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A04581 Summary:

A04581 Actions:

A04581 Committee Votes:

Committee:HEALTH   Chair:Paulin      
DATE:03/21/2023AYE/NAY:25/0  Action: Favorable         
Paulin
Aye
Jensen
Aye
Dinowitz
Aye
McDonough
Excused
Gunther
Aye
Byrnes
Aye
Rosenthal L 
Aye
Gandolfo
Aye
Hevesi
Aye
Mikulin
Aye
Steck
Aye
Blumencranz
Aye
Braunstein
Aye
Bendett
Aye
Solages
Aye
Gray
Aye
Bichotte Hermel
Aye
Sayegh
Aye
Rosenthal D 
Aye
McDonald
Aye
Reyes
Aye
Gonzalez-Rojas
Aye
Rajkumar
Aye
Forrest
Aye
Kelles
Aye
Lucas
Aye

A04581 Floor Votes:

A04581 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          4581
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 17, 2023
                                       ___________
 
        Introduced  by  M.  of  A. PAULIN, McDONOUGH, COLTON, SAYEGH, DeSTEFANO,
          DARLING, SIMON -- read once and referred to the Committee on Health
 
        AN ACT to amend the public health law and the  mental  hygiene  law,  in
          relation to patient health information and medical records
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 17 of the public health law, as amended by  chapter
     2  165  of the laws of 1991, the first undesignated paragraph as amended by
     3  chapter 322 of the laws of 2017, is amended to read as follows:
     4    § 17. Release of [medical] health records to a designated health  care
     5  provider.   1. Upon the written request of any competent patient, parent
     6  or guardian of an infant,  a  guardian  appointed  pursuant  to  article
     7  eighty-one  of  the mental hygiene law, or conservator of a conservatee,
     8  [an examining, consulting or treating  physician  or  hospital  must]  a
     9  health  care provider who has provided professional health care services
    10  pertaining to a patient shall release and  deliver,  exclusive  of  non-
    11  clinical  personal notes of the [said physician or hospital] health care
    12  provider, copies of all [x-rays, medical] requested health records  [and
    13  test  records  including all laboratory tests] regarding that patient to
    14  any other designated [physician or  hospital  provided,  however,  that]
    15  health care provider.  However, such records concerning the treatment of
    16  an infant patient for venereal disease or the performance of an abortion
    17  operation  upon  such  infant  patient  shall  not be released or in any
    18  manner be made available to the parent or guardian of such  infant,  and
    19  provided, further, that original mammograms, rather than copies thereof,
    20  shall be released and delivered.
    21    [Either the physician or hospital] 2. A health care provider incurring
    22  the expense of providing copies of [x-rays, medical] health records [and
    23  test  records including all laboratory tests] pursuant to the provisions
    24  of this section may impose a reasonable charge to be paid by the  person
    25  requesting  the release and deliverance of such records as reimbursement
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04131-01-3
        A. 4581                             2
 
     1  [for such] not to exceed the health  care  provider's  actual  expenses,
     2  provided, however, that the [physician or hospital] health care provider
     3  may  not  impose  a  charge  for  copying an original mammogram when the
     4  original has been released or delivered to any competent patient, parent
     5  or  guardian  of  an  infant,  a  guardian appointed pursuant to article
     6  eighty-one of the mental hygiene law, or a conservator of a  conservatee
     7  and provided, further, that any charge for delivering an original mammo-
     8  gram  pursuant  to  this  section shall not exceed the documented actual
     9  costs associated therewith[. However, the reasonable charge], which  for
    10  paper  copies shall not exceed seventy-five cents per page. A release of
    11  records under this section shall not be denied solely because of inabil-
    12  ity to pay. No charge may be imposed under this section  for  providing,
    13  releasing,  or  delivering  medical records or copies of medical records
    14  where requested for the purpose of supporting an application,  claim  or
    15  appeal  for  any  government  benefit or program, provided that, where a
    16  provider maintains medical records in electronic form, it shall  provide
    17  the  copy in either electronic or paper form, as required by the govern-
    18  ment benefit or program, or at the patient's request.
    19    3. Where a health care  provider  provides  health  care  professional
    20  services  as  an  employee of or under contract with another health care
    21  provider, compliance with this section shall be  the  responsibility  of
    22  the  health  care provider that employs or contracts for the services of
    23  the other health care provider, unless the terms of  the  employment  or
    24  contract  explicitly  provide  otherwise.  If  a  health  care  provider
    25  receives a request under this section and compliance is the responsibil-
    26  ity of a different health care  provider  under  this  subdivision,  the
    27  health  care provider receiving the request shall immediately inform the
    28  requesting party to which health care provider  the  request  should  be
    29  directed.
    30    4. For the purposes of this section the [term "laboratory tests" shall
    31  include] following terms shall have the following meanings:
    32    (a)  "Health  record"  includes  any patient information as defined in
    33  section eighteen of this title, X-rays and other images, and records  of
    34  laboratory  tests  including  but not [be] limited to tests and examina-
    35  tions administered in clinical laboratories  or  blood  banks  as  those
    36  terms are defined in section five hundred seventy-one of this chapter.
    37    (b)  "Health  care  provider"  and "health care practitioner" have the
    38  same meanings as defined in section eighteen of this title.
    39    (c) "Professional health care services" means the services of a health
    40  care provider examining, assessing, treating or consulting  in  relation
    41  to  a  patient or patient's condition, within the scope of practice of a
    42  health care practitioner.
    43    § 2. Paragraphs (c), (d) and (e) of subdivision 1 of section 18 of the
    44  public health law, paragraphs (c) and (d) as added by chapter 497 of the
    45  laws of 1986, paragraph (e) as amended by chapter 2 of the laws of 1990,
    46  and the closing paragraph of paragraph (e) as amended by chapter 576  of
    47  the  laws  of 1998, are amended and a new paragraph (k) is added to read
    48  as follows:
    49    (c) "Health care facility" or "facility" means a hospital  as  defined
    50  in  article twenty-eight of this chapter, a home care services agency as
    51  defined in article thirty-six of this chapter, a hospice as  defined  in
    52  article  forty  of  this  chapter,  a health maintenance organization as
    53  defined in article forty-four of this chapter,  [and]  a  shared  health
    54  facility as defined in article forty-seven of this chapter; or an entity
    55  that  provides  the  health  care professional services of a health care
        A. 4581                             3

     1  provider by employing or contracting for the  health  care  professional
     2  services of a health care provider.
     3    (d)  "Health  care  practitioner"  or  "practitioner"  means  a person
     4  licensed under article one hundred thirty-one  (medicine),  one  hundred
     5  thirty-one-B  (physician assistants), one hundred thirty-one-C (special-
     6  ist assistant), one hundred thirty-two (chiropractic), one hundred thir-
     7  ty-three (dentistry, dental hygiene, and registered  dental  assisting),
     8  one hundred thirty-four (licensed perfusionists), one hundred thirty-six
     9  (physical  therapy and physical therapy assistants), one hundred thirty-
    10  seven (pharmacy), one hundred thirty-nine (nursing), one  hundred  forty
    11  (professional midwifery practice), one hundred forty-one (podiatry), one
    12  hundred  forty-three  (optometry),  one  hundred  forty-four (ophthalmic
    13  dispensing), one hundred fifty-three (psychology),  one  hundred  fifty-
    14  four  (social  work),  one  hundred  fifty-five  (massage  therapy), one
    15  hundred fifty-six [or] (occupational therapy), one  hundred  fifty-seven
    16  (dietetics  and  nutrition),  one  hundred  fifty-nine  (speech-language
    17  pathologists and audiologists), one  hundred  sixty  (acupuncture),  one
    18  hundred  sixty-two  (athletic trainers), one hundred sixty-three (mental
    19  health practitioners), one hundred  sixty-four  (respiratory  therapists
    20  and  respiratory  therapy technicians), one hundred sixty-five (clinical
    21  laboratory technology practice), one hundred sixty-six (medical  physics
    22  practice), or one hundred sixty-seven (applied behavior analysis) of the
    23  education  law  [or a person certified under section twenty-five hundred
    24  sixty of this chapter].
    25    (e) (i) "Patient information" or "information" means: any  information
    26  or  health  record  concerning  or  relating  to the examination, health
    27  assessment including, but not limited to, a health assessment for insur-
    28  ance and employment purposes [or], consulting in relation  to  treatment
    29  of  providing  drugs  or  devices, or providing professional health care
    30  services pertaining to an identifiable subject maintained  or  possessed
    31  by  a  health  care  [facility or health care practitioner who] provider
    32  which has provided or is providing services [for assessment of a  health
    33  condition  including, but not limited to, a health assessment for insur-
    34  ance and employment purposes or has treated or is treating such subject,
    35  except (i)].  It shall include X-rays and other images, and  records  of
    36  laboratory  tests  including  but  not limited to tests and examinations
    37  administered in clinical laboratories or blood banks as those terms  are
    38  defined  in  section  five hundred seventy-one of this chapter. It shall
    39  include records of charges to, and payments received from,  the  patient
    40  or  identifiable  subject or any other party on behalf of the patient or
    41  identifiable subject, for any such services, drugs or devices.
    42    (ii) "Patient information" or  "information"  shall  not  include  (A)
    43  information  and  clinical  records subject to the provisions of section
    44  [23.05 or] 33.13 of the mental hygiene  law[,  (ii)];  (B)  non-clinical
    45  personal  notes and observations of a health care practitioner, provided
    46  that such personal notes and observations are maintained by the  practi-
    47  tioner  and  not disclosed by the practitioner to any other person after
    48  January first, nineteen hundred eighty-seven[, (iii)];  (C)  information
    49  maintained  by a practitioner, concerning or relating to the prior exam-
    50  ination or treatment of a subject received  from  another  practitioner,
    51  provided  however, that such information may be requested by the subject
    52  directly from such other practitioner in accordance with the  provisions
    53  of this section, and provided further that this clause does not apply to
    54  any  referral,  order,  authorization, or prescription received from the
    55  other practitioner; and [(iv)] (D) data disclosed to a  practitioner  in
    56  confidence  by  other  persons on the basis of an express condition that
        A. 4581                             4
 
     1  such data would never be disclosed to  the  subject  or  other  persons,
     2  provided that such data has never been disclosed to any other person. If
     3  at  any  time  such  personal  notes  and  observations  or such data is
     4  disclosed,  it  shall  be considered patient information for purposes of
     5  this section. For purposes of this subdivision, "disclosure to any other
     6  person" shall not include disclosures made to practitioners as part of a
     7  consultation or referral during the treatment of the subject, to persons
     8  reviewing information or records in the ordinary course of ensuring that
     9  a provider is in compliance with applicable quality of  care,  licensure
    10  or  accreditation  standards,  to  an employee or official of a federal,
    11  state or local agency for the sole purpose of conducting an audit in the
    12  course of his or her official duties,  to  the  statewide  planning  and
    13  research cooperative system, to other persons pursuant to a court order,
    14  to  governmental  agencies, insurance companies licensed pursuant to the
    15  insurance law and other third parties  requiring  information  necessary
    16  for  payments  to  be  made  to  or  on behalf of patients, to qualified
    17  researchers, to the  [state  board  for  professional  medical  conduct]
    18  department  of  health  or the department of education when such [board]
    19  requests such information in the exercise of its statutory function,  to
    20  an  insurance  carrier  insuring,  or an attorney consulted by, a health
    21  care provider, or to a health maintenance organization certified  pursu-
    22  ant  to  article  forty-four of this chapter or licensed pursuant to the
    23  insurance law, or to the committee or a court pursuant to the provisions
    24  of this section.
    25    (iii) For purposes of this subdivision treatment of  a  subject  shall
    26  not  include  diagnostic  services,  except  mammography, performed by a
    27  practitioner  at  the  request  of  another  health  care   practitioner
    28  provided,  however,  that  such  information,  and  mammograms,  may  be
    29  requested by the subject directly from the practitioner at whose request
    30  such  diagnostic  services  were  performed,  in  accordance  with   the
    31  provisions of this section.
    32    (k) "Professional health care services" means the services of a health
    33  care  provider  examining, assessing, treating or consulting in relation
    34  to an identifiable subject of an identifiable subject's condition, with-
    35  in the scope of practice of a health care practitioner.
    36    § 3. Paragraph (e) of subdivision 2 of section 18 of the public health
    37  law, as amended by chapter 322 of the laws of 2017, is amended and a new
    38  paragraph (j) is added to read as follows:
    39    (e) The provider may impose a reasonable charge  for  all  inspections
    40  and  copies,  not  exceeding the reasonable and actual costs incurred by
    41  such provider, provided, however, that  a  provider  may  not  impose  a
    42  charge  for  copying  an  original  mammogram when the original has been
    43  furnished to any qualified person and provided, further, that any charge
    44  for furnishing an original mammogram pursuant to this section shall  not
    45  exceed  the documented costs associated therewith[. However, the reason-
    46  able charge], which for paper copies shall not exceed seventy-five cents
    47  per page. A qualified person shall  not  be  denied  access  to  patient
    48  information solely because of inability to pay. No charge may be imposed
    49  under  this  section  for  providing,  releasing,  or delivering patient
    50  information or copies of patient information  where  requested  for  the
    51  purpose of supporting an application, claim or appeal for any government
    52  benefit  or  program,  provided that, where a provider maintains patient
    53  information in electronic form, it shall  provide  the  copy  in  either
    54  electronic  or  paper  form,  as  required  by the government benefit or
    55  program, or at the patient's request.
        A. 4581                             5
 
     1    (j) Where a health care provider  provides  health  care  professional
     2  services  as  an  employee of or under contract with another health care
     3  provider, compliance with this section shall be  the  responsibility  of
     4  the  health  care provider that employs or contracts for the services of
     5  the  other  health  care provider, unless the terms of the employment or
     6  contract  explicitly  provide  otherwise.  If  a  health  care  provider
     7  receives a request under this section and compliance is the responsibil-
     8  ity  of  a  different  health  care provider under this subdivision, the
     9  health care provider receiving the request shall immediately inform  the
    10  requesting  party  to  which  health care provider the request should be
    11  directed.
    12    § 4. Paragraphs 1, 3 and 4 of subdivision (a) of section 33.16 of  the
    13  mental  hygiene law, paragraphs 1 and 4 as amended by chapter 226 of the
    14  laws of 1991, and paragraph 3 as amended by chapter 37 of  the  laws  of
    15  2011, are amended to read as follows:
    16    1. "Clinical  record"  means any information concerning or relating to
    17  the examination or treatment of, consulting in relation to treatment of,
    18  providing drugs or devices, or providing professional mental  or  behav-
    19  ioral  health  care  services  pertaining  to an identifiable patient or
    20  client maintained or possessed by a facility which  has  treated  or  is
    21  treating such patient or client, except data disclosed to a practitioner
    22  in confidence by other persons on the basis of an express condition that
    23  such  data  would  never  be disclosed to the patient or client or other
    24  persons, provided that such data has never been disclosed by the practi-
    25  tioner or a facility to any other person. If at any time  such  data  is
    26  disclosed,  it  shall be considered clinical records for the purposes of
    27  this section.   For purposes of this  subdivision,  "disclosure  to  any
    28  other  person"  shall  not  include disclosures made pursuant to section
    29  33.13 of this article, to practitioners as part  of  a  consultation  or
    30  referral during the treatment of the patient or client, to the statewide
    31  planning and research cooperative system, or to the committee or a court
    32  pursuant  to  the  provisions of this section or to an insurance carrier
    33  insuring, or an attorney consulted by,  a  facility.    Clinical  record
    34  shall  include  X-rays and other images, and records of laboratory tests
    35  including but not limited to  tests  and  examinations  administered  in
    36  clinical  laboratories  or  blood  banks  as  those terms are defined in
    37  section five hundred seventy-one of the  public  health  law.  It  shall
    38  include  records  of charges to, and payments received from, the patient
    39  or identifiable subject or any other party on behalf of the  patient  or
    40  identifiable subject, for any such services, drugs or devices.
    41    3. "Facility"  means  a  facility  as  defined in section 1.03 of this
    42  chapter, a program requiring approval for operation pursuant to  article
    43  thirty-two  of this chapter, institutions offering training in psychoth-
    44  erapy, psychoanalysis and related areas chartered  pursuant  to  section
    45  two  hundred  sixteen  of the education law, or, notwithstanding section
    46  1.03 of this chapter, any provider of services for persons  with  mental
    47  illness  or  developmental  disabilities  which  is  operated  by, under
    48  contract with, receives funding from, or is otherwise approved to render
    49  services by, a  director  of  community  services  pursuant  to  article
    50  forty-one  of  this chapter or one or both of the offices, including any
    51  such provider which is exempt from  the  requirement  for  an  operating
    52  certificate under article sixteen or article thirty-one of this chapter;
    53  or  an  entity  that  provides  mental or behavioral health professional
    54  services by employing or contracting for the professional services of  a
    55  mental health practitioner.
        A. 4581                             6
 
     1    4. "Mental  health  practitioner"  or  "practitioner"  means  a person
     2  employed by or rendering a service at a facility maintaining  the  clin-
     3  ical record [licensed under article one hundred thirty-one of the educa-
     4  tion law who practices psychiatry or a person licensed under article one
     5  hundred  thirty-nine,  one hundred fifty-three or one hundred fifty-four
     6  of the education law] who is a practitioner as defined in section  eigh-
     7  teen  of the public health law or any other person not prohibited by law
     8  from providing mental health or developmental disabilities services.
     9    § 5. Paragraph 6 of subdivision (b) of section  33.16  of  the  mental
    10  hygiene  law,  as amended by chapter 322 of the laws of 2017, is amended
    11  to read as follows:
    12    6. The facility may impose a reasonable charge for all inspections and
    13  copies, not exceeding the  documented  actual  costs  incurred  by  such
    14  provider[.  However, the reasonable charge] which for paper copies shall
    15  not exceed seventy-five cents per page. A qualified person shall not  be
    16  denied access to the clinical record solely because of inability to pay.
    17  No charge may be imposed under this section for providing, releasing, or
    18  delivering   clinical  records  or  copies  of  clinical  records  where
    19  requested for the purpose of supporting an application, claim or  appeal
    20  for  any  government benefit or program, provided that, where a provider
    21  maintains clinical records in electronic form, it shall provide the copy
    22  in either electronic or paper form, as required by the government  bene-
    23  fit or program, or at the patient's request.
    24    §  6.  Section  33.16 of the mental hygiene law is amended by adding a
    25  new subdivision (l) to read as follows:
    26    (l) This section shall not be construed  to  supplant  or  diminish  a
    27  right  or benefit that any patient, qualified person or person acting on
    28  behalf of a patient under sections seventeen or eighteen of  the  public
    29  health law has under either such sections of the public health law.
    30    §  7. This act shall take effect on the first of January next succeed-
    31  ing the date on which it shall have become a law.