Florida Senate - 2017                                     SB 826
       
       
        
       By Senator Mayfield
       
       17-00675-17                                            2017826__
    1                        A bill to be entitled                      
    2         An act relating to medical records; amending s.
    3         395.3025, F.S.; revising costs that licensed
    4         facilities may include in their charge for patient
    5         records and reports; authorizing a flat fee for the
    6         furnishing of electronic medical records; amending s.
    7         456.057, F.S.; revising who may charge for reproducing
    8         a patient’s records and who may receive the patient’s
    9         records for certain costs; authorizing a flat fee for
   10         the furnishing of electronic medical records; removing
   11         the authority of boards and departments to specify the
   12         cost of patient medical records; amending ss.
   13         316.1932, 316.1933, 395.4025, and 440.185, F.S.;
   14         conforming provisions to changes made by the act;
   15         providing an effective date.
   16          
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Subsection (1) of section 395.3025, Florida
   20  Statutes, is amended, present subsections (2) through (11) are
   21  redesignated as (4) through (13), respectively, and new
   22  subsections (2) and (3) are added to that section, to read:
   23         395.3025 Patient and personnel records; copies;
   24  examination.—
   25         (1) Any licensed facility shall, upon written request, and
   26  only after discharge of the patient, furnish, in a timely
   27  manner, without delays for legal review, to the patient or to
   28  his or her any person admitted therein for care and treatment or
   29  treated thereat, or to any such person’s guardian, curator,
   30  attorney, or personal representative, or in the absence of one
   31  of those persons, to the next of kin of a decedent or the parent
   32  of a minor, or to anyone designated by such person in writing, a
   33  true and correct copy of all patient records and reports,
   34  including X rays, and insurance information concerning such
   35  person, which records are in the possession of the licensed
   36  facility, provided the person requesting such records and
   37  reports agrees to pay a charge, if one is necessary. The
   38  exclusive charge for furnishing copies of patient records and
   39  reports or making the records and reports available for digital
   40  scanning under this section shall be no more than a reasonable,
   41  cost-based fee, provided that the fee includes only the cost of:
   42         (a)Labor for copying the patient records and reports that
   43  the person requested, whether in paper or electronic form. Labor
   44  for copying includes only labor for creating and delivering the
   45  electronic or paper copy in the form and format the person
   46  requested or agreed upon. Reviewing the request for access and
   47  searching for, retrieving, and otherwise preparing the requested
   48  information for copying may not be used for purposes of
   49  calculating the fees that can be charged to individuals;
   50         (b) Supplies for creating the paper copy or electronic
   51  media, if the individual requests that the electronic copy be
   52  provided on portable media;
   53         (c)Postage, when the individual has requested the records
   54  and reports be mailed; and
   55         (d)Sales tax may include sales tax and actual postage,
   56  and, except for nonpaper records that are subject to a charge
   57  not to exceed $2, may not exceed $1 per page. A fee of up to $1
   58  may be charged for each year of records requested.
   59  
   60  These charges shall apply to all records furnished, whether
   61  directly from the facility or from a copy service providing
   62  these services on behalf of the facility. However, a patient
   63  whose records are copied or searched for the purpose of
   64  continuing to receive medical care is not required to pay a
   65  charge for copying or for the search. The licensed facility
   66  shall further allow any such person to examine the original
   67  records in its possession, or microforms or other suitable
   68  reproductions of the records, upon such reasonable terms as
   69  shall be imposed to assure that the records will not be damaged,
   70  destroyed, or altered.
   71         (2)As an alternative to the fee charged in subsection (1),
   72  a licensed facility or a business operating on its behalf may
   73  charge individuals a flat fee for all requests for electronic
   74  copies of patient records and reports maintained electronically,
   75  provided the fee does not exceed $6.50, inclusive of all labor,
   76  supplies, and any applicable postage.
   77         (3)Costs associated with updates to or maintenance of
   78  systems and data, capital expenditures for data storage and
   79  maintenance, labor associated with ensuring compliance with 45
   80  C.F.R. s. 164.524 and other applicable laws in fulfilling the
   81  access request, and administrative and other costs associated
   82  with outsourcing the function of responding to individual
   83  requests for patient records and reports may not be used for
   84  purposes of calculating the fees that can be charged to
   85  individuals.
   86         Section 2. Subsection (17) of section 456.057, Florida
   87  Statutes, is amended to read:
   88         456.057 Ownership and control of patient records; report or
   89  copies of records to be furnished; disclosure of information.—
   90         (17) A health care practitioner or records owner, or a
   91  business operating on his or her behalf, who is furnishing
   92  copies of reports or records or making the reports or records
   93  available for digital scanning under pursuant to this section
   94  for a patient; a patient’s guardian, curator, attorney, or
   95  personal representative; or, in the absence of one of those
   96  persons, to the next of kin of a decedent or the parent of a
   97  minor, or to anyone designated by such person, shall charge no
   98  more than either the actual cost of copying, including
   99  reasonable staff time and postage, or a flat fee for all
  100  requests for electronic copies of patient records and reports
  101  maintained electronically, provided the fee does not exceed
  102  $6.50, inclusive of all labor, supplies, and any applicable
  103  postage, or the amount specified in administrative rule by the
  104  appropriate board, or the department when there is no board.
  105         Section 3. Paragraph (f) of subsection (1) of section
  106  316.1932, Florida Statutes, is amended to read:
  107         316.1932 Tests for alcohol, chemical substances, or
  108  controlled substances; implied consent; refusal.—
  109         (1)
  110         (f)1. The tests determining the weight of alcohol in the
  111  defendant’s blood or breath shall be administered at the request
  112  of a law enforcement officer substantially in accordance with
  113  rules of the Department of Law Enforcement. Such rules must
  114  specify precisely the test or tests that are approved by the
  115  Department of Law Enforcement for reliability of result and ease
  116  of administration, and must provide an approved method of
  117  administration which must be followed in all such tests given
  118  under this section. However, the failure of a law enforcement
  119  officer to request the withdrawal of blood does not affect the
  120  admissibility of a test of blood withdrawn for medical purposes.
  121         2.a. Only a physician, certified paramedic, registered
  122  nurse, licensed practical nurse, other personnel authorized by a
  123  hospital to draw blood, or duly licensed clinical laboratory
  124  director, supervisor, technologist, or technician, acting at the
  125  request of a law enforcement officer, may withdraw blood for the
  126  purpose of determining its alcoholic content or the presence of
  127  chemical substances or controlled substances therein. However,
  128  the failure of a law enforcement officer to request the
  129  withdrawal of blood does not affect the admissibility of a test
  130  of blood withdrawn for medical purposes.
  131         b. Notwithstanding any provision of law pertaining to the
  132  confidentiality of hospital records or other medical records, if
  133  a health care provider, who is providing medical care in a
  134  health care facility to a person injured in a motor vehicle
  135  crash, becomes aware, as a result of any blood test performed in
  136  the course of that medical treatment, that the person’s blood
  137  alcohol level meets or exceeds the blood-alcohol level specified
  138  in s. 316.193(1)(b), the health care provider may notify any law
  139  enforcement officer or law enforcement agency. Any such notice
  140  must be given within a reasonable time after the health care
  141  provider receives the test result. Any such notice shall be used
  142  only for the purpose of providing the law enforcement officer
  143  with reasonable cause to request the withdrawal of a blood
  144  sample pursuant to this section.
  145         c. The notice shall consist only of the name of the person
  146  being treated, the name of the person who drew the blood, the
  147  blood-alcohol level indicated by the test, and the date and time
  148  of the administration of the test.
  149         d. Nothing contained in s. 395.3025(6) s. 395.3025(4), s.
  150  456.057, or any applicable practice act affects the authority to
  151  provide notice under this section, and the health care provider
  152  is not considered to have breached any duty owed to the person
  153  under s. 395.3025(6) s. 395.3025(4), s. 456.057, or any
  154  applicable practice act by providing notice or failing to
  155  provide notice. It shall not be a breach of any ethical, moral,
  156  or legal duty for a health care provider to provide notice or
  157  fail to provide notice.
  158         e. A civil, criminal, or administrative action may not be
  159  brought against any person or health care provider participating
  160  in good faith in the provision of notice or failure to provide
  161  notice as provided in this section. Any person or health care
  162  provider participating in the provision of notice or failure to
  163  provide notice as provided in this section shall be immune from
  164  any civil or criminal liability and from any professional
  165  disciplinary action with respect to the provision of notice or
  166  failure to provide notice under this section. Any such
  167  participant has the same immunity with respect to participating
  168  in any judicial proceedings resulting from the notice or failure
  169  to provide notice.
  170         3. The person tested may, at his or her own expense, have a
  171  physician, registered nurse, other personnel authorized by a
  172  hospital to draw blood, or duly licensed clinical laboratory
  173  director, supervisor, technologist, or technician, or other
  174  person of his or her own choosing administer an independent test
  175  in addition to the test administered at the direction of the law
  176  enforcement officer for the purpose of determining the amount of
  177  alcohol in the person’s blood or breath or the presence of
  178  chemical substances or controlled substances at the time
  179  alleged, as shown by chemical analysis of his or her blood or
  180  urine, or by chemical or physical test of his or her breath. The
  181  failure or inability to obtain an independent test by a person
  182  does not preclude the admissibility in evidence of the test
  183  taken at the direction of the law enforcement officer. The law
  184  enforcement officer shall not interfere with the person’s
  185  opportunity to obtain the independent test and shall provide the
  186  person with timely telephone access to secure the test, but the
  187  burden is on the person to arrange and secure the test at the
  188  person’s own expense.
  189         4. Upon the request of the person tested, full information
  190  concerning the results of the test taken at the direction of the
  191  law enforcement officer shall be made available to the person or
  192  his or her attorney. Full information is limited to the
  193  following:
  194         a. The type of test administered and the procedures
  195  followed.
  196         b. The time of the collection of the blood or breath sample
  197  analyzed.
  198         c. The numerical results of the test indicating the alcohol
  199  content of the blood and breath.
  200         d. The type and status of any permit issued by the
  201  Department of Law Enforcement which was held by the person who
  202  performed the test.
  203         e. If the test was administered by means of a breath
  204  testing instrument, the date of performance of the most recent
  205  required inspection of such instrument.
  206  
  207  Full information does not include manuals, schematics, or
  208  software of the instrument used to test the person or any other
  209  material that is not in the actual possession of the state.
  210  Additionally, full information does not include information in
  211  the possession of the manufacturer of the test instrument.
  212         5. A hospital, clinical laboratory, medical clinic, or
  213  similar medical institution or physician, certified paramedic,
  214  registered nurse, licensed practical nurse, other personnel
  215  authorized by a hospital to draw blood, or duly licensed
  216  clinical laboratory director, supervisor, technologist, or
  217  technician, or other person assisting a law enforcement officer
  218  does not incur any civil or criminal liability as a result of
  219  the withdrawal or analysis of a blood or urine specimen, or the
  220  chemical or physical test of a person’s breath pursuant to
  221  accepted medical standards when requested by a law enforcement
  222  officer, regardless of whether or not the subject resisted
  223  administration of the test.
  224         Section 4. Paragraph (a) of subsection (2) of section
  225  316.1933, Florida Statutes, is amended to read:
  226         316.1933 Blood test for impairment or intoxication in cases
  227  of death or serious bodily injury; right to use reasonable
  228  force.—
  229         (2)(a) Only a physician, certified paramedic, registered
  230  nurse, licensed practical nurse, other personnel authorized by a
  231  hospital to draw blood, or duly licensed clinical laboratory
  232  director, supervisor, technologist, or technician, acting at the
  233  request of a law enforcement officer, may withdraw blood for the
  234  purpose of determining the alcoholic content thereof or the
  235  presence of chemical substances or controlled substances
  236  therein. However, the failure of a law enforcement officer to
  237  request the withdrawal of blood shall not affect the
  238  admissibility of a test of blood withdrawn for medical purposes.
  239         1. Notwithstanding any provision of law pertaining to the
  240  confidentiality of hospital records or other medical records, if
  241  a health care provider, who is providing medical care in a
  242  health care facility to a person injured in a motor vehicle
  243  crash, becomes aware, as a result of any blood test performed in
  244  the course of that medical treatment, that the person’s blood
  245  alcohol level meets or exceeds the blood-alcohol level specified
  246  in s. 316.193(1)(b), the health care provider may notify any law
  247  enforcement officer or law enforcement agency. Any such notice
  248  must be given within a reasonable time after the health care
  249  provider receives the test result. Any such notice shall be used
  250  only for the purpose of providing the law enforcement officer
  251  with reasonable cause to request the withdrawal of a blood
  252  sample pursuant to this section.
  253         2. The notice shall consist only of the name of the person
  254  being treated, the name of the person who drew the blood, the
  255  blood-alcohol level indicated by the test, and the date and time
  256  of the administration of the test.
  257         3. Nothing contained in s. 395.3025(6) s. 395.3025(4), s.
  258  456.057, or any applicable practice act affects the authority to
  259  provide notice under this section, and the health care provider
  260  is not considered to have breached any duty owed to the person
  261  under s. 395.3025(6) s. 395.3025(4), s. 456.057, or any
  262  applicable practice act by providing notice or failing to
  263  provide notice. It shall not be a breach of any ethical, moral,
  264  or legal duty for a health care provider to provide notice or
  265  fail to provide notice.
  266         4. A civil, criminal, or administrative action may not be
  267  brought against any person or health care provider participating
  268  in good faith in the provision of notice or failure to provide
  269  notice as provided in this section. Any person or health care
  270  provider participating in the provision of notice or failure to
  271  provide notice as provided in this section shall be immune from
  272  any civil or criminal liability and from any professional
  273  disciplinary action with respect to the provision of notice or
  274  failure to provide notice under this section. Any such
  275  participant has the same immunity with respect to participating
  276  in any judicial proceedings resulting from the notice or failure
  277  to provide notice.
  278         Section 5. Subsection (12) of section 395.4025, Florida
  279  Statutes, is amended to read:
  280         395.4025 Trauma centers; selection; quality assurance;
  281  records.—
  282         (12) Patient care, transport, or treatment records or
  283  reports, or patient care quality assurance proceedings, records,
  284  or reports obtained or made pursuant to this section, s.
  285  395.3025(6)(f) s. 395.3025(4)(f), s. 395.401, s. 395.4015, s.
  286  395.402, s. 395.403, s. 395.404, s. 395.4045, s. 395.405, s.
  287  395.50, or s. 395.51 must be held confidential by the department
  288  or its agent and are exempt from the provisions of s. 119.07(1).
  289  Patient care quality assurance proceedings, records, or reports
  290  obtained or made pursuant to these sections are not subject to
  291  discovery or introduction into evidence in any civil or
  292  administrative action.
  293         Section 6. Subsection (4) of section 440.185, Florida
  294  Statutes, is amended to read:
  295         440.185 Notice of injury or death; reports; penalties for
  296  violations.—
  297         (4) Additional reports with respect to such injury and of
  298  the condition of such employee, including copies of medical
  299  reports, funeral expenses, and wage statements, shall be filed
  300  by the employer or carrier to the department at such times and
  301  in such manner as the department may prescribe by rule. In
  302  carrying out its responsibilities under this chapter, the
  303  department or agency may by rule provide for the obtaining of
  304  any medical records relating to medical treatment provided
  305  pursuant to this chapter, notwithstanding the provisions of ss.
  306  90.503 and 395.3025(6) 395.3025(4).
  307         Section 7. This act shall take effect upon becoming a law.