2021 -- H 5864

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LC001300

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2021

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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 Shanley, Craven, Barros, and Amore

     Date Introduced: February 24, 2021

     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 to

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

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

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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 of

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that representative, any heir-at-law his or her heirs-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 healthcare communication" means a communication of healthcare

 

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

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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 healthcare

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provider, including members of the patient's family.

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

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healthcare history, diagnosis, condition, treatment, or evaluation obtained from a healthcare

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provider who has treated the patient.

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

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

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facility or other healthcare 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 supportive

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of health services.

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

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counseling or any other acts that may be permissible under the healthcare licensing statutes of this

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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 employer,

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an employee organization, or any other entity providing coverage for healthcare services to operate

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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 subsection (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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subsection (7), that provides for the financing and delivery of healthcare services to persons

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enrolled in the plan through:

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     (i) Arrangements with selected providers to furnish healthcare 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, or

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other state-licensed or other state-recognized provider of healthcare services or supplies, that has

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

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enrolled in a managed-care plan.

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     (12) "Patient" means a person who receives healthcare services from a healthcare provider.

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     (13) "Personally identifiable confidential healthcare information" means confidential

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healthcare 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 osteopathic

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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 an

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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

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healthcare information relates and other than a healthcare provider.

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

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

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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 "authorized representative" in the confidentiality of

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health care communications and information act to provide that an authorized representative may

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include any heir-at-law when the patient is deceased and the personal representative is absent.

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     This act would take effect upon passage.

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