Revision: Dec. 17, 2009, midnight
HB 1649-FN – AS INTRODUCED
2010 SESSION
01/04
HOUSE BILL 1649-FN
AN ACT relative to health information and patient rights and establishing a commission to study adding certain information to a driver’s license.
SPONSORS: Rep. Bridgham, Carr 2; Rep. Rosenwald, Hills 22; Rep. Batula, Hills 19
COMMITTEE: Health, Human Services and Elderly Affairs
This bill establishes procedures for access to protected health information for treatment. This bill also establishes a commission to study the feasibility of adding a box to the driver’s license which if checked would enable the sharing of information in the individual’s electronic health care record.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2323
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to health information and patient rights and establishing a commission to study adding certain information to a driver’s license.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Statement of Intent. The general court hereby recognizes that a person’s consent or refusal to consent before his or her protected health information is shared should be honored, consistent with one of the principles of medical ethics of the American Medical Association: “The physician should not reveal confidential communications or information without the express consent of the patient, unless required to do so by law.”
2 Definitions. Amend RSA 332-I:1, II(a)(3) and (4) to read as follows:
(3) Disclosure; [and]
(4) Protected health information; and
(5) Organized health care arrangement.
3 Health Care Information and Rights; Definitions. Amend RSA 332-I:1, II(b) to read as follows:
(b) “Health care provider” means any person, organized health care arrangement, corporation, facility, or institution either licensed by this state or otherwise lawfully providing health care services, including, but not limited to, a physician, hospital, office, clinic, health center or other health care facility, dentist, nurse, optometrist, pharmacist, podiatrist, physical therapist, or mental health professional, and any officer, employee, or agent of such provider acting in the course and scope of employment or agency related to or supportive of health care services.
4 New Subparagraphs; Definitions Added. Amend RSA 332-I:1, II by inserting after paragraph (d) the following new subparagraphs:
(e) “Audit trail” means a chronological record identifying specific persons who have accessed an electronic medical record, the date and time the record was accessed, and, if such information is available, the area of the record that was accessed. An audit trail shall not be considered a part of a person’s medical care.
(f) “Individual” means the subject of the protected health information, including a guardian or other legal representative.
5 Patient Information. Amend RSA 332-I:2, I(e) to read as follows:
(e) The health care provider shall not [reveal confidential communications or] disclose protected health information for treatment without the consent of the patient, unless [provided for] required by law or by the need to protect the welfare of the individual or the public interest.
(1) The subparagraph shall not prohibit the disclosure of protected health information during a medical emergency when the treating health care provider is unable to obtain the individual’s authorization due to the individual’s condition or the nature of the medical emergency. The treating health care provider shall make the clinical determination as to whether or not a medical emergency exists.
(2) A health care provider shall not be required to provide treatment to an individual who elects not to disclose protected health information that the health care provider deems clinically necessary, unless such treatment is required by law. No health care provider who, in good faith, renders reasonable care shall be held liable for any adverse health outcome to an individual that results from that individual’s election to limit access to his or her protected health information permitted by this section.
6 New Subparagraph; Patient Information; Electronic Form. Amend RSA 332-I:2, I by inserting after subparagraph (f) the following new subparagraph:
(g) When an individual’s medical record is maintained in electronic form, the individual has the right to a report, based on whatever audit trail of that record is then maintained, of access to the record by a health care provider named by the individual within an identified period in the prior 3 years. The report shall indicate whether the named provider had access, or did not have access, or whether access could not be determined with the available data. If the named provider had access, the report shall summarize, as the available data permit, the extent of access to the record. This subparagraph shall not apply to individuals being held in correctional facilities within the state.
7 Patient Information. Amend RSA 332-I:2, II to read as follows:
II. Facilities subject to RSA 151:21 and RSA 151:21-b shall be exempt from [paragraph] subparagraphs I(a)-(d) and (f).
8 Unauthorized Disclosure, Complaints. Amend RSA 332-I:5 and 332-I:6 to read as follows:
332-I:5 Unauthorized Disclosure. In the event of a use or disclosure of protected health information by a health care provider or a business associate of a health care provider that is allowed under federal law but not permitted by RSA 332-I:2, I(e) or RSA 332-I:4, the health care provider shall promptly notify in writing the individual or individuals whose protected health information was disclosed. A business associate shall be responsible for the cost of such notification if the use or disclosure was by the business associate.
332-I:6 Complaints; Right of Action. An aggrieved individual may bring a civil action under RSA 332-I:2, I(e), RSA 332-I:4 or RSA 332-I:5 and, if successful, shall be awarded special or general damages of not less than $1,000 for each violation, and costs and reasonable legal fees.
9 Patients’ Bill of Rights; Reference Addition. Amend RSA 151:21, X to read as follows:
X. The patient shall be ensured confidential treatment of all [information] protected health information, in accordance with RSA 332-I, contained in the patient’s personal and clinical record, including that stored in an automatic data bank, and the patient’s written consent shall be required for the release of information to anyone not otherwise authorized by law to receive it. Medical information contained in the medical records at any facility licensed under this chapter shall be deemed to be the property of the patient. The patient shall be entitled to a copy of such records upon request. The charge for the copying of a patient’s medical records shall not exceed $15 for the first 30 pages or $.50 per page, whichever is greater; provided, that copies of filmed records such as radiograms, x-rays, and sonograms shall be copied at a reasonable cost.
10 Home Care Clients’ Bill of Rights; Reference Addition. Amend RSA 151:21-b, II(i) to read as follows:
(i) Be ensured of confidential treatment of all [information] protected health information, in accordance with RSA 332-I, contained in the client’s personal and clinical record, including the requirement of the client’s written consent to release such information to anyone not otherwise authorized by law to receive it. Medical information contained in the client’s record shall be deemed to be the client’s property and the client has the right to a copy of such records upon request and at a reasonable cost.
11 Commission Established. There is established a commission to study the feasibility of adding a box to the driver’s license which if checked would enable the sharing of information about the individual’s electronic health care record.
12 Membership and Compensation.
I. The members of the commission shall be as follows:
(a) Two members of the house of representatives, appointed by the speaker of the house of representatives.
(b) One member of the senate, appointed by the president of the senate.
(c) The director of the division of motor vehicles, or designee.
(d) A representative of the New Hampshire Hospital Association, appointed by the association.
(e) A representative of the New Hampshire Medical Society, appointed by the society.
(f) A licensed physician who primarily works in the emergency room, appointed by the governor.
(g) A representative of the New Hampshire Civil Liberties Union, appointed by the union.
II. Legislative members of the commission shall receive mileage at the legislative rate when attending to the duties of the commission.
13 Duties. The commission shall study the feasibility of adding a box to the driver’s license which if checked would enable the sharing of information on the individual’s electronic health care record.
14 Chairperson; Quorum. The members of the commission shall elect a chairperson from among the members. The first meeting of the commission shall be called by the first-named house member. The first meeting of the commission shall be held within 45 days of the effective date of this section. Five members of the commission shall constitute a quorum.
15 Report. The commission shall report its findings and any recommendations for proposed legislation to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, and the state library on or before November 1, 2010.
16 Effective Date.
I. Sections 1-10 of this act shall take effect January 1, 2011.
II. The remainder of this act shall take effect upon its passage.
LBAO
10-2323
12/16/09
HB 1649-FN - FISCAL NOTE
AN ACT relative to health information and patient rights and establishing a commission to study adding certain information to a driver’s license.
FISCAL IMPACT:
The Insurance Department states this bill may increase state, county, and local expenditures, and state revenues by an indeterminable amount in FY 2011 and each year thereafter. This bill will have no fiscal impact on county and local revenue.
METHODOLOGY:
The Insurance Department states this bill establishes certain standards with respect to the patient’s health information. While the proposed bill primarily impacts providers, it may have an impact on their costs, which could impact the cost of health insurance premiums. Other entities such as county and local governments may see increased costs to provide their health insurance programs as well. The state collects premium taxes on health insurance premiums, and increased premiums may lead to higher revenues. The state is self-funded and does not pay taxes on premiums, but may experience increased costs due to the additional costs placed on providers. The exact fiscal impact cannot be determined at this time.
The Department of Administrative Services is unable to determine whether this bill may impose additional costs on providers. The Department states this bill will have no fiscal impact on the Department.
The Department of Health and Human Services states this bill will have no fiscal impact on the Department.