2019 -- H 5505

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LC001529

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - CONFIDENTIALITY OF HEALTH

CARE COMMUNICATIONS AND INFORMATION ACT

     

     Introduced By: Representatives Millea, Shekarchi, Craven, Jacquard, and Knight

     Date Introduced: February 14, 2019

     Referred To: House Judiciary

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 5-37.3-3 of the General Laws in Chapter 5-37.3 entitled

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"Confidentiality of Health Care Communications and Information Act" is hereby amended to read

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as follows:

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     5-37.3-3. Definitions.

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     As used in this chapter:

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     (1) "Authorized representative" means:

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     (i) A person empowered by the patient/client to assert or to waive the confidentiality, or

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to disclose or consent to the disclosure of confidential information, as established by this chapter.

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That person is not, except by explicit authorization, empowered to waive confidentiality or to

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disclose or consent to the disclosure of confidential information;

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     (ii) A guardian or conservator, if the person whose right to confidentiality is protected

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under this chapter is incompetent to assert or waive that right;

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     (iii) If the patient/client is deceased, his or her personal representative or, in the absence

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of that representative, his or her heirs-at-law any heir-at-law; or

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     (iv) A patient's attorney.

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     (2) "Board of medical licensure and discipline" means the board created under chapter 37

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of this title.

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     (3)(i) "Confidential health care communication" means a communication of health care

 

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information by an individual to a health care provider, including a transcription of any

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information, not intended to be disclosed to third persons except if those persons are:

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     (A) Present to further the interest of the patient in the consultation, examination or

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interview;

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     (B) Reasonably necessary for the transmission of the communication; or

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     (C) Participating in the diagnosis and treatment under the direction of the health care

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provider, including members of the patient's family.

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     (ii) "Confidential health care information" means all information relating to a patient's

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health care history, diagnosis, condition, treatment, or evaluation obtained from a health care

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provider who has treated the patient.

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     (4) "Health care provider" means any person licensed by this state to provide or lawfully

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providing health care services, including, but not limited to, a physician, hospital, intermediate

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care facility or other health care facility, dentist, nurse, optometrist, podiatrist, physical therapist,

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psychiatric social worker, pharmacist or psychologist, and any officer, employee, or agent of that

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provider acting in the course and scope of his or her employment or agency related to or

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supportive of health services.

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     (5) "Health care services" means acts of diagnosis, treatment, medical evaluation, or

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counseling or any other acts that may be permissible under the health care licensing statutes of

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this state.

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     (6) "Managed care contractor" means a person that:

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     (i) Establishes, operates, or maintains a network of participating providers;

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     (ii) Conducts or arranges for utilization review activities; and

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     (iii) Contracts with an insurance company, a hospital or medical service plan, an

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employer, an employee organization, or any other entity providing coverage for health care

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services to operate a managed care plan.

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     (7) "Managed care entity" includes a licensed insurance company, hospital or medical

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service plan, health maintenance organization, an employer or employee organization, or a

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managed care contractor as described in subdivision (6) of this section, that operates a managed

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care plan.

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     (8) "Managed care plan" means a plan operated by a managed care entity as described in

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subdivision (7) of this section, that provides for the financing and delivery of health care services

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to persons enrolled in the plan through:

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     (i) Arrangements with selected providers to furnish health care services;

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     (ii) Explicit standards for the selection of participating providers;

 

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     (iii) Organizational arrangements for ongoing quality assurance, utilization review

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programs, and dispute resolution; and

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     (iv) Financial incentives for persons enrolled in the plan to use the participating providers

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and procedures provided for by the plan.

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     (9) "Medical peer review board" means a peer review board under chapter 37 of this title.

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     (10) "Nurse" means a registered nurse or licensed practical nurse licensed to practice

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nursing in the state.

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     (11) "Participating provider" means a physician, hospital, pharmacy, laboratory, dentist,

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or other state licensed or other state recognized provider of health care services or supplies, that

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has entered into an agreement with a managed care entity to provide any services or supplies to a

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patient enrolled in a managed care plan.

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     (12) "Patient" means a person who receives health care services from a health care

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provider.

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     (13) "Personally identifiable confidential health care information" means confidential

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health care information, which explicitly or by implication identifies a particular patient.

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     (14) "Physician" means a person registered or licensed to practice allopathic or

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osteopathic medicine in this state under Rhode Island general laws.

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     (15) "Psychiatric social worker" means a person holding a Master's or further advanced

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degree from a school of social work accredited by the council of social work education.

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     (16) "Psychologist" means a certified psychologist under chapter 44 of this title.

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     (17) "Qualified personnel" means persons whose training and experience are appropriate

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to the nature and level of the work in which they are engaged and who, when working as part of

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an organization, are performing that work with published and adequate administrative safeguards

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against disclosure unauthorized under this chapter.

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     (18) "Third party" means a person other than the patient to whom the confidential health

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care information relates and other than a health care provider.

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     (19) "Third-party requestor" means any person or entity presenting a patient signed

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Health Insurance Portability and Accountability Act (HIPAA)-compliant authorization allowing

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them to obtain a copy of the patient's medical records or reports.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - CONFIDENTIALITY OF HEALTH

CARE COMMUNICATIONS AND INFORMATION ACT

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     This act would amend the definition of a deceased patient/client's authorized

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representative from his or her heirs-at-law to any heir-at-law.

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     This act would take effect upon passage.

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