Requires affirmative written consent for certain entities to disclose individual's medical information regarding reproductive health care services, with limited exceptions, unless disclosure is necessary to provide those services.

A2220

ASSEMBLY, No. 2220

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblywoman SHANIQUE SPEIGHT

District 29 (Essex and Hudson)

Assemblywoman LUANNE M. PETERPAUL

District 11 (Monmouth)

Assemblywoman VERLINA REYNOLDS-JACKSON

District 15 (Hunterdon and Mercer)

Co-Sponsored by:

Assemblyman Verrelli, Assemblywomen Park, Haider,
Collazos-Gill, Assemblyman Tully, Assemblywomen Morales, Drulis, Assemblyman
Calabrese, Assemblywoman Bagolie and Assemblyman Bhalla

SYNOPSIS

���� Requires affirmative written consent for certain
entities to disclose individual's medical information regarding reproductive
health care services, with limited exceptions, unless disclosure is necessary
to provide those services.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act
concerning disclosure of reproductive health care
services and supplementing Title 45 of the Revised Statutes and Chapter 30 of
Title 17B of the New Jersey Statutes.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.��� a.
�A health care provider
or
business associate of a covered entity shall be prohibited
from intentionally sharing, selling, using
for marketing, or otherwise disclosing any medical information regarding
reproductive health care services for any purpose not necessary to provide
those reproductive health care services to a patient of the health care
provider, except as provided
in subsection c. of this section,
without the affirmative written consent
of the patient or the patient's conservator, guardian, or other authorized
legal representative.

���� b.��� A health care provider
or business
associate of a covered entity shall inform
a patient or a patient's conservator, guardian, or other authorized
legal representative
of the

right to withhold such affirmative written consent at or before the time
reproductive health care services are rendered or at such time as the patient
discloses any information relating to reproductive health care services that
have been previously rendered.

���� c.���� A health care provider
or business
associate of a covered entity
shall
be exempt from the provisions of subsection a. regarding affirmative written
consent if the disclosure of medical information regarding reproductive health
care services is required by any of the following:�

����
(1)��
to medical
personnel to the extent necessary to meet a bona fide medical emergency;

���� (2)�� to
the extent that the health care provider is a covered entity and the disclosure
is made to a business associate under a valid business associate agreement;

���� (3)�� as required to comply
with the laws of this State, federal law, or the Rules of Court;

���� (4)�� pursuant to a court
order issued by a court of competent jurisdiction in this State upon a showing
of good cause;

���� (5)�� by a
health care provider
against whom a
claim has been made, or there is a reasonable belief will be made, in an action
or proceeding, to the
health care
provider�s
attorney or professional liability insurer or insurer's agent
for use in the defense of the action or proceeding;

���� (6) to the Commissioner of
Health, Human Services, or Banking and Insurance, or any professional licensing
board operating under the authority of the Division of Consumer Affairs in the
Department of Law and Public Safety for records of a patient of a health care
provider in connection with an investigation of a complaint, if the records are
related to the complaint;

���� (7)�� to a federal or State
agency charged with investigating known or, in good faith, suspected child
abuse, abuse of an elderly individual, abuse of an individual who is
incapacitated, or abuse of an individual with a physical or mental disability,
if such disclosure is requested in connection with an investigation of abuse
that would constitute a crime under the laws of this State and such records are
related to such investigation; and

���� (8)�� pursuant to regulations
promulgated by the Commissioner of Health.

���� d.��� Nothing contained herein
shall be construed to limit, diminish, or abrogate the rights of a person under
HIPAA or the obligations of a health care provider under HIPAA.

���� e.���� (1) If a court of
competent jurisdiction finds that a health care provider has violated this
section, the court may award damages, computed at a rate of $1,000 per
violation, reasonable attorney�s fees, and the costs incurred in maintaining
that civil action.

���� (2) The private right of
action authorized pursuant to this section does not supplant any other claim or
cause of action available to a person under common law or by statute. The
provisions of this subsection apply in addition to any other common law and
statutory remedies.

����
f.���� As used in this section:

����
�Affirmative
written consent� means a freely given, specific agreement, collected on a
standalone form, which form clearly states to the patient how records containing
medical information could be used and to whom the contents of the records could
be disclosed , and allows the patient to refuse consent for specific
disclosures.

���� �Business associate� has the
same meaning as in 45 CFR s. 160.103.

����
�Covered entity� has the same meaning as in 45
CFR s.160.103.

���� �Health care provider� means an individual or entity
which, acting within the scope of its licensure or certification, provides a
health care service.� Health care provider includes, but is not limited to, a
physician and other health care professionals licensed pursuant to Title 45 of
the Revised Statutes, and a hospital and other health care facilities licensed
pursuant to Title 26 of the Revised Statutes.

���� �HIPAA� means the federal
�Health Insurance Portability and Accountability Act of 1996,� Pub.L.104-191,
and any regulations promulgated thereunder by the Secretary of the United
States Department of Health and Human Services.

���� �Medical information� means any information that
includes or contains any element that is sufficient to allow identification of
the individual, in electronic or physical form, in possession of or derived
from a health care provider regarding a patient�s medical history, mental or
physical condition, or treatment.� �Medical information� shall include
information that is
acquired using in-person or telephone communication,
submitted documentation, a mobile application, an Internet website, or a
wearable device.

���� �Reproductive health care
services� means all medical, surgical, counseling, or referral services
relating to the human reproductive system including, but not limited to,
services relating to pregnancy, contraception, or termination of a pregnancy.

���� 2.��� a.
�A carrier
shall be prohibited
from intentionally sharing, selling, using
for marketing, or otherwise disclosing any medical information regarding
reproductive health care services for any purpose not necessary to provide
those reproductive health care services to or pay benefits for reproductive
health care services for a covered person, except as provided
in
subsection c. of this section,
without
the affirmative consent of the covered person or the covered person's
conservator, guardian, or other authorized legal representative.

���� b.��� A carrier
shall inform
a covered person or a covered person's
conservator, guardian, or other authorized legal representative
of the
right to withhold such affirmative written
consent at or before the time reproductive health care services are rendered or
at such time as the covered person discloses any information relating to
reproductive health care services that have been previously rendered.

���� c.���� A carrier shall be exempt from the provisions of
subsection a. regarding affirmative written consent if the disclosure of
medical information regarding reproductive health care services is made�

���� (1)�� as required to comply
with the laws of this State, federal law, or the Rules of Court;

���� (2)�� pursuant to a court
order issued by a court of competent jurisdiction in this State upon a showing
of good cause;

���� (3)�� to the extent that the carrier
is a covered entity and the disclosure is made to a business associate under a
valid business associate agreement;

���� (4)�� by a
carrier
against whom a claim has
been made, or there is a reasonable belief will be made, in an action or
proceeding, to the
carrier�s
attorney
or professional liability insurer or insurer's agent for use in the defense of
the action or proceeding;

���� (5) to the Commissioner of
Health, Human Services, or Banking and Insurance, or any professional licensing
board operating under the authority of the Division of Consumer Affairs in the
Department of Law and Public Safety for records of a covered person in
connection with an investigation of a complaint, if the records are related to
the complaint;

���� (6)�� to a federal or State
agency charged with investigating known or, in good faith, suspected child
abuse, abuse of an elderly individual, abuse of an individual who is
incapacitated, or abuse of an individual with a physical or mental disability,
if such disclosure is requested in connection with an investigation of abuse
that would constitute a crime under the laws of this State and such records are
related to such investigation; and

���� (7)�� pursuant to regulations
promulgated by the Commissioner of Banking and Insurance.

���� d.��� Nothing contained herein
shall be construed to limit, diminish, or abrogate the rights of a person under
HIPAA or the obligations of a carrier under HIPAA.

���� e.���� (1) If a court of
competent jurisdiction finds that a carrier has violated this section, the
court may award damages, computed at a rate of $1,000 per violation, reasonable
attorney�s fees, and the costs incurred in maintaining that civil action.

���� (2) The private right of
action authorized pursuant to this section does not supplant any other claim or
cause of action available to a person under common law or by statute. The
provisions of this subsection apply in addition to any other common law and
statutory remedies.

����
f.���� As used in this section:

����
�Affirmative
written consent� means a freely given, specific agreement, collected on a
standalone form, which form clearly states to the patient how records containing
medical information could be used and to whom the contents of the records could
be disclosed , and allows the patient to refuse consent for specific
disclosures.

���� �Business associate� has the
same meaning as in 45 CFR s. 160.103.

����
�Covered entity� has the same meaning as in 45
CFR s.160.103.

���� �Carrier� means an insurance
company, health service corporation, hospital service corporation, medical
service corporation, or health maintenance organization authorized to issue
health benefits plans in this State.� Carrier includes any entity that is contracted
with a carrier, such as a pharmacy benefits manager or a medical group.

���� �Covered person� means a
person on whose behalf a carrier offering a health benefits plan is obligated
to pay benefits or provide services pursuant to the health benefits plan.

���� �HIPAA� means the federal
�Health Insurance Portability and Accountability Act of 1996,� Pub.L.104-191,
and any regulations promulgated thereunder by the Secretary of the United
States Department of Health and Human Services.

���� �Medical information� means any information that
includes or contains any element that is sufficient to allow identification of
the individual, in electronic or physical form, in possession of or derived
from a health care provider regarding a patient�s medical history, mental or
physical condition, or treatment.� �Medical information� shall include
information that is
acquired using in-person or telephone communication,
submitted documentation, a mobile application, an Internet website, or a
wearable device.

���� �Reproductive health care
services� means all medical, surgical, counseling, or referral services
relating to the human reproductive system including, but not limited to,
services relating to pregnancy, contraception, or termination of a pregnancy.

���� 3.��� The Commissioners of
Health and Banking and Insurance, pursuant to the �Administrative Procedures
Act,� P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations
to effectuate the purposes of this act.

���� 4.��� This act shall take
effect on the 180th day following enactment, except that the Commissioner of
Human Services and the Commissioner of Banking and Insurance may take such
anticipatory administrative action in advance as shall be necessary for the
implementation of the act.

STATEMENT

���� This bill requires health care
providers, business associates of a covered entity, and carriers to receive
affirmative written consent in order to disclose a patient�s or covered
person�s medical information regarding reproductive health care services, with
limited exceptions, unless disclosure is necessary to provide those services.�
Under the bill: �h
ealth care
provider� means an individual or entity which, acting within the scope of its
licensure or certification, provides a health care service;�
a �business associate of a covered
entity� means the same as those terms are defined under federal �Health
Insurance Portability and Accountability Act� rules, or a person or entity that
performs certain functions or activities that involve the use or disclosure of
protected health information on behalf of, or provides services to,
health plans, health care clearinghouses,
and health care providers
;
�carrier� means
an insurance
company, health service corporation, hospital service corporation, medical
service corporation, or health maintenance organization authorized to issue
health benefits plans in this State; and
�r
eproductive health care services� means all medical, surgical,
counseling, or referral services relating to the human reproductive system
including, but not limited to, services relating to pregnancy, contraception,
or termination of a pregnancy.

���� Specifically, this bill
prohibits a health care provider, a business associate of a covered entity, or
carrier from
intentionally sharing,
selling, using for marketing, or otherwise disclosing any
personally
identifiable
medical information
regarding reproductive health care services for any purpose not necessary to
provide, or pay benefits for, those services
,
without the affirmative written consent of the patient or
the covered person, or an authorized legal representative.� Under the bill,
�Medical information� includes information that is
acquired using in-person
or telephone communication, submitted documentation, a mobile application, an
Internet website, or a wearable device.
�
Further, �affirmative written consent� means a freely given, specific agreement
collected on a standalone form, which clearly states to the patient how records
containing medical information could be used and to whom the contents of the
records could be disclosed, and allows the patient to refuse consent for
specific disclosures.

���� The bill further mandates that a health care provider
,
a business associate of a covered entity,
or carrier
are required to inform
a patient or a covered person, or authorized legal
representative,
of the
right
to withhold such affirmative written consent at or before the time reproductive
health care services are rendered or at such time as the covered person
discloses any information relating to reproductive health care services that
have been previously rendered.

���� The bill allows for disclosure without affirmative
written consent under certain circumstances.� These exceptions include when
disclosure is:� 1)
to medical personnel
to the extent necessary to meet a bona fide medical emergency
; 2)
to the extent that the health care provider or carrier
is a covered entity and the disclosure is made to a business associate under a
valid business associate agreement
; 3) as required to comply with the
laws of this State, federal law, or the Rules of Court; 4) pursuant to a court
order issued by a court of competent jurisdiction in this State upon a showing
of good cause; 5) by a health care provider or
carrier
against whom a claim has been made, for use in
the defense of the action or proceeding; 6) to certain State entities or
licensing boards for records of a patient or covered person in connection with
an investigation of a complaint, if the records are related to the complaint;
7) to a federal or State agency charged with investigating known or, in good
faith, suspected child abuse, abuse of an elderly individual, abuse of an
individual who is incapacitated, or abuse of an individual with a physical or
mental disability, if such disclosure is requested in connection with an investigation
of abuse that would constitute a crime under the laws of this State and such
records are related to such investigation; and 8) pursuant to regulations
promulgated by the Commissioners of Health and Banking and Insurance.

���� Under the bill, if a court of
competent jurisdiction finds that a health care provider or carrier has
violated the provisions of this bill, the court may award damages, computed at
a rate of $1,000 per violation, reasonable attorney�s fees, and the costs
incurred in maintaining that civil action.

���� Finally, nothing contained in
the bill is to be construed to limit, diminish, or abrogate the rights of a
person under the federal �Health Insurance Portability and Accountability Act
of 1996,� Pub.L.104-191 or the obligations of a health care provider or carrier
under that law.