Missouri Senate

Senate Committee Substitute

FURNISHING OF MEDICAL RECORDS (Section 191.227)

Current law allows a health care provider to condition the furnishing of medical records on the payment of a fee to cover costs of copying, off-site records storage, postage and notary services. This act allows for a search and retrieval amount not to exceed $22.82 plus copying in the amount of 53 cents for supplies and labor per page as well as for $21.36 for off-site record storage. The fee amounts shall be adjusted annually per the Consumer Price Index.

This act also allows for the records to be furnished electronically upon payment of the search, retrieval, and copying fees set under this act at the time of the request or $100 total, whichever is less, if such person:

(1) Requests health records to be delivered electronically in a format of the health care provider's choice;

(2) The health care provider stores such records completely in an electronic health record; and

(3) The health care provider is capable of providing the requested records and affidavit, if requested, in an electronic format.

This provision is identical to HCS/SCS/SB 88 (2013) and substantially similar to HB 324 (2013).

HOSPITAL LICENSURE AND REGULATION (Sections 197.080, 197.100 and Section 1)

This act requires the Department of Health and Senior Services to review and revise its regulations governing hospital licensure and enforcement to promote efficiency and eliminate duplicate regulations and inspections by or on behalf of the state and federal agencies.

The Department shall adopt regulations that require among other things: (1) Specific findings of deficiencies to refer to the specific written interpretive guidance developed by the department and any publicly available, professionally recognized standards of care that are the basis of the citation and finding; (2) Consistency with, but not contradictory to, the federal Centers for Medicare and Medicaid Services' (CMS) Conditions of Participation; (3) Published guidelines for complaint investigations and a process to determine if a complaint warrants an onsite investigation; (4) Requiring the departmental investigation of a complaint to be primarily focused on the specific regulatory standard and departmental written interpretive guidance and publicly available professionally recognized standard of care related to the complaint; (5) Permitting the department, during the course of any complaint investigation, to cite any serious and immediate threat discovered that may potentially jeopardize the health and safety of patients.

Hospitals and hospital personnel shall have the opportunity to participate in annual continuing training sessions provided to state licensure surveyors with prior approval from the department director and CMS when appropriate. This act also establishes specific timelines identical, to the extent practicable, to those in CMS's State Operations Manual. SECTION 197.080

The Department shall also accept a hospital inspection report from Joint Commission and the American Osteopathic Association Healthcare Facilities Accreditation Program, provided the accreditation inspection was conducted within one year of the date of license renewal and the accrediting organization's survey process has been deemed appropriate and found to be comparable to the department's licensure survey. It is the accrediting organization's responsibility to provide the department the information necessary to determine if its survey process is comparable and fully meets the intent of the licensure regulations. SECTION 197.100

The department shall post on its website information regarding investigations of complaints made against hospitals. The act details the requirements of such postings, including the required time lines for posting. SECTION 1

The hospital licensure provisions are substantially similar to SCS/SB 109 (2013) and to HCS/SB 88 (2013); SS/SCS/SB 621 (2012); HB 1123 (2012); and similar to HCS/HB 579 (2011).

ADRIANE CROUSE