PRINTER'S NO. 163
No. 166 Session of 1999
INTRODUCED BY KUKOVICH, JANUARY 19, 1999
REFERRED TO PUBLIC HEALTH AND WELFARE, JANUARY 19, 1999
AN ACT
1 Providing for patient access to health information in the
2 custody of individual health care providers.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Patient
7 Right-to-Know Act.
8 Section 2. Purpose.
9 It is the purpose of this act to extend to the
10 nonhospitalized patients of individual health care providers the
11 right of access to their health information records that is
12 already provided under existing statutes and regulations to
13 patients in hospitals and mental health facilities and to
14 patients receiving treatment for drug and alcohol abuse.
15 Section 3. Definitions.
16 The following words and phrases when used in this act shall
17 have the meanings given to them in this section unless the
1 context clearly indicates otherwise:
2 "Health care provider." A person who is licensed, certified
3 or otherwise authorized by law to administer health care in the
4 ordinary course of business or practice of a profession. The
5 term includes physicians, psychiatrists, psychologists and other
6 health care providers such as social workers, rape counselors
7 and family planning counselors.
8 "Health information." Documentation of information
9 concerning, related to or resulting from the examination or
10 treatment of an identifiable subject which is maintained or
11 possessed by a health care provider who has treated or is
12 treating the subject. The term includes diagnostic documentation
13 such as X-rays, electrocardiograms, electroencephalograms and
14 other test results.
15 "Subject." A person for whom health information is
16 maintained by a health care provider.
17 Section 4. Access to health information.
18 (a) Inspection.--Within ten days of a written request, a
19 health care provider shall afford an opportunity for a subject,
20 a designated representative or the next of kin of a deceased
21 subject to inspect any health information concerning the subject
22 which is in the possession of the health care provider.
23 (b) Copying.--Upon written request of the subject, and with
24 reasonable notice and the payment of reasonable costs, not to
25 exceed the cost to the provider, a health care provider shall
26 furnish the subject or a designated representative with a copy
27 of any health information concerning the subject in the
28 possession of the provider.
29 (c) Conditions.--A provider may place reasonable limitations
30 on the time, place and frequency of any inspections of health
19990S0166B0163 - 2 -
1 information. In the event that a provider does not have space
2 available to permit inspection of health information, the
3 provider may, in the alternative, furnish the subject with a
4 copy of the information within ten days of the request. A
5 provider may request the opportunity to review the health
6 information with the subject requesting it, but the review may
7 not be a prerequisite for furnishing the information.
8 (d) Minor subjects.--
9 (1) Except as otherwise provided by law or court order
10 and subject to paragraph (2), upon the written request of the
11 parent or guardian of a minor, a health care provider shall
12 afford an opportunity within ten days for the parent or
13 guardian to inspect or obtain copies of any health
14 information possessed by the provider concerning care or
15 treatment of the minor for which the consent of the parent or
16 guardian was obtained.
17 (2) A parent or guardian may not inspect or make copies
18 of any health information concerning a minor subject where
19 the health care provider determines that access to the
20 information by the parent or guardian would have a
21 detrimental effect on the provider's professional
22 relationship with the minor, on the care and treatment of the
23 minor or on the minor's relationship with the parent or
24 guardian.
25 (3) A minor over 12 years of age shall be notified of
26 any request to review the minor's health information, and if
27 the minor objects to disclosure, the provider may deny the
28 request.
29 (e) Challenges.--A subject, or the parent or guardian of a
30 minor subject who has received access to health information
19990S0166B0163 - 3 -
1 under subsection (d), may challenge the accuracy of information
2 maintained in a health information record and may require that a
3 brief written statement prepared by the subject concerning the
4 challenged information be inserted in the record. This statement
5 shall become a permanent part of the record and shall be
6 released whenever the information at issue is released.
7 (f) Waivers.--Any agreement by a subject to waive any right
8 to inspect, copy or seek correction of health information as
9 provided for in this section shall be deemed to be void as
10 against public policy and wholly unenforceable.
11 Section 5. Limitations on access.
12 (a) Review of information.--Upon receipt of a request to
13 inspect or copy health information pursuant to section 4, a
14 health care provider may review the information requested. If,
15 after consideration of all attendant facts and circumstances,
16 the provider determines that disclosure to the requester of all
17 or part of the health information requested can reasonably be
18 expected to cause substantial and identifiable harm to the
19 subject or others which would outweigh the subject's right of
20 access to the information, the provider may deny access to all
21 or part of the information and may provide a prepared summary of
22 the information.
23 (b) Factors to consider.--In making this determination, the
24 provider may consider any of the following factors:
25 (1) The need for and the fact of continuing care and
26 treatment.
27 (2) The extent to which the knowledge of the information
28 may be harmful to the health and safety of the subject or
29 others.
30 (3) The extent to which the information contains
19990S0166B0163 - 4 -
1 sensitive material disclosed in confidence to the provider by
2 family members, friends and other persons.
3 (4) The extent to which the information contains
4 sensitive materials disclosed to the provider by the subject
5 which would be injurious to the subject's relationships with
6 other persons, except when the requester is the subject.
7 (5) In the case of a request of a minor subject, the age
8 of the subject.
9 Section 6. Civil action.
10 (a) Action may be brought.--A person aggrieved by a
11 violation of this act may bring an action for relief as provided
12 in this section. The aggrieved person shall have the burden of
13 proof unless otherwise required by law.
14 (b) Damages.--In any action brought under this section in
15 which the court determines that a health care provider or other
16 person has willfully violated any provision of this act, the
17 patient or client may recover from the person any of the
18 following:
19 (1) Actual damages, but not less than liquidated
20 damages, computed at the rate of $1,000 for each violation.
21 (2) Punitive damages.
22 (3) Reasonable attorney fees and other litigation costs
23 reasonably incurred.
24 Section 7. Effective date.
25 This act shall take effect in 60 days.
L28L35DMS/19990S0166B0163 - 5 -