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SECOND REGULAR SESSION
HOUSE BILL NO. 3030
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE HARDWICK.
6361H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal section 191.227, RSMo, and to enact in lieu thereof one new section relating to
medical records.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 191.227, RSMo, is repealed and one new section enacted in lieu
2 thereof, to be known as section 191.227, to read as follows:
191.227. 1. All physicians, chiropractors, hospitals, dentists, and other duly licensed
2 practitioners in this state, herein called "providers", shall, upon written request of a patient, or
3 guardian or legally authorized representative of a patient, furnish a copy of his or her record
4 of that patient's health history and treatment rendered to the person submitting a written
5 request, except that such right shall be limited to access consistent with the patient's condition
6 and sound therapeutic treatment as determined by the provider . Beginning August 28, 1994,
7 such record shall be furnished within a reasonable time of the receipt of the request therefor
8 and upon payment of a fee as provided in this section.
9 2. Health care providers may condition the furnishing of the patient's health care
10 records to the patient, the patient's authorized representative or any other person or entity
11 authorized by law to obtain or reproduce such records upon payment of a fee for:
12 (1) (a) Search and retrieval, in an amount not more than twenty-four dollars and
13 eighty-five cents plus copying in the amount of fifty-seven cents per page for the cost of
14 supplies and labor plus, if the health care provider has contracted for of f-site records storage
15 and management, any additional labor costs of outside storage retrieval, not to exceed twenty-
16 three dollars and twenty-six cents, as adjusted annually pursuant to subsection 6 of this
17 section; or
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
18 (b) The records shall be furnished electronically upon payment of the search,
19 retrieval, and copying fees set under this section at the time of the request or one hundred
20 eight dollars and eighty-eight cents total, whichever is less, if such person:
21 a. Requests health records to be delivered electronically in a format of the health care
22 provider's choice;
23 b. The health care provider stores such records completely in an electronic health
24 record; and
25 c. The health care provider is capable of providing the requested records and
26 af fidavit, if requested, in an electronic format;
27 (2) Postage, to include packaging and delivery cost;
28 (3) Notary fee, not to exceed two dollars, if requested.
29
30 Such fee shall be the fee in effect on February 1, 2018, increased or decreased annually under
31 this section.
32 3. For purposes of subsections 1 and 2 of this section, "a copy of his or her record of
33 that patient's health history and treatment rendered" or "the patient's health care records"
34 includes a statement or record that no such health history or treatment record responsive to the
35 request exists.
36 4. Notwithstanding provisions of this section to the contrary , providers may char ge
37 for the reasonable cost of all duplications of health care record material or information which
38 cannot routinely be copied or duplicated on a standard commercial photocopy machine.
39 5. The transfer of the patient's record done in good faith shall not render the provider
40 liable to the patient or any other person for any consequences which resulted or may result
41 from disclosure of the patient's record as required by this section.
42 6. Ef fective February first of each year , the fees listed in subsection 2 of this section
43 shall be increased or decreased annually based on the annual percentage change in the
44 unadjusted, U.S. city average, annual average inflation rate of the medical care component of
45 the Consumer Price Index for All Urban Consumers (CPI-U). The current reference base of
46 the index, as published by the Bureau of Labor Statistics of the United States Department of
47 Labor , shall be used as the reference base. For purposes of this subsection, the annual average
48 inflation rate shall be based on a twelve-month calendar year beginning in January and ending
49 in December of each preceding calendar year . The department of health and senior services
50 shall report the annual adjustment and the adjusted fees authorized in this section on the
51 department's internet website by February first of each year .
52 7. A health care provider may disclose a deceased patient's health care records or
53 payment records to the executor or administrator of the deceased person's estate, or pursuant
54 to a valid, unrevoked power of attorney for health care that specifically directs that the
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55 deceased person's health care records be released to the agent after death. If an executor ,
56 administrator , or agent has not been appointed, the deceased prior to death did not specifically
57 object to disclosure of his or her records in writing, and such disclosure is not inconsistent
58 with any prior expressed preference of the deceased that is known to the health care provider ,
59 a deceased patient's health care records may be released upon written request of a person who
60 is deemed as the personal representative of the deceased person under this subsection.
61 Priority shall be given to the deceased patient's spouse and the records shall be released on the
62 af fidavit of the surviving spouse that he or she is the surviving spouse. If there is no surviving
63 spouse, the health care records may be released to one of the following persons:
64 (1) The acting trustee of a trust created by the deceased patient either alone or with
65 the deceased patient's spouse;
66 (2) An adult child of the deceased patient on the affidav it of the adult child that he or
67 she is the adult child of the deceased;
68 (3) A parent of the deceased patient on the af fidavit of the parent that he or she is the
69 parent of the deceased;
70 (4) An adult brother or sister of the deceased patient on the affidav it of the adult
71 brother or sister that he or she is the adult brother or sister of the deceased;
72 (5) A guardian or conservator of the deceased patient at the time of the patient's death
73 on the affidavi t of the guardian or conservator that he or she is the guardian or conservator of
74 the deceased; or
75 (6) A guardian ad litem of the deceased's minor child based on the af fidavit of the
76 guardian that he or she is the guardian ad litem of the minor child of the deceased.
77 8. (1) Records containing a patient's health history and treatment created by an
78 emer gency care provider , as defined in section 191.630, or a telecommunicator first
79 responder , as defined in section 650.320, in the course of the provider's or responder's of ficial
80 duties while responding to a formal request for assistance shall be made available, upon
81 written request, to any person authorized to obtain the patient's health care records under the
82 provisions of this section, or in response to a subpoena or court order .
83 (2) The furnishing of health care records under this subsection may be conditioned
84 upon the payment of a fee in an amount equal to the fee allowed for the furnishing of any
85 other health care record under this section.
86 (3) Personal health information, including patient health history and treatment, shall
87 not be considered a public record, as described under chapter 610. Nothing in this section
88 shall limit the release of information or public records with personal health information that is
89 redacted regarding the general nature of the event.
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90 (4) Nothing in this subsection shall limit the release of information to facilitate the
91 normal delivery of patient care or to evaluate the quality of care as part of an established
92 quality improvement program.
93 9. Notwithstanding any pr ovisions of this section to the contrary , a health car e
94 pr ovider or health care facility shall not charge a fee for medical or mental health
95 r ecords req uested by a patient, former patient, or attorney or other authorized
96 r epresent ative of a patient or former patient for use in supporting an application for
97 benefits under:
98 (1) Chapter 287;
99 (2) 42 U.S.C. Section 401 et seq.;
100 (3) 42 U.S.C. Section 1382 et seq.;
101 (4) 42 U.S.C. Section 1395 et seq.;
102 (5) 38 U.S.C. Section 1 101 et seq.; or
103 (6) 38 U.S.C. Section 1501 et seq.
104
105 The health care pr ovider or health care facility may pr ovide the recor ds in the form that
106 is most cost-effective, pr ovided that r ecords pro vided electr onically shall be pro duced in
107 a universally accessible format.
✔
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