Expand Access to Medical Records

Section 1. Section 17 of the public health law, as amended by chapter 165 of the laws of 1991, the first undesignated paragraph as amended by chapter 322 of the laws of 2017, is amended to read as follows:

§ 17. Release of [medical] health records to a designated health care provider. 1. Upon the written request of any competent patient, parent or guardian of an infant, a guardian appointed pursuant to article eighty-one of the mental hygiene law, or conservator of a conservatee, [an examining, consulting or treating physician or hospital must] a health care provider who has provided professional health care services pertaining to a patient shall release and deliver, exclusive of nonclinical personal notes of the [said physician or hospital] health care provider, copies of all [x-rays, medical] requested health records [and test records including all laboratory tests] regarding that patient to any other designated [physician or hospital provided, however, that] health care provider. However, such records concerning the treatment of an infant patient for venereal disease or the performance of an abortion operation upon such infant patient shall not be released or in any manner be made available to the parent or guardian of such infant, and provided, further, that original mammograms, rather than copies thereof, shall be released and delivered.

[Either the physician or hospital] 2. A health care provider incurring the expense of providing copies of [x-rays, medical] health records [and test records including all laboratory tests] pursuant to the provisions of this section may impose a reasonable charge to be paid by the person requesting the release and deliverance of such records as reimbursement

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD03429-01-9

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[for such] not to exceed the health care provider's actual expenses, provided, however, that the [physician or hospital] health care provider may not impose a charge for copying an original mammogram when the original has been released or delivered to any competent patient, parent or guardian of an infant, a guardian appointed pursuant to article eighty-one of the mental hygiene law, or a conservator of a conservatee and provided, further, that any charge for delivering an original mammogram pursuant to this section shall not exceed the documented actual costs associated therewith[. However, the reasonable charge], which for paper copies shall not exceed seventy-five cents per page. A release of records under this section shall not be denied solely because of inability to pay. No charge may be imposed under this section for providing, releasing, or delivering medical records or copies of medical records where requested for the purpose of supporting an application, claim or appeal for any government benefit or program, provided that, where a provider maintains medical records in electronic form, it shall provide the copy in either electronic or paper form, as required by the government benefit or program, or at the patient's request.

3. Where a health care provider provides health care professional services as an employee of or under contract with another health care provider, compliance with this section shall be the responsibility of the health care provider that employs or contracts for the services of the other health care provider, unless the terms of the employment or contract explicitly provide otherwise. If a health care provider receives a request under this section and compliance is the responsibility of a different health care provider under this subdivision, the health care provider receiving the request shall immediately inform the requesting party to which health care provider the request should be directed.

4. For the purposes of this section the [term "laboratory tests" shall include] following terms shall have the following meanings:

(a) "Health record" includes any patient information as defined in section eighteen of this title, X-rays and other images, and records of laboratory tests including but not [be] limited to tests and examinations administered in clinical laboratories or blood banks as those terms are defined in section five hundred seventy-one of this chapter.

(b) "Health care provider" and "health care practitioner" have the same meanings as defined in section eighteen of this title.

(c) "Professional health care services" means the services of a health care provider examining, assessing, treating or consulting in relation to a patient or patient's condition, within the scope of practice of a health care practitioner.

§ 2. Paragraphs (c), (d) and (e) of subdivision 1 of section 18 of the public health law, paragraphs (c) and (d) as added by chapter 497 of the laws of 1986, paragraph (e) as amended by chapter 2 of the laws of 1990, and the closing paragraph of paragraph (e) as amended by chapter 576 of the laws of 1998, are amended and a new paragraph (j) is added to read as follows:

(c) "Health care facility" or "facility" means a hospital as defined in article twenty-eight of this chapter, a home care services agency as defined in article thirty-six of this chapter, a hospice as defined in article forty of this chapter, a health maintenance organization as defined in article forty-four of this chapter, [and] a shared health facility as defined in article forty-seven of this chapter; or an entity that provides the health care professional services of a health care

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provider by employing or contracting for the health care professional services of a health care provider.

(d) "Health care practitioner" or "practitioner" means a person licensed under article one hundred thirty-one (medicine), one hundred thirty-one-B (physician assistants), one hundred thirty-one-C (specialist assistant), one hundred thirty-two (chiropractic), one hundred thirty-three (dentistry and dental hygiene), one hundred thirty-four (licensed perfusionists), one hundred thirty-six (physical therapy and physical therapy assistants), one hundred thirty-seven (pharmacy), one hundred thirty-nine (nursing), one hundred forty (professional midwifery practice), one hundred forty-one (podiatry), one hundred forty-three (optometry), one hundred forty-four (ophthalmic dispensing), one hundred fifty-three (psychology), one hundred fifty-four (social work), one hundred fifty-five (massage therapy), one hundred fifty-six [or] (occupational therapy, one hundred fifty-seven (dietetics and nutrition), one hundred fifty-nine (speech-language pathologists or audiologists), one hundred sixty (acupuncture), one hundred sixty-two (athletic trainers), one hundred sixty-three (mental health practitioners), one hundred sixty-four (respiratory therapists and respiratory therapy technicians), one hundred sixty-five (clinical laboratory technology practice), one hundred sixty-six (medical physics practice), or one hundred sixty-seven (applied behavior analysis) of the education law [or a person certified under section twenty-five hundred sixty of this chapter].

(e) (i) "Patient information" or "information" means: any information or health record concerning or relating to the examination, health assessment including, but not limited to, a health assessment for insurance and employment purposes [or], consulting in relation to treatment of providing drugs or devices, or providing professional health care services pertaining to an identifiable subject maintained or possessed by a health care [facility or health care practitioner who] provider which has provided or is providing services [for assessment of a health condition including, but not limited to, a health assessment for insurance and employment purposes or has treated or is treating such subject, except (i)]. It shall include X-rays and other images, and records of laboratory tests including but not limited to tests and examinations administered in clinical laboratories or blood banks as those terms are defined in section five hundred seventy-one of this chapter. It shall include records of charges to, and payments received from, the patient or identifiable subject or any other party on behalf of the patient or identifiable subject, for any such services, drugs or devices.

(ii) "Patient information" or "information" shall not include (A) information and clinical records subject to the provisions of section [23.05 or] 33.13 of the mental hygiene law[, (ii)]; (B) non-clinical personal notes and observations of a health care practitioner, provided that such personal notes and observations are maintained by the practitioner and not disclosed by the practitioner to any other person after January first, nineteen hundred eighty-seven[, (iii)]; (C) information maintained by a practitioner, concerning or relating to the prior examination or treatment of a subject received from another practitioner, provided however, that such information may be requested by the subject directly from such other practitioner in accordance with the provisions of this section, and provided further that this clause does not apply to any referral, order, authorization, or prescription received from the other practitioner; and [(iv)] (D) data disclosed to a practitioner in confidence by other persons on the basis of an express condition that such data would never be disclosed to the subject or other persons,

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provided that such data has never been disclosed to any other person. If at any time such personal notes and observations or such data is disclosed, it shall be considered patient information for purposes of this section. For purposes of this subdivision, "disclosure to any other person" shall not include disclosures made to practitioners as part of a consultation or referral during the treatment of the subject, to persons reviewing information or records in the ordinary course of ensuring that a provider is in compliance with applicable quality of care, licensure or accreditation standards, to an employee or official of a federal, state or local agency for the sole purpose of conducting an audit in the course of his or her official duties, to the statewide planning and research cooperative system, to other persons pursuant to a court order, to governmental agencies, insurance companies licensed pursuant to the insurance law and other third parties requiring information necessary for payments to be made to or on behalf of patients, to qualified researchers, to the [state board for professional medical conduct] department of health or the department of education when such [board] requests such information in the exercise of its statutory function, to an insurance carrier insuring, or an attorney consulted by, a health care provider, or to a health maintenance organization certified pursuant to article forty-four of this chapter or licensed pursuant to the insurance law, or to the committee or a court pursuant to the provisions of this section.

(iii) For purposes of this subdivision treatment of a subject shall not include diagnostic services, except mammography, performed by a practitioner at the request of another health care practitioner provided, however, that such information, and mammograms, may be requested by the subject directly from the practitioner at whose request such diagnostic services were performed, in accordance with the provisions of this section.

(j) "Professional health care services" means the services of a health care provider examining, assessing, treating or consulting in relation to an identifiable subject of an identifiable subject's condition, within the scope of practice of a health care practitioner.

§ 3. Paragraph (e) of subdivision 2 of section 18 of the public health law, as amended by chapter 322 of the laws of 2017, is amended and a new paragraph (j) is added to read as follows: