Bill Text: TX HB3468 | 2023-2024 | 88th Legislature | Comm Sub
Bill Title: Relating to a patient's access to health records; authorizing a civil penalty; authorizing fees.
Spectrum: Partisan Bill (Republican 4-0)
Status: (Introduced - Dead) 2023-05-10 - Committee report sent to Calendars [HB3468 Detail]
Download: Texas-2023-HB3468-Comm_Sub.html
88R24933 LRM-F | |||
By: Capriglione, Hull, et al. | H.B. No. 3468 | ||
Substitute the following for H.B. No. 3468: | |||
By: Klick | C.S.H.B. No. 3468 |
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relating to a patient's access to health records; authorizing a | ||
civil penalty; authorizing fees. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 15.05, Business & Commerce Code, is | ||
amended by adding Subsection (a-1) to read as follows: | ||
(a-1) It is unlawful for a person to place a restraint on | ||
trade or commerce by intentionally violating federal laws | ||
regulating information blocking, as that term is defined by 45 | ||
C.F.R. Section 171.103. | ||
SECTION 2. Section 181.001(b), Health and Safety Code, is | ||
amended by adding Subdivision (3-a) to read as follows: | ||
(3-a) "Information blocking" has the meaning assigned | ||
by 45 C.F.R. Section 171.103. | ||
SECTION 3. Section 181.004(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) A covered entity, as that term is defined by 45 C.F.R. | ||
Section 160.103, shall comply with: | ||
(1) the Health Insurance Portability and | ||
Accountability Act and Privacy Standards; and | ||
(2) federal laws regulating information blocking. | ||
SECTION 4. Section 181.102, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 181.102. CONSUMER ACCESS TO [ |
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RECORDS. (a) The health information of a patient contained in the | ||
patient's physical or electronic health records is considered the | ||
patient's property and, subject to the payment of fees required | ||
under this section, a patient or the patient's legally authorized | ||
representative on request is entitled to copies of those health | ||
records. | ||
(b) Except as provided by Subsection (d) [ |
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care provider is using an electronic health records system that is | ||
capable of fulfilling the request, the health care provider, as | ||
soon as practicable but not later than the 15th business day after | ||
the date the health care provider receives a written request from a | ||
person for the person's electronic health record, shall provide the | ||
requested record to the person in electronic form unless the person | ||
agrees to accept the record in another form. | ||
(c) Except as provided by Subsection (d), a health care | ||
provider's violation of federal laws regulating information | ||
blocking constitutes a violation of this section. | ||
(d) [ |
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access to a person's protected health information that is excepted | ||
from access, or to which access may be denied, under 45 C.F.R. | ||
Section 164.524. | ||
(e) [ |
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the executive commissioner, in consultation with the department, | ||
the Texas Medical Board, and the Texas Department of Insurance, by | ||
rule may recommend a standard electronic format for the release of | ||
requested health records. The standard electronic format | ||
recommended under this section must be consistent, if feasible, | ||
with federal law regarding the release of electronic health | ||
records. | ||
(f) A covered entity that receives a request from a patient | ||
or the patient's legally authorized representative for a copy of | ||
the patient's health records may charge a fee to produce those | ||
records in an amount consistent with the requirements under 45 | ||
C.F.R. Section 164.524, except that a covered entity may not charge | ||
an aggregate amount that exceeds $100 to produce the records if: | ||
(1) the patient is a Medicaid recipient; or | ||
(2) the patient's household income is at or below 200 | ||
percent of the federal poverty level. | ||
(g) A covered entity shall post in a conspicuous location | ||
for patients requesting health records notice of the option to | ||
obtain a copy of the patient's health records under Subsection (f). | ||
(h) A covered entity may require a patient or the patient's | ||
legally authorized representative to submit a written or electronic | ||
request for copies of the patient's health records but may not | ||
require a patient or the patient's legally authorized | ||
representative to submit a request by facsimile. | ||
(i) Unless explicitly authorized by state or federal law, a | ||
covered entity may not enter into a contract with a person that | ||
includes terms restricting a patient or the patient's legally | ||
authorized representative from accessing the patient's health | ||
records. Any contract clause or provision that restricts a patient | ||
or the patient's legally authorized representative from accessing | ||
the patient's health records is unenforceable. | ||
SECTION 5. Section 181.201, Health and Safety Code, is | ||
amended by amending Subsections (b) and (d) and adding Subsections | ||
(g) and (h) to read as follows: | ||
(b) In addition to the injunctive relief provided by | ||
Subsection (a), the attorney general may institute an action for | ||
civil penalties against a covered entity for a violation of this | ||
chapter, other than a violation of Section 181.102. A civil | ||
penalty assessed under this section may not exceed: | ||
(1) $5,000 for each violation that occurs in one year, | ||
regardless of how long the violation continues during that year, | ||
committed negligently; | ||
(2) $25,000 for each violation that occurs in one | ||
year, regardless of how long the violation continues during that | ||
year, committed knowingly or intentionally; or | ||
(3) $250,000 for each violation in which the covered | ||
entity knowingly or intentionally used protected health | ||
information for financial gain. | ||
(d) In determining the amount of a penalty imposed under | ||
Subsections [ |
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(1) the seriousness of the violation, including the | ||
nature, circumstances, extent, and gravity of the disclosure or | ||
information blocking; | ||
(2) the covered entity's compliance history; | ||
(3) whether the violation poses a significant risk of | ||
financial, reputational, or other harm to an individual whose | ||
protected health information is involved in the violation; | ||
(4) whether the covered entity was certified at the | ||
time of the violation as described by Section 182.108; | ||
(5) the amount necessary to deter a future violation; | ||
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(6) the covered entity's efforts to correct the | ||
violation; | ||
(7) the size and geographic location of the covered | ||
entity; and | ||
(8) the financial impact the penalty would have on the | ||
covered entity's financial viability and ability to adequately | ||
serve an underserved community or population. | ||
(g) In addition to the injunctive relief provided by | ||
Subsection (a), the attorney general may institute an action for | ||
civil penalties against a covered entity for a violation of Section | ||
181.102. A civil penalty assessed under this subsection may not | ||
exceed: | ||
(1) $10,000 for each negligent violation, regardless | ||
of the length of time the violation continues during any year; or | ||
(2) $250,000 for each intentional violation committed | ||
for the purpose of financial gain, regardless of the length of time | ||
the violation continues during any year. | ||
(h) If the court in a pending action under Subsection (g) | ||
finds the violations occurred with a frequency constituting a | ||
pattern or practice, the court may assess additional civil | ||
penalties for each violation. | ||
SECTION 6. Section 241.154(b), Health and Safety Code, is | ||
amended to read as follows: | ||
(b) Except as provided by Subsection (d), the hospital or | ||
its agent may charge a reasonable fee for providing the health care | ||
information except payment information and is not required to | ||
permit the examination, copying, or release of the information | ||
requested until the fee is paid unless there is a medical | ||
emergency. The fee may not exceed the aggregate amount specified | ||
under Section 181.102(f) and [ |
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otherwise delivering the provided copies. | ||
SECTION 7. If any provision of this Act or its application | ||
to any person or circumstance is held invalid, the invalidity does | ||
not affect other provisions or applications of this Act which can be | ||
given effect without the invalid provision or application, and to | ||
this end the provisions of this Act are severable. | ||
SECTION 8. The changes in law made by this Act apply only to | ||
a violation of law that occurs on or after the effective date of | ||
this Act. A violation that occurs before the effective date of this | ||
Act is governed by the law in effect on the date the violation | ||
occurred, and the former law is continued in effect for that | ||
purpose. For purposes of this section, a violation of law occurred | ||
before the effective date of this Act if any element of the | ||
violation occurred before that date. | ||
SECTION 9. This Act takes effect September 1, 2023. |