SB 423

                      An Act
ENROLLED SENATE
BILL NO. 423  By: Rader of the Senate
                                                and
                                         Caldwell (Chad) of the
                                         House
       An Act relating to medical records; amending 76 O.S.
       2021, Section 19, which relates to access to medical
       records; modifying applicability of certain
       provisions; eliminating certain duties of health care
       providers; authorizing imposition of certain fees;
       modifying certain fee limits; defining terms; making
       certain acts unlawful; providing administrative
       penalties; providing for civil relief; and providing
       an effective date.
SUBJECT:   Medical records
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
    SECTION 1.     AMENDATORY    76 O.S. 2021, Section 19, is
amended to read as follows:
    Section 19. A. 1. Any person who is or has been a patient of
a doctor, hospital or other medical institution health care provider
or health care facility, or such person’s personal representative,
shall, as provided under 45 C.F.R., Section 164.502, be entitled,
upon request, to obtain access to the information contained in the
patient’s medical records including any x-ray or other photograph or
image, pathology slide, or the patient’s medical bills.
    2. Disclosure of the information described in paragraph 1 of
this subsection regarding a deceased patient shall require either a
court order or a written release of an executor, administrator, or
personal representative appointed by the court, or if there is no
such appointment, by the spouse of the patient or, if none, by any
responsible member of the family of the patient. As used in this
paragraph, “responsible family member” shall mean the parent, adult
child, adult sibling, or other adult relative who was actively
involved in providing care to or monitoring the care of the patient
as verified by the doctor, hospital or other medical institution
health care provider or health care facility responsible for the
care and treatment of such person.
    2. Any person who is or has been a patient of a doctor,
hospital or other medical institution shall be furnished copies of
all medical records including any x-ray, other photograph or image,
pathology slide or all medical bills pertaining to that person’s
case upon request and upon the tender of the expenses enumerated in
this paragraph. The cost of each copy to such person or to the
personal representative, spouse or responsible family member of such
person, not including any x-ray or other photograph or image or
pathology slide, shall be fifty cents ($0.50) for each page.
    3. A health care provider or health care facility may impose a
reasonable, cost-based fee when patients or their personal
representatives request copies of medical records; provided, that
the fee includes only the cost of applicable expenses listed in 42
C.F.R., Section 164.524(c)(4).
    4. Requests for medical records and medical bills from, or
directed to, attorneys, insurance companies, other third parties,
and by way of subpoena shall be charged a base fee of Twenty Dollars
($20.00) not more than Twenty-five Dollars ($25.00) in addition to
the a per page charges required pursuant to this section fee of:
        a.   not more than seventy cents ($0.70) for paper copies,
             plus postage or delivery fee, or
        b.   not more than forty cents ($0.40) for electronic
             copies.
    The base fee shall be charged regardless of whether any records
related to the request are located. A fee of not more than Fifteen
Dollars ($15.00) shall be charged if a certification or an affidavit
by the provider regarding the authenticity of the medical records or
ENR. S. B. NO. 423  Page 2
bills is requested. The physician, hospital or other medical
professionals and institutions, or their business associates as the
term is defined in Section 160.103 of Title 45 of the United States
Code of Federal Regulations shall produce the records in digital
form at the rate of thirty cents ($0.30) per page if:
        a.   the entire request can be reproduced from an
             electronic health record system,
        b.   the records are specifically requested to be delivered
             in electronic format, and
        c.   the records can be delivered electronically.
If a provider or business associate transmits the records
electronically, no postage shall be charged but a delivery charge
shall apply. In no event shall a charge for the reproduction of
electronically stored and delivered medical records pursuant to this
paragraph exceed Two Hundred Dollars ($200.00) Two Hundred Seventy
Dollars ($270.00) plus postage or delivery fee. The cost of each
printed x-ray, other photograph, or image to such person or to the
legal representative of such person shall be not more than Fifteen
Dollars ($15.00). If the x-ray, other photograph, or image is
provided on a CD/DVD or other electronic media, the fee shall be
Twenty Dollars ($20.00) not more than Twenty-five Dollars ($25.00)
per CD/DVD or other electronic media. The physician, hospital, or
other medical professionals and institutions, or their business
associates as the term is defined in Section 160.103 of Title 45 of
the United States Code of Federal Regulations, shall not charge a
person who requests their own record a fee for searching,
retrieving, reviewing, and preparing medical records of the person.
No mailing fee shall be charged for copies provided by facsimile.
All requests for medical records made pursuant to this subsection
shall be subject to the fees described in this section regardless of
where the copies or electronic versions of such records are actually
produced.
    3. 5. The provisions of paragraphs 1 and 2 of this subsection
shall not apply to:
        a.   psychological, psychiatric, mental health, or
             substance abuse treatment records. In the case of
ENR. S. B. NO. 423  Page 3
             psychological, psychiatric, mental health, or
             substance abuse treatment records, access to
             information contained in the records shall be obtained
             pursuant to Section 1-109 of Title 43A of the Oklahoma
             Statutes.
    4. The provisions of paragraphs 1 and 2 of this subsection
shall not apply to, and
        b.   requests for medical records made by the Disability
             Determination Division of the State Department of
             Rehabilitation Services. The fee for such requests
             shall be at a rate allowed by the Social Security
             Administration.
    B. 1. In cases involving a claim for personal injury or death
against any practitioner of the healing arts or a licensed hospital,
or a nursing facility or nursing home licensed pursuant to Section
1-1903 of Title 63 of the Oklahoma Statutes arising out of patient
care, where any person has placed the physical or mental condition
of that person in issue by the commencement of any action,
proceeding, or suit for damages, or where any person has placed in
issue the physical or mental condition of any other person or
deceased person by or through whom the person rightfully claims,
that person shall be deemed to waive any privilege granted by law
concerning any communication made to a physician or health care
provider with reference to any physical or mental condition or any
knowledge obtained by the physician or health care provider by
personal examination of the patient; provided that, before any
communication, medical or hospital record, or testimony is admitted
in evidence in any proceeding, it must be material and relevant to
an issue therein, according to existing rules of evidence.
Psychological, psychiatric, mental health, and substance abuse
treatment records and information from psychological, psychiatric,
mental health, and substance abuse treatment practitioners may only
be obtained provided the requirements of Section 1-109 of Title 43A
of the Oklahoma Statutes are met.
    2. Any person who obtains any document pursuant to the
provisions of this section shall provide copies of the document to
any opposing party in the proceeding upon payment of the expense of
copying the document pursuant to the provisions of this section.
ENR. S. B. NO. 423  Page 4
    C. This section shall not apply to the records of an inmate in
a correctional institution when the correctional institution
believes the release of such information to be a threat to the
safety or security of the inmate or the institution.
    D. 1. As used in this section, the terms “covered entity” and
“protected health information” shall have the same meaning as
provided under the Health Insurance Portability and Accountability
Act of 1996 (HIPAA).
    2. It shall be unlawful for a covered entity to use or disclose
protected health information except as authorized under HIPAA.
    3. Intentional violation of paragraph 2 of this subsection
shall be deemed unprofessional conduct by the covered entity’s
licensure board or regulatory agency if applicable and subject to
mandatory license revocation.
    4. If a covered entity believes a violation of paragraph 2 of
this subsection has occurred or will occur in relation to a request
for medical records, the covered entity may apply to a court of
competent jurisdiction for relief and the court shall award
appropriate relief including, but not limited to, temporary,
preliminary, or permanent injunctive relief.
   SECTION 2.   This act shall become effective November 1, 2026.
ENR. S. B. NO. 423  Page 5
    Passed the Senate the 14th day of May, 2026.
                                      Presiding Officer of the Senate
    Passed the House of Representatives the 6th day of May, 2026.
                                       Presiding Officer of the House
                                                   of Representatives
                         OFFICE OF THE GOVERNOR
    Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
    Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.
                                     _________________________________
                                     Governor of the State of Oklahoma
                     OFFICE OF THE SECRETARY OF STATE
    Received by the Office of the Secretary of State this __________
day of __________________, 20 _______, at _______ o'clock _______ M.
By: _________________________________
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