BILL NUMBER: AB 2831 CHAPTERED 07/09/02 CHAPTER 128 FILED WITH SECRETARY OF STATE JULY 9, 2002 APPROVED BY GOVERNOR JULY 9, 2002 PASSED THE ASSEMBLY JUNE 24, 2002 PASSED THE SENATE JUNE 20, 2002 AMENDED IN SENATE JUNE 18, 2002 AMENDED IN ASSEMBLY APRIL 17, 2002 AMENDED IN ASSEMBLY APRIL 10, 2002 INTRODUCED BY Assembly Member Simitian FEBRUARY 25, 2002 An act to amend Section 123148 of the Health and Safety Code, relating to health records. LEGISLATIVE COUNSEL'S DIGEST AB 2831, Simitian. Health records: delivery of laboratory test results by Internet posting. Existing law provides that a health care professional who orders a laboratory test shall provide a patient, upon request, those test results in plain language and in oral or written form. Existing law permits test results to be delivered in electronic form if requested by the patient and if deemed appropriate by the health care professional who requested the test, subject to specified requirements regarding, among other things, consent of the patient. Under existing law, certain clinical laboratory test results are prohibited from being conveyed to a patient by Internet posting or other electronic means, including test results related to routinely processed tissues. This bill would instead provide that clinical laboratory test results related to routinely processed tissues may not be conveyed to the patient by Internet posting or other electronic means if they reveal a malignancy. This bill would also provide that the requirements described above do not prohibit direct communication by Internet posting or other electronic means to convey clinical laboratory test results by a treating health care professional, as specified. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 123148 of the Health and Safety Code is amended to read: 123148. (a) Notwithstanding any other provision of law, a health care professional at whose request a test is performed shall provide or arrange for the provision of the results of a clinical laboratory test to the patient who is the subject of the test if so requested by the patient, in oral or written form. The results shall be conveyed in plain language and in oral or written form, except the results may be conveyed in electronic form if requested by the patient and if deemed most appropriate by the health care professional who requested the test. (b) (1) Consent of the patient to receive his or her laboratory results by Internet posting or other electronic means shall be obtained in a manner consistent with the requirements of Section 56.10 or 56.11 of the Civil Code. In the event that a health care professional arranges for the provision of test results by Internet posting or other electronic manner, the results shall be delivered to a patient in a reasonable time period, but only after the results have been reviewed by the health care professional. Access to clinical laboratory test results shall be restricted by the use of a secure personal identification number when the results are delivered to a patient by Internet posting or other electronic manner. (2) Nothing in paragraph (1) shall prohibit direct communication by Internet posting or the use of other electronic means to convey clinical laboratory test results by a treating health care professional who ordered the test for his or her patient or by a health care professional acting on behalf of, or with the authorization of, the treating health care professional who ordered the test. (c) When a patient requests to receive his or her laboratory test results by Internet posting, the health care professional shall advise the patient of any charges that may be assessed directly to the patient or insurer for the service and that the patient may call the health care professional for a more detailed explanation of the laboratory test results when delivered. (d) The electronic provision of test results under this section shall be in accordance with any applicable federal law governing privacy and security of electronic personal health records. However, any state statute, if enacted, that governs privacy and security of electronic personal health records, shall apply to test results under this section and shall prevail over federal law if federal law permits. (e) The test results to be reported to the patient pursuant to this section shall be recorded in the patient's medical record, and shall be reported to the patient within a reasonable time period after the test results are received at the offices of the health care professional who requested the test. (f) Notwithstanding subdivisions (a) and (b), none of the following clinical laboratory test results and any other related results shall be conveyed to a patient by Internet posting or other electronic means: (1) HIV antibody test. (2) Presence of antigens indicating a hepatitis infection. (3) Abusing the use of drugs. (4) Test results related to routinely processed tissues, including skin biopsies, Pap smear tests, products of conception, and bone marrow aspirations for morphological evaluation, if they reveal a malignancy. (g) Patient identifiable test results and health information that have been provided under this section shall not be used for any commercial purpose without the consent of the patient, obtained in a manner consistent with the requirements of Section 56.11 of the Civil Code. (h) Any third party to whom laboratory test results are disclosed pursuant to this section shall be deemed a provider of administrative services, as that term is used in paragraph (3) of subdivision (c) of Section 56.10 of the Civil Code, and shall be subject to all limitations and penalties applicable to that section. (i) A patient may not be required to pay any cost, or be charged any fee, for electing to receive his or her laboratory results in any manner other than by Internet posting or other electronic form. (j) A patient or his or her physician may revoke any consent provided under this section at any time and without penalty, except to the extent that action has been taken in reliance on that consent.