Medical Records – Disclosure of Directory Information and Medical Records
The new law was sponsored by: Delegates Valentino-Smith, Kelly, West and Morales
New Maryland Health Care Law: House Bill (HB) 1468/ Senate Bill (SB) 584 Effective October 1, 2017
The Maryland General Assembly recently unanimously passed through both the Senate Finance and Health/Government Operation Committee a new law which will rectify the restrictive nature of protected health information in Maryland where the current practice was more restrictive than HIPAA. This new law will allow Maryland to be more HIPAA compliant.
The new bill also expresses the intent of the Maryland General Assembly that provision in the State law relating to the confidentiality of medial records (1) may not be interpreted to be more restrictive than the federal privacy regulations adopted under the Federal Health Insurance Portability and Accountability ACT (HIPAA ; (2) are not intended to be in conflict with HIPAA; and (3) are to be interpreted in away that is consistent with any federal regulation, policy guidance, and judicial decision relating to HIPAA.
The change in the law occurred in part due to anecdotal testimony from a gentleman concerning his son who is an adult and has a medical condition of psychosis. A hospital where the son was initially admitted would not disclose any directory information to the parents when the adult son was transferred to a different hospital. The parents spent three months searching for their son through the various hospitals in Maryland. The parents would have been able to find their son if this law had been in place.
Summary of Provision of the New Health Care Law:
A health care provider may disclose a medical record without the authorization of a person in interest to immediate family members of the patient or any other individual with whom the patient is known to have a close personal relationship, if the disclosure is limited to information that is directly relevant to the individual’s involvement in the patient’s health care and other conditions are met. Specifically, if the patient is available before the disclosure and has the capacity to make health care decisions, the patient must have been provided with an opportunity to object and either not done so or the health care provider must be able to reasonably infer that the patient does not object. Alternatively, if the patient is not available before the disclosure is made, or objection is not practicable because the patient is incapacitated or in need of emergency care, the provider must determine, based on the provider’s professional judgment, that the disclosure is in the patient best interest.
Health care providers may disclose specified directory information about a patient, without the authorization of a person in interest, unless the patient has instructed the health care provider in writing not to do so or the information was developed primarily in connection with mental health services. Additionally, unless the patient instructs otherwise or the records were developed primarily in connection with the provision of mental health services, health care providers may disclose medical records without the authorization of the person in interest to immediate family members of the patient or any other individual with whom the patient is known to have a close personal relationship, if made in accordance with good medical or other professional practice.
New Law – HB 1468/ SB 584 – Effective October 1st
A health care provider must inform a patient of the health care information that the provider may include in a directory and the persons to whom such information may be disclosed, and as soon as practicable, provide the patient with the opportunity to restrict or prohibit disclosure of directory information. If an opportunity to restrict or prohibit disclosure is not practicable because the patient is incapacitated or in need of emergency care or treatment, the health care provider may still disclose directory information if the disclosure is consistent with a prior expressed preference of the patient that is known to the provider and is determined to be in the patient’s best interest.
BY repealing and reenacting, without amendments, Article – Health – General Section 4–301(a) and 4–302(c) Annotated Code of Maryland (2015 Replacement Volume and 2016 Supplement)
BY repealing and reenacting, with amendments, Article – Health – General Section 4–301(b), 4–302(c), and 4–305(b)(7) Annotated Code of Maryland (2015 Replacement Volume and 2016 Supplement
Website: General Assembly of Maryland 2017 Regular Session Health & Government Operations Session Legislative
Alexander & Cleaver
Attorneys At Law
Respectfully submitted by:
Vicki N. Reynolds, RHIT
Advocacy Chairman MdHIMA
Linda Metro, RHIA
Government Relations Division
Alexander & Cleaver