PRIOR PRINTER'S NO. 2487
PRINTER'S NO. 2722
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1956
Session of
2024
INTRODUCED BY KOSIEROWSKI, JOZWIAK, PROBST, VENKAT, MADDEN,
CURRY, DONAHUE, SANCHEZ, DALEY, BOROWSKI, CIRESI, CEPEDA-
FREYTIZ, SHUSTERMAN, TWARDZIK, GILLEN AND ZIMMERMAN,
JANUARY 9, 2024
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, MARCH 18, 2024
AN ACT
Amending the act of October 24, 2018 (P.L.719, No.112), entitled
"An act providing for notification of patient test results to
be sent directly to a patient or the patient's designee; and
providing for duties of the Department of Health," further
providing for definitions, for test results and for duties of
Department of Health.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Sections 2, 3 and 4 of the act of October 24,
2018 (P.L.719, No.112), known as the Patient Test Result
Information Act, are amended to read:
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Chronic condition." An illness that frequently recurs or
persists for a period in excess of three months.
"Diagnostic imaging service." A medical imaging test
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performed on a patient that is intended to diagnose the presence
or absence of a disease, including, but not limited to, a
malignancy. The term does not include a nonimaging study,
including an electrocardiogram, standard electrocardiogram
treadmill stress test, cardiac monitor, pulmonary function test
or similar test.
"Diagnostic radiograph." A projectional radiograph that
acquires an image or digital image with x-rays to produce a high
contrast, two-dimensional image, otherwise known as an x-ray.
"Health care practitioner." As defined in section 103 of the
act of July 19, 1979 (P.L.130, No.48), known as the Health Care
Facilities Act.
["Significant abnormality." A finding by a diagnostic
imaging service of an abnormality or anomaly which would cause a
reasonably prudent person to seek additional or follow-up
medical care within three months.]
Section 3. Test results.
[(a) General rule.--When, in the judgment of the entity
performing a diagnostic imaging service, a significant
abnormality may exist, the entity performing the diagnostic
imaging service shall directly notify the patient or the
patient's designee by providing notice that the entity has
completed a review of the test performed on the patient and has
sent results to the health care practitioner who ordered the
diagnostic imaging service. The notice shall include all of the
following:
(1) The name of the ordering health care practitioner.
(2) The date the test was performed.
(3) The date the results were sent to the ordering
health care practitioner.
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(4) The following statements:
You are receiving this notice as a result of a
determination by your diagnostic imaging service that
further discussions of your test results are warranted
and would be beneficial to you.
The complete results of your test or tests have been or
will be sent to the health care practitioner that ordered
the test or tests. It is recommended that you contact
your health care practitioner to discuss your results as
soon as possible.
(5) The contact information necessary for the patient to
obtain a full report.]
(a.1) W ritten notice at time of service.--The entity
performing the diagnostic imaging service shall provide written
notice to the patient or the patient's designee at the time of
the diagnostic imaging service. The notice shall include the
following statement:
Your test results will be made immediately available to
you once the results are ready. You can access your test
results online through your electronic health record
(EHR) patient portal. If you do not have access to your
online patient portal, you can request that your test
results be delivered to you by mail. You may be charged a
reasonable fee for the administrative costs of mailing
the test results.
(b) Exceptions.--The following shall be exempted from the
requirements of subsection [(a)] (a.1):
(1) Routine obstetrical ultrasounds used to monitor the
development of a fetus.
(2) Diagnostic imaging services performed on a patient
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who is being treated on an inpatient basis [or] in an
emergency [room] department or observation unit of a
hospital.
(3) Diagnostic radiographs.
(4) Diagnostic imaging services performed on a patient
with a chronic condition if the patient has previously
received notice of the chronic condition.
(5) Diagnostic imaging services test results provided to
a patient or a patient's designee at the time of the test.
[(c) Time.--Except as provided under subsection (d)(2)(v),
no later than 20 days after the date the results were sent to
the ordering health care practitioner as provided under
subsection (a)(3), the entity performing the diagnostic imaging
service shall provide the patient or patient's designee with the
notice under subsection (a).
(d) Method of transmittal.--
(1) The notice under subsection (a) shall be provided in
a manner deemed acceptable by the patient or the patient's
designee.
(2) A notice provided under subsection (a) shall be
presumed to comply with this act if:
(i) mailed in a properly addressed and stamped
letter through the United States Postal Service;
(ii) sent electronically by e-mail;
(iii) sent by automatic alert from an electronic
medical record system that the notice under subsection
(a) has been posted to the patient's electronic medical
record that is presently viewable;
(iv) sent by facsimile; or
(v) provided directly to the patient at the time of
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service, so long as the patient acknowledges the receipt
of the results and signs the patient's medical record
accordingly.
(e) Construction.--
(1) Nothing in this act shall be construed to require an
entity to provide a patient or patient's designee the notice
under subsection (a) if the results are provided to the
patient or patient's designee by the health care practitioner
at the time of the test.
(2) Nothing in this act shall be construed to prohibit
an entity from providing a patient with:
(i) the summary of a diagnostic imaging service
report, otherwise known as an impression or conclusion;
or
(ii) the complete results of the diagnostic imaging
service provided to the ordering health care
practitioner.]
(f) Disclosure of test results.-- The EXCEPT AS PROVIDED
UNDER SUBSECTION (G), THE following test results and any other
related results shall not be disclosed to a patient as part of
the patient's electronic health record, and in the case of a
clinical laboratory test result or pathology report shall not be
disclosed by the person or entity that administers and controls
the patient's electronic health record, until 72 hours ONE FULL
BUSINESS DAY HAS ELAPSED after the results are finalized, unless
the ORDERING health care practitioner directs the release of the
results before the end of that 72-hour period:
(1) Pathology reports or radiology reports that have a
reasonable likelihood of showing a finding of malignancy.
(2) Tests that could reveal genetic markers.
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(G) EXCEPTION.-- THE PROHIBITION UNDER SUBSECTION (F) SHALL
NOT APPLY IF THE TEST RESULTS ARE PROVIDED TO A PATIENT OR THE
PATIENT'S DESIGNEE AT THE TIME OF THE TEST.
(H) POLICIES AND PROCEDURES.--A HEALTH CARE FACILITY,
CLINICAL LABORATORY OR AN ENTITY PERFORMING A DIAGNOSTIC IMAGING
SERVICE SHALL DEVELOP AND IMPLEMENT POLICIES AND PROCEDURES FOR
PROVIDING PATIENT TEST RESULTS IN ACCORDANCE WITH THIS SECTION.
(I) FACE-TO-FACE REQUIREMENTS.--NOTHING IN THIS ACT SHALL BE
CONSTRUED TO REPEAL ANY LAW OF THIS COMMONWEALTH THAT REQUIRES A
HEALTH CARE PRACTITIONER TO CONDUCT A FACE-TO-FACE MEETING OR
COUNSELING SESSION WITH A PATIENT PRIOR TO A TEST RESULT BEING
DISCLOSED TO THE PATIENT OR BEING POSTED IN THE PATIENT'S
ELECTRONIC HEALTH RECORD.
Section 4. Duties of Department of Health.
(a) Reviews and complaints.--The Department of Health
shall[:
(1) in accordance with law, conduct compliance reviews
on health care facilities licensed by the department as part
of the inspection performed by the department or an
accrediting organization and investigate complaints filed
relating to the requirements of section 3; [and]
(2) establish a complaint procedure, which shall be made
available on the department's publicly accessible Internet
website[.]; and
(3) coordinate with the appropriate State licensing
boards on complaints received by the department relating to
entities performing diagnostic imaging services not under the
department's jurisdiction and on how the complaints will be
referred to the appropriate State licensing boards for
review.
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(b) Regulations.--The Department of Health may, by
regulation, exempt other tests in addition to those specified
under section 3(b) and (f). CONDUCT COMPLIANCE REVIEWS ON HEALTH
CARE FACILITIES AND CLINICAL LABORATORIES LICENSED OR PERMITTED
BY THE DEPARTMENT.
(B) LIMITATION.--THE DEPARTMENT OF HEALTH SHALL LIMIT THE
SCOPE OF THE COMPLIANCE REVIEWS UNDER SUBSECTION (A) TO
DETERMINING WHETHER POLICIES AND PROCEDURES HAVE BEEN DEVELOPED
AND IMPLEMENTED IN ACCORDANCE WITH SECTION 3(H).
Section 2. This act shall take effect in 60 days.
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