H*3498(Rat #0154, Act #0085 of 1999)  General Bill, By Lourie, J. Smith, 
Campsen, Lee, Davenport, Taylor, Kirsh, Leach, Loftis, Maddox, Allen, Klauber, 
W. McLeod, Breeland, Pinckney, J. Brown, Wilder, Parks, Hawkins, Rutherford, 
Lucas, Neilson, McMahand, Harrison, Quinn, Mack, Phillips, McCraw, F. Smith, 
Battle, R. Smith, Cato, Moody-Lawrence, Simrill, Robinson, Hamilton, Easterday, 
Rice, Delleney, Bales, Bowers, Rhoad, Wilkes, M. McLeod, Knotts, McGee, Canty, 
Townsend, Stille, Rodgers, Gourdine, Hinson, Riser, Bailey, Jennings, Harris, 
J.H. Neal, Scott, Howard, Sandifer, Hayes, Barfield and Seithel
 A BILL TO AMEND TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING
 CHAPTER 117 SO AS TO ENACT THE "PRESCRIPTION INFORMATION PRIVACY ACT" WHICH
 PROHIBITS PATIENT PRESCRIPTION DRUG INFORMATION FROM BEING TRANSFERRED WITHOUT
 THE WRITTEN CONSENT OF THE PATIENT, AND TO PROVIDE EXCEPTIONS AND PENALTIES;
 TO AMEND SECTION 44-30-90, RELATING TO THE PROMULGATION OF REGULATIONS TO
 CARRY OUT THE PURPOSE OF THE "SOUTH CAROLINA HEALTH CARE PROFESSIONAL
 COMPLIANCE ACT", SO AS TO REQUIRE ALL ORDERS FOR MEDICATION DISPENSED OR
 TREATMENT PROVIDED IN A HOSPITAL TO BE AUTHENTICATED ACCORDING TO HOSPITAL
 POLICY, TO SPECIFY REQUIREMENTS FOR TAKING THESE ORDERS, AND TO REQUIRE THE
 DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL TO PROMULGATE REGULATIONS
 CONSISTENT WITH THESE REQUIREMENTS; AND TO AMEND SECTION 44-115-80, AS
 AMENDED, RELATING TO FEES THAT A PHYSICIAN MAY CHARGE FOR SEARCH AND
 DUPLICATION OF MEDICAL RECORDS, SO AS TO REQUIRE COPIES OF RECORDS TO BE
 PROVIDED AT NO CHARGE WHEN THE PATIENT IS REFERRED BY THE PHYSICIAN FOR
 CONTINUATION OF TREATMENT.-AMENDED TITLE

   02/10/99  House  Introduced and read first time HJ-12
   02/10/99  House  Referred to Committee on Medical, Military,
                     Public and Municipal Affairs HJ-13
   04/21/99  House  Committee report: Favorable with amendment
                     Medical, Military, Public and Municipal Affairs HJ-91
   04/22/99  House  Amended HJ-44
   04/22/99  House  Read second time HJ-46
   04/22/99  House  Unanimous consent for third reading on next
                     legislative day HJ-46
   04/23/99  House  Read third time and sent to Senate HJ-4
   04/27/99  Senate Introduced and read first time SJ-11
   04/27/99  Senate Referred to Committee on Medical Affairs SJ-11
   05/27/99  Senate Committee report: Favorable with amendment
                     Medical Affairs SJ-36
   05/27/99  Senate Amended SJ-36
   05/27/99  Senate Read second time SJ-36
   05/27/99  Senate Ordered to third reading with notice of
                     amendments SJ-36
   06/02/99  Senate Amended SJ-88
   06/02/99  Senate Read third time and returned to House with
                     amendments SJ-88
   06/02/99  House  Concurred in Senate amendment and enrolled HJ-146
   06/09/99         Ratified R 154
   06/11/99         Signed By Governor
   06/11/99         Effective date 03/01/00 (Sec. 01); Sec 2
                     effective 06/11/99
   06/11/99         See act for exception to or explanation of
                     effective date
   07/07/99         Copies available
   07/07/99         Act No. 85

AN ACT TO AMEND TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING CHAPTER 117 SO AS TO ENACT THE "PRESCRIPTION INFORMATION PRIVACY ACT" WHICH PROHIBITS PATIENT PRESCRIPTION DRUG INFORMATION FROM BEING TRANSFERRED WITHOUT THE WRITTEN CONSENT OF THE PATIENT, AND TO PROVIDE EXCEPTIONS AND PENALTIES; TO AMEND SECTION 44-30-90, RELATING TO THE PROMULGATION OF REGULATIONS TO CARRY OUT THE PURPOSE OF THE "SOUTH CAROLINA HEALTH CARE PROFESSIONAL COMPLIANCE ACT", SO AS TO REQUIRE ALL ORDERS FOR MEDICATION DISPENSED OR TREATMENT PROVIDED IN A HOSPITAL TO BE AUTHENTICATED ACCORDING TO HOSPITAL POLICY, TO SPECIFY REQUIREMENTS FOR TAKING THESE ORDERS, AND TO REQUIRE THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL TO PROMULGATE REGULATIONS CONSISTENT WITH THESE REQUIREMENTS; AND TO AMEND SECTION 44-115-80, AS AMENDED, RELATING TO FEES THAT A PHYSICIAN MAY CHARGE FOR SEARCH AND DUPLICATION OF MEDICAL RECORDS, SO AS TO REQUIRE COPIES OF RECORDS TO BE PROVIDED AT NO CHARGE WHEN THE PATIENT IS REFERRED BY THE PHYSICIAN FOR CONTINUATION OF TREATMENT.

Be it enacted by the General Assembly of the State of South Carolina:

Patient prescription drug information may not be transferred

SECTION 1. Title 44 of the 1976 Code is amended by adding:

Section 44-117-10. This chapter may be cited as the 'Prescription Information Privacy Act'.

Section 44-117-20. As used in this chapter:

(1) 'Patient prescription drug information' means data that is conveyed by or on behalf of a practitioner in ordering a prescription drug or device before being dispensed and that identifies the patient as the recipient of the prescription drug or device. The term also includes any data concerning the dispensing of a drug or device that identifies a patient as having been the recipient of a prescription drug or device, whether this data is held by a practitioner, pharmacy, or another entity.

(2) 'Practitioner' means a licensed health care professional authorized under state law to order a prescription drug or device.

(3) 'Prescription drug or device' means a drug or device that is dispensed pursuant to the order of a practitioner.

Section 44-117-30. No patient prescription drug information may be transferred or received by a person without the written consent of the patient or a person authorized by law to act on behalf of the patient. However, this prohibition does not apply to:

(1) the lawful transmission of a prescription drug order in accordance with all state and federal laws pertaining to the practice of pharmacy.

(2) communications among licensed practitioners, licensed pharmacists, and other health care professionals who provide or have provided medical or therapeutic treatment, pharmacy service, or medical or therapeutic consultation service for the person who received the drug or device;

(3) information gained as a result of a person requesting informational material from a prescription drug or device manufacturer or vendor;

(4) information necessary to effect the recall of a defective drug or device or other information necessary to protect the health and welfare of an individual or the public generally;

(5) information whereby the release or transfer is mandated by other state or federal laws, court order, or subpoena, or regulations including, but not limited to, accreditation or licensure requirements;

(6) information necessary to adjudicate or process payment claims for health care, whether under a health insurance benefits program or other payment system, if the recipient makes no other use or further disclosure of the information;

(7) information voluntarily disclosed by a patient to entities outside of the provider-patient relationship;

(8) information used in clinical research monitored by an institutional review board;

(9) information which does not identify patients by name, or that is encoded in a manner that information identifying a particular patient by name or address is not generally obtainable, and that is used for epidemiological studies, research, statistical analysis, medical outcomes, or pharmacoeconomic research;

(10) information transferred in connection with the sale of a business or medical practice to a successor in interest;

(11) information necessary to disclose to third parties in order to perform quality assurance programs, medical records review, internal audits, medical records maintenance, or similar programs, if the third party makes no other use or further disclosure of the information;

(12) information that may be revealed to a party who, on behalf of the patient, obtains a dispensed prescription from a pharmacy;

(13) information necessary to disclose to third parties in order for a health plan licensed by the South Carolina Department of Insurance to perform case management, utilization management, and disease management for individuals enrolled in that health plan, if the third party makes no other use or further disclosure of the information.

Section 44-117-40. An individual or entity, corporate or otherwise, who knowingly violates a provision of this chapter is guilty of a misdemeanor and, upon conviction, must be fined not more than ten thousand dollars per occurrence.

Section 44-117-50. This chapter does not invalidate:

(a) any other provision of law concerning medical records or patient prescription drug information, the alteration of medical records or patient prescription drug information, any interest a patient has in the information contained within the medical record or patient prescription drug information, or any civil action brought in the state or federal courts alleging negligence by a practitioner or pharmacist;

(b) the authority of a court to issue a subpoena for medical records and patient prescription drug information;

(c) the authority of a licensing or disciplinary board of this State to obtain these records as provided by law; or

(d) the authority of the Department of Health and Environmental Control to obtain medical records or patient prescription drug information as provided by state and federal law."

Hospital orders; regulations

SECTION 2. Section 44-30-90 of the 1976 Code, as added by Act 403 of 1992, is amended to read:

"Section 44-30-90. The department and each licensing board shall promulgate regulations necessary to accomplish the purposes set forth in this chapter and to comply with public law no later than October 1, 1992. All orders for medication dispensed or treatment provided in a hospital shall be authenticated according to hospital policy. The orders shall be taken by personnel qualified by hospital medical staff rules and shall include the date, time, and name of persons who gave the order, and the signature of the person taking the order. The Department of Health and Environmental Control shall promulgate regulations consistent with this provision."

Fees for medical records

SECTION 3. Section 44-115-80 of the 1976 Code, as last amended by Act 468 of 1994, is further amended to read:

"Section 44-115-80. A physician, or other owner of medical records as provided for in Section 44-115-130, may charge a fee for the search and duplication of a medical record, but the fee may not exceed sixty-five cents per page for the first thirty pages and fifty cents per page for all other pages, and a clerical fee for searching and handling not to exceed fifteen dollars per request plus actual postage and applicable sales tax. A physician, health care provider, or other owner of medical records must provide a patient's medical records at no charge when the patient is referred by the physician, health care provider, or an employee, agent, or contractor of the owner of the record to another physician or health care provider for continuation of treatment for a specific condition or conditions. The physician may charge a patient or the patient's representative no more than the actual cost of reproduction of an X-ray. Actual cost means the cost of materials and supplies used to duplicate the X-ray and the labor and overhead costs associated with the duplication."

Time effective

SECTION 4. As listed above, Section 1 becomes effective on March 1, 2000. As listed above, Section 2 becomes effective upon approval by the Governor; provided, however, Section 2 shall remain in effect until such time as the department shall promulgate and implement new regulations consistent with the standards outlined in Section 2. As listed above, Section 3 becomes effective upon approval by the Governor.

Ratified the 9th day of June, 1999.

Approved the 11th day of June, 1999.