First Regular Session

Sixty-first General Assembly

LLS NO. 97­0535.01 BWM SENATE BILL 97­129

STATE OF COLORADO

BY SENATORS Tanner, Dennis, Hernandez, and Pascoe;

also REPRESENTATIVE Tate.

HEALTH, ENVIRONMENT,

WELFARE & INSTITUTIONS

REENGROSSED

A BILL FOR AN ACT

CONCERNING PATIENT RIGHTS WITH RESPECT TO MAMMOGRAPHY PROCEDURES.

Bill Summary

(Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments which may be subsequently adopted.)

Requires all licensees conducting mammography exams to inform patients of their basic legal rights with respect to mammograms and breast health records. Requires such information to be communicated to patients at the time informed consent is granted or at some other professionally appropriate point of treatment. Authorizes such information to be displayed on a card of a certain size on the premises of the facility. Requires original mammograms and copies of written breast health records to be maintained for a period of 50 years. After a period of 10 years such information may be stored in an appropriate form.

Specifies that, upon written request of a patient or legal representative, original mammograms and copies of written breast health records shall be made available as directed within 5 business days if such information is maintained on the premises of the provider or within 7 business days if the information is maintained at another location. Requires licensees conducting mammography exams to mail notices to the patient indicating that a mammogram has been read, any results indicated, and that the patient should contact the patient's physician or obtain a physician for a complete review of the results of the mammography examination.

Be it enacted by the General Assembly of the State of Colorado:

SECTION 1.  25­11­104 (8) (a.5), Colorado Revised Statutes, 1989 Repl. Vol., as amended, is amended to read:

25­11­104.  Rules and regulations to be adopted ­ fees ­ fund created. (8) (a.5) (I)  No person shall perform a mammography exam nor shall anyone employ a person to perform a mammography exam unless said person has been approved by the department as meeting the qualifications for mammographers adopted by the state board of health pursuant to subsection (2.5) of this section. On or before December 31, 1993, the state board of health shall adopt rules requiring that all machine sources of ionizing radiation which are used in the conduct of a mammography exam be operated only by a qualified mammographer, that a list of qualified mammographers operating the machine be posted on or near said machines, and that said machines be inspected at least annually for compliance with the requirements of this subsection (8). Documentation establishing the qualifications of mammographers shall be available for inspection upon request.

(II)  ALL LICENSEES UNDER THIS PART 1 THAT CONDUCT MAMMOGRAPHY EXAMS SHALL INFORM EACH PATIENT IN WRITING OF THE FOLLOWING INFORMATION AT THE TIME INFORMED CONSENT IS OBTAINED OR AT SOME OTHER PROFESSIONALLY PROPER POINT DURING TREATMENT BY USE OF AN APPROPRIATE COMMUNICATION MEDIUM AND IN A MANNER UNDERSTOOD BY THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE:

(A)  THAT A PATIENT'S MAMMOGRAM AND OTHER BREAST HEALTH RECORDS ARE CONFIDENTIAL;

(B)  THAT A PATIENT MAY CONSENT IN WRITING TO MAKE ORIGINAL MAMMOGRAMS AND COPIES OF OTHER WRITTEN BREAST HEALTH RECORDS AVAILABLE TO DESIGNATED PERSONS DURING THE PATIENT'S LIFETIME AND AFTER THE PATIENT'S DEATH;

(C)  THAT ORIGINAL MAMMOGRAMS ARE NEEDED FOR DIAGNOSTIC PURPOSES. COPIES ARE NOT APPROPRIATE.

(D)  THAT A PATIENT HAS THE RIGHT TO PERMANENTLY OR TEMPORARILY TRANSFER ALL THE PATIENT'S ORIGINAL MAMMOGRAMS AND ALL COPIES OF OTHER WRITTEN BREAST HEALTH RECORDS TO ANOTHER HEALTH CARE PROVIDER OR FACILITY, AND THE PATIENT MAY REQUEST THE ASSISTANCE OF THE LICENSEE IN EFFECTING SUCH PERMANENT OR TEMPORARY TRANSFER. IN THE CASE OF A TEMPORARY TRANSFER OR LOAN, SUCH ORIGINAL MAMMOGRAM OR COPY OF OTHER WRITTEN BREAST HEALTH RECORDS SHALL BE RETURNED WITHIN THIRTY DAYS AFTER THE TRANSFER OR LOAN. SUCH ORIGINAL MAMMOGRAMS AND COPIES OF OTHER WRITTEN BREAST HEALTH RECORDS SHALL BE MADE AVAILABLE WITHIN FIVE BUSINESS DAYS IF THEY ARE STORED ON THE PREMISES OR SEVEN BUSINESS DAYS IF STORED AT ANOTHER LOCATION.

(E)  THAT AN INDEPENDENT SECOND OPINION BY A RADIOLOGIST AFFILIATED WITH A DIFFERENT FACILITY CAN BE HELPFUL IN EVALUATING MAMMOGRAMS. THE PATIENT MAY HAVE TO BEAR THE COST OF SUCH SECOND OPINION IF IT IS NOT COVERED BY APPLICABLE HEALTH CARE COVERAGE.

(F)  THAT IT IS THE PHYSICIAN'S RESPONSIBILITY TO INFORM THE PATIENT OF RESULTS. HOWEVER, IT IS THE PATIENT'S RESPONSIBILITY TO CONTACT THE FACILITY OR PHYSICIAN TO OBTAIN RESULTS IF NOT GIVEN. THESE RESULTS ARE IMPORTANT FOR THE PATIENT'S OVERALL HEALTH, AND THE PATIENT SHOULD NOT OVERLOOK MAMMOGRAPHY RESULTS.

(G)  THAT UNDER FEDERAL AND STATE LAW, MAMMOGRAPHY X­RAY MACHINES ARE REQUIRED TO BE INSPECTED AND MAMMOGRAPHERS ARE REQUIRED TO BE APPROVED AS MEETING QUALIFICATION REQUIREMENTS. THE PATIENT SHOULD BE ABLE TO SEE OR REQUEST TO SEE A CURRENT INSPECTION DESIGNATION ON THE MACHINE INDICATING IT HAS PASSED REQUIRED FEDERAL AND STATE INSPECTIONS AND A LIST OF QUALIFIED MAMMOGRAPHERS OPERATING THE MACHINE POSTED ON OR NEAR THE MACHINE.

(H)  THAT ORIGINAL MAMMOGRAMS AND COPIES OF OTHER WRITTEN BREAST HEALTH RECORDS USUALLY ARE GIVEN FREE OF CHARGE TO THE PATIENT'S PHYSICIAN AND OTHER HEALTH CARE PROVIDERS. RECORDS REQUESTED BY THE PATIENT WILL USUALLY BE ASSESSED A FEE.

(I)  THAT THE PATIENT IS ENCOURAGED TO ASK THE MAMMOGRAPHER AND OTHER EMPLOYEES OF THE LICENSEE ANY QUESTIONS THE PATIENT MAY HAVE. THE PATIENT HAS THE RIGHT TO HAVE THE EXAMINATION FULLY EXPLAINED.

(J)  THAT THE PATIENT SHOULD RETAIN THIS INFORMATION FOR THE PATIENT'S OWN RECORDS FOR FUTURE REFERENCE.

(III)  THE INFORMATION REQUIRED TO BE PROVIDED UNDER SUBPARAGRAPH (II) OF THIS PARAGRAPH (a.5) MAY ALSO BE DISPLAYED BY THE LICENSEE AT ALL TIMES IN A PROMINENT PLACE ON THE PREMISES OF THE FACILITY ON A PRINTED CARD WITH A MINIMUM HEIGHT OF THREE FEET AND A WIDTH OF TWO AND ONE­HALF FEET WITH EACH LETTER TO BE A MINIMUM OF ONE­HALF INCH IN HEIGHT. IN THE ALTERNATIVE, A LICENSEE MAY DISPLAY A PRINTED CARD MEETING THE REQUIREMENTS OF THIS SUBPARAGRAPH (III) WITH LETTERS A MINIMUM OF TWO INCHES IN HEIGHT STATING: "PLEASE ASK US FOR A COPY OF MAMMOGRAPHY PATIENTS' RIGHTS". DISPLAYING THE INFORMATION OR PROVIDING A COPY THEREOF AS AUTHORIZED UNDER THIS SUBPARAGRAPH (III) SHALL NOT SUBSTITUTE FOR ACTUAL COMMUNICATION OF THE INFORMATION AS REQUIRED UNDER SUBPARAGRAPH (II) OF THIS PARAGRAPH (a.5).

(IV)  AFTER A MAMMOGRAPHY EXAM, EACH LICENSEE SHALL SEND A NOTICE TO THE PATIENT INDICATING THAT THE MAMMOGRAM HAS BEEN READ, ANY RESULTS INDICATED, AND INFORMING THE PATIENT THAT THE PATIENT SHOULD CONTACT THE PATIENT'S PHYSICIAN OR OBTAIN A PHYSICIAN FOR A FULL REVIEW OF THE RESULTS OF THE MAMMOGRAPHY EXAM.

(V)  NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ALL LICENSEES THAT CONDUCT MAMMOGRAPHY EXAMS SHALL MAINTAIN OR CAUSE ORIGINAL MAMMOGRAMS AND COPIES OF OTHER WRITTEN BREAST HEALTH RECORDS TO BE MAINTAINED FOR A PERIOD OF FIFTY YEARS AND AFTER TEN YEARS MAY REDUCE ANY SUCH RECORDS TO STORAGE IN ANY APPROPRIATE FORM FOR FUTURE REFERENCE.

(VI)  EACH FACILITY SHALL NOTIFY A PATIENT IN WRITING UPON CLOSURE OF THE FACILITY TO GIVE THE PATIENT THE RIGHT TO OBTAIN THE PATIENT'S ORIGINAL MAMMOGRAMS AND OTHER WRITTEN BREAST HEALTH RECORDS AND TO PROVIDE THE PATIENT WITH KNOWLEDGE OF WHERE SUCH RECORDS WILL BE STORED.

(VII)  NOTWITHSTANDING ANY OTHER PROVISION OF LAW, UPON THE SIGNATURE OR WRITTEN REQUEST OF A PATIENT OR LEGAL REPRESENTATIVE OF A PATIENT, ORIGINAL MAMMOGRAMS AND COPIES OF OTHER WRITTEN BREAST HEALTH RECORDS SHALL BE MADE AVAILABLE IN THE MANNER REQUESTED WITHIN FIVE BUSINESS DAYS IF SUCH RECORDS ARE MAINTAINED ON THE PREMISES OF THE LICENSEE OR WITHIN SEVEN BUSINESS DAYS IF SUCH RECORDS ARE MAINTAINED AT A LOCATION OTHER THAN THAT OF THE LICENSEE.

SECTION 2.  Effective date. This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety­day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.