drugs to, any person shall, upon written request of such
  272  person or the person’s legal representative, furnish, within 14
  273  working days after such request in a timely manner, without
  274  delays for legal review, copies of all reports and records
  275  relating to such examination or treatment, including X-rays X
  276  rays and insurance information. If the health care practitioner
  277  maintains a system of electronic health records as defined in s.
  278  408.051, the health care practitioner shall furnish the
  279  requested records in the manner chosen by the requester, which
  280  may include paper documents, electronic format, access through a
  281  web-based patient portal, or submission through a patient’s
  282  electronic personal health record.
  283         (b)Within 10 working days after receiving a written
  284  request by a patient or the patient’s legal representative to
  285  examine the health care practitioner’s original reports and
  286  records pertaining to the patient, a health care practitioner
  287  must provide access to examine such original reports and
  288  records, or microforms or other suitable reproductions of the
  289  reports and records in the health care practitioner’s
  290  possession. The health care practitioner may impose any
  291  reasonable terms necessary to ensure that the reports and
  292  records will not be damaged, destroyed, or altered.
  293         (c) For the purposes of this subsection, the term “legal
  294  representative” means a patient’s legal guardian or, if the
  295  patient is younger than 18 years old, the patient’s parent or
  296  legal guardian.
  297         (d)However, When a patient’s psychiatric, chapter 490
  298  psychological, or chapter 491 psychotherapeutic records are
  299  requested by the patient or the patient’s legal representative,
  300  the health care practitioner may provide a report of examination
  301  and treatment in lieu of copies of records. Upon a patient’s
  302  written request, complete copies of the patient’s psychiatric
  303  records shall be provided directly to a subsequent treating
  304  psychiatrist. The furnishing of such report or copies may shall
  305  not be conditioned upon payment of a fee for services rendered.
  306         (17) A licensed health care practitioner may charge the
  307  requester no more than the reasonable costs of reproducing the
  308  reports and records, including reasonable staff time.
  309         (a)The reasonable costs of reproducing copies of written
  310  or typed documents or reports, in any format or medium, may not
  311  exceed $1 per page