BILL ANALYSIS Ó
AB 1337
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Date of Hearing: May 5, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
AB 1337
(Linder) - As Amended April 21, 2015
SUBJECT: Medical records: electronic delivery.
SUMMARY: Provides a standardized authorization form for medical
records requests and requires a medical provider or employer to
provide electronic copies of medical records, as specified.
Specifically, this bill:
1)Requires medical providers and employers to accept a signed
and completed authorization form for the disclosure of health
information that is substantially similar to the form
specified in this bill.
2)Requires a medical provider or employer to provide an
electronic copy of a requested medical record if the medical
record exists in a digital or electronic format that can be
delivered electronically.
3)Precludes a medical provider or employer from conditioning
treatment, payment, enrollment, or eligibility for benefits on
the submission of an authorization form for medical records
requests.
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EXISTING LAW:
1)Requires health care providers to make a patient's medical
records available for inspection and copying by an attorney,
prior to the filing of any action or the appearance of a
defendant in an action, when the attorney presents written
authorization from a patient, or the patient's designated
representative, as specified.
2)Prohibits a health care provider or employer from copying
requested medical records when the requesting attorney has
employed a professional photocopier, as specified.
3)Makes the person or entity having custody of the medical
records liable for all reasonable expenses, including
attorney's fees, incurred in any proceeding when the medical
records are not made available within five days of the written
request.
4)Permits all reasonable costs incurred by a health care
provider in making patient records available to be charged
against the person requesting the records.
5)Grants, under the federal Health Information Portability and
Accountability Act (HIPAA), patients the right to obtain a
copy of their medical records from any medical provider, with
exceptions.
FISCAL EFFECT: None
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COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, health care
facilities use individualized authorization forms used to
release patient health records which vary widely depending on
the individual health care provider, facility, or health plan
or insurer. The author asserts that the use of
provider-specific authorization forms is burdensome and
results in delays in obtaining records, as patients and/or
their representatives must contact individual providers to
obtain their specific authorization forms in order to request
records. The author states that this bill will resolve this
problem by establishing a standardized medical request form
which will provide a streamlined process for patients and
health care facilities to request medical records.
2)BACKGROUND. Existing federal and California Law gives
patients the right to access their medical records. According
to the Health Consumer Alliance, medical records requests fall
under various sections of California law, including the
federal Patient Access to Health Records Act, the
Confidentiality of Medical Information Act, and the
Information Practices Act of 1977. The California Evidence
Code also contains provisions that give special access to
medical records to attorneys or their representatives with
patient authorization.
The federal HIPAA grants patients the right to copies of their
own medical records. HIPAA allows providers 30 days to
complete a records request. However, under California law,
this time period is shorted to five days. HIPAA allows health
care providers to withhold certain types of medical records,
including psychotherapy notes, information the provider is
compiling for lawsuits, and medical information the provider
believes could reasonably endanger the life or safety of
another person.
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HIPAA precludes medical providers and employers from
conditioning treatment, payment, enrollment, or eligibility
for benefits on the signing of a medical records request
authorization form. These provisions are intended to protect
patients from retaliation if a medical provider or employer
believes the requested medical records will be used in legal
proceedings against the entity providing the records. This
bill would implement these provisions in state law.
3)SUPPORT. According to the sponsor, the Consumer Attorneys of
California (CAOC), the wide variance among authorization forms
leads to delays in processing patient health records requests.
CAOC states that a patient's attorney must contact the
applicable health care facility, obtain a specific form, have
the client sign that form, and then submit it back to the
health facility, which is a burdensome process. CAOC asserts
that health care facilities receive medical records request
forms that differ from their own, which results in additional
delays and costs for providers to process records requests.
The California Hospital Association (CHA) states in support that
this bill creates a uniform authorization that all hospitals
and physicians will recognize to release medical records to an
attorney prior to the filing of a lawsuit. CHA states that
today, lawyers, physicians and hospitals make up their own
forms, and having one easily-recognizable form will help
hospitals and physicians identify when a request has been
made. CHA also states that with a standardized form,
hospitals and physicians will not have to analyze the form to
make sure it complies with medical privacy laws.
4)PRIOR LEGISLATION. AB 2059 (Muratsuchi) of 2014 would have
required a medical provider, as specified, or their employer
to provide an electronic copy of the requested medical record
when an attorney presents written authorization signed by the
patient or patient's representative when the medical record
exists in a digital or electronic format that can be delivered
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electronically. AB 2059 was held on the Senate inactive file.
5)POLICY CONSIDERATIONS. This bill currently contains
provisions to protect against blanket disclosure of sensitive
patient records. Current language for the standardized form
requires a requestor to check an additional box and specify a
date range in order to obtain records relating to mental
health, drugs and alcohol, and HIV test results. Records of
this kind are subject to heightened confidentiality
requirements imposed on physicians under the
Lanterman-Petris-Short Act (LPS Act). The provisions of the
LPS Act may require authorization not only from the patient,
but also from other health care providers or administrative
officers before information may be released to a third party,
and requires the authorization to specify the use of the
information and the specific information to be released.
Additionally, some physicians may have internal policies to
protect patient records from unauthorized disclosure that may
require additional information or specificity from the
requestor before they are comfortable releasing the records.
The author may wish to consider amending the standardized form
to ensure that providers have sufficient time and ability to
clarify the scope and sensitivity of medical record requests
before they are in violation of the time limits imposed by the
law to respond to such requests.
REGISTERED SUPPORT / OPPOSITION:
Support
Consumer Attorneys of California (sponsor)
AB 1337
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California Hospital Association
Opposition
None on File.
Analysis Prepared by:Rylan Gervase / HEALTH / (916) 319-2097