BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 2253|
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THIRD READING
Bill No: AB 2253
Author: Pan (D)
Amended: As introduced
Vote: 21
SENATE JUDICIARY COMMITTEE : 5-0, 7/3/12
AYES: Evans, Harman, Blakeslee, Corbett, Leno
ASSEMBLY FLOOR : 73-1, 5/14/12 - See last page for vote
SUBJECT : Clinical laboratory test results: electronic
conveyance
SOURCE : Author
DIGEST : This bill authorizes the electronic conveyance
of clinical laboratory test results related to HIV
antibodies, hepatitis, drug abuse, and specified test
results that reveal a malignancy, if requested by the
patient, and the health care professional deems electronic
conveyance the most appropriate method of disclosure, and
the professional has already discussed the results with the
patient.
ANALYSIS : Existing law requires that a health care
provider, health care service plan, or contractor must
disclose a patient's medical information to him/her.
(Civil Code (CIV) Section 56.10(b)(7).) Existing law
provides that an adult patient of a health care provider,
any minor patient authorized by law to consent to medical
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treatment, and any patient representative shall be entitled
to inspect the patient's records upon presenting to the
health care provider a written request for those records
and upon payment of reasonable clerical costs incurred in
locating and making the records available. (Health and
Safety Code (HSC) Section 123110)
Existing law requires a health care professional at whose
request a clinical laboratory test is performed to provide
or arrange for the results to be delivered to the patient.
At the patient's request, and if deemed most appropriate by
the health care professional, the results may be conveyed
in electronic form. (HSC Section 123148(a))
Existing law requires the electronic provision of test
results to be delivered to a patient in a reasonable time
period, after the results have been reviewed by the health
care professional, and recorded in the patient's medical
record. (HSC Section 123148(b) and (e))
Existing law establishes use limitations and protections
for clinical lab test results conveyed by electronic means,
including:
the information shall not be used for any commercial
purpose without the consent of the patient; and
any third party to whom the results or information are
disclosed to are deemed a provider and subject to
limitations under the Civil Code. (HSC Section 123148(g)
and (h))
Existing law provides that a patient or his or her
physician may revoke any consent to receive test results
electronically at any time and without penalty, except to
the extent that action has been taken in reliance on that
consent. (HSC Section 123148(j))
Existing law prohibits the results of the following
clinical laboratory tests from being conveyed
electronically to patients:
HIV antibody test;
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presence of antigens indicating a hepatitis infection;
abusing the use of drugs; and
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. (HSC Section
123148(f))
This bill authorizes clinical laboratory test results for
HIV antibodies, hepatitis, drug abuse, and test results
related to routinely processed tissues, as specified, if:
the patient requests the electronic conveyance;
the health care professional deems this conveyance as the
most appropriate means; and
a health care professional has first discussed the
results with the patient.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 7/6/12)
California Society of Pathologists
Center for Democracy and Technology
Quest Diagnostics Incorporated
OPPOSITION : (Verified 7/6/12)
American Civil Liberties Union (unless amended)
ARGUMENTS IN SUPPORT : According to the author, "This
bill promotes the expansion of health information exchange
and electronic health records, as well as, furthering the
participation of patients in their own medical decision
making. As the federal government has moved to implement
health information exchange and technology with the goal of
expanding electronic health records, California has been
identified as one of a number of states with state laws
that present barriers to the expansion of health
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information exchange. Particularly, existing state law
prohibits the conveyance of HIV, hepatitis, abuse of drugs,
and pathology test results electronically. The explicit
prohibition against conveyance of test results to patients
on the specified test creates a special class of
information that exceeds the Health Insurance Portability
and Accountability Act (HIPAA) privacy standards regulating
all other types of personal health information. This bill
would assist eligible professionals and hospitals to
qualify for these incentive payments while allowing
patients to take an active role in their health care."
ARGUMENTS IN OPPOSITION : The American Civil Liberties
Union (ACLU) opposes this bill, unless it is amended, to
require the patient to make the request for an electronic
conveyance of test results in writing. The ACLU argues
that a written request will "ensure that the patient
understands and in fact agrees to receive the results
electronically."
In response, the author writes, "existing state law
sufficiently ensures that a patient must have already given
written consent to conduct the specified test, to share
with third parties, including themselves; and for the
information to be conveyed electronically if the ordering
physician deems it appropriate. In order to protect
patient privacy, AB 2253 only releases clinical lab results
to the patient who is the subject of the test and only if
so requested by the patient."
ASSEMBLY FLOOR : 73-1, 5/14/12
AYES: Achadjian, Alejo, Allen, Beall, Bill Berryhill,
Block, Blumenfield, Bonilla, Bradford, Brownley,
Buchanan, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Conway, Cook, Davis, Dickinson, Donnelly, Eng,
Feuer, Fong, Fuentes, Furutani, Beth Gaines, Galgiani,
Garrick, Gatto, Gordon, Gorell, Grove, Hagman, Halderman,
Hall, Harkey, Hayashi, Roger Hernández, Hill, Huber,
Hueso, Huffman, Jeffries, Jones, Knight, Lara, Logue,
Bonnie Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell,
Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan,
V. Manuel Pérez, Portantino, Silva, Skinner, Smyth,
Solorio, Swanson, Torres, Wagner, Williams, Yamada, John
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A. Pérez
NOES: Ammiano
NO VOTE RECORDED: Atkins, Butler, Fletcher, Perea,
Valadao, Wieckowski
RJG:m 7/6/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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