C.R.S. § 25-1-801: Patient records in custody of health-care facility - definitions.

(1) (a) Every patient record in the custody of a health facility licensed or certified pursuant to section 25-1.5-103 (1) or article 3 of this title, or both, or any entity regulated under title 10, C.R.S., providing health-care services, as defined in section 10-16-102 (33), C.R.S., directly or indirectly through a managed care plan, as defined in section 10-16-102 (43), C.R.S., or otherwise, shall be available for inspection to the patient or the patient's personal representative through the attending health-care provider or the provider's designated representative at reasonable times and upon reasonable notice, except records withheld in accordance with 45 CFR 164.524 (a). A summary of records pertaining to a patient's mental health problems may, upon written request and signed and dated authorization, be made available to the patient or the patient's personal representative following termination of the treatment program.

(b) (I) (A) A health facility licensed or certified pursuant to section 25-1.5-103 (1) or article 3 of this title 25 or an entity regulated under title 10, providing health-care services, as defined in section 10-16-102, directly or indirectly through a managed care plan, as defined in section 10-16-102 or otherwise, must provide copies of a patient's medical records, including X rays, to the patient or the patient's personal representative upon request and payment of the fee a covered entity may impose in accordance with the "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended, and any rules promulgated pursuant to the act, or to a third person who requests the records upon submission of a HIPAA-compliant authorization, valid subpoena, or court order and upon the payment of the reasonable fees. For a request not exceeding six hundred sixty-four pages, the fees charged to a third person shall not exceed the reasonable fees.

(B) The health-care facility must deliver the medical records in electronic format if the person requests electronic format, the original medical records are stored in electronic format, and the medical records are readily producible in electronic format.

(II) In the event that a licensed health-care professional determines that a copy of any X ray, mammogram, CT SCAN, MRI, or other film is not sufficient for diagnostic or other treatment purposes, the health facility or entity shall make the original of any such film available to the patient or another health-care professional or facility as specifically directed by the patient pursuant to a written authorization-request for films and upon the payment of the reasonable costs for such film. If a health facility releases an original film pursuant to this subparagraph (II), it shall not be responsible for any loss, damage, or other consequences as a result of such release. Any original X ray, mammogram, CT SCAN, MRI, or other film made available pursuant to this subparagraph (II) shall be returned upon request to the lending facility within thirty days.

(III) The total sum of fees that a health-care facility may charge and collect for a record request made by an attorney who represents the patient or the attorney of the patient's personal representative, pursuant to a submission of an authorization in compliance with the federal "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191; a valid subpoena; or a valid court order, if the requested record exceeds six hundred sixty-four pages, must not exceed four hundred dollars.

(IV) On January 1, 2028, and every January 1 every even-numbered year thereafter, the four-hundred-dollar limit set forth in subsection (1)(b)(III) of this section must be adjusted for inflation. The adjusted limit must be rounded to the nearest whole dollar. The secretary of state shall publish the adjusted limit on its website no later than October 1 of every year the limit is subject to an adjustment. The adjusted limit must not be decreased below four hundred dollars. As used in this subsection (1)(b)(IV), "inflation" means the annual percentage change in the United States department of labor's bureau of labor statistics consumer price index for Denver-Aurora-Lakewood for all items paid by all urban consumers, or its successor index.

(c) The hospital or related facility or institution shall post in conspicuous public places on the premises a statement of the requirements set forth in paragraphs (a) and (b) of this subsection (1) and shall make available a copy of said statement to each patient upon admission.

(d) Nothing in this section requires a person responsible for the diagnosis or treatment of sexually transmitted infections, a substance use disorder, or the use of drugs in the case of minors pursuant to sections 13-22-102 and 25-4-409 to release patient records of such diagnosis or treatment to a parent, guardian, or person other than the minor or his or her designated representative.

(e) Subsection (1)(b)(III) of this section does not apply if a health-care facility is required to segregate, withhold, or redact protected health information from the requested record to comply with applicable law or within the scope or limitations detailed in subsection (1)(b)(III) of this section.

(f) (I) The health-care facility shall deliver the medical records in electronic format, upon request and payment of the fees detailed in this subsection (1), if:

(A) The individual or entity requests electronic format;

(B) The original medical records are stored in electronic format; and

(C) The medical records are readily producible in electronic format.

(II) An invoice for all records provided in response to a request for medical records must be provided to the requestor within thirty days of receiving a valid request, and the records must be provided upon payment of the invoice.

(III) If a health-care facility is unable to provide access to medical records within thirty days, as required by subsection (1)(f)(II) of this section, the health-care facility may extend the time frame for providing records by an additional thirty days, and the health-care facility must notify the requestor in writing of the extension within the initial thirty-day period.

(IV) A record not provided within thirty days or without written notification of a thirty-day extension must be provided to the requestor at no cost, absent an independent intervening force majeure that renders the requested records inaccessible, irretrievable, or undeliverable within the required time frame. If a health-care facility is unable to comply with a request for medical records within the time required pursuant to this subsection (1)(f)(IV) due to a force majeure event, the facility shall provide written notice to the requestor. The notice must be given as soon as reasonably practicable, but not later than five business days after the facility becomes aware of the force majeure event. For existing requests, or not later than five business days after receipt of a new request, the thirty-day time period to respond to a request for records commences upon resolution of the force majeure event. The entity shall notify the requestor within five business days after the force majeure event has been resolved. All notices required pursuant to this subsection (1)(f)(IV) must be delivered in the same format in which it was received. As used in this subsection (1)(f)(IV), "force majeure" means a factor outside the parties' control that means performance of the task is impossible or impracticable as a result of an event or effect that the parties could not have anticipated or controlled.

(g) Nothing in subsection (1)(b), (1)(e), or (1)(f) of this section requires a health-care facility to disclose information that is privileged, confidential, or protected from discovery or admission under state or federal law, including pursuant to sections 12-30-204 and 25-3-109 or 42 U.S.C. sec. 1320c-1.

(2) All requests by a patient or the patient's personal representative for inspection of the patient's medical records made under this section shall be noted with the time and date of the request and the time and date of inspection noted by the attending health-care provider or his or her designated representative. The patient or personal representative shall acknowledge the fact of the inspection by dating and signing the record file. A health-care facility shall not charge a fee for the inspection of medical records.

(3) Nothing in this section shall apply to any nursing institution conducted by or for the adherents of any well-recognized church or religious denomination for the purpose of providing facilities for the care and treatment of the sick who depend exclusively upon spiritual means through prayer for healing and the practice of the religion of such church or denomination.

(4) For the purposes of this section, medical information transmitted during the delivery of health care via telemedicine, as defined in section 12-240-104 (10), is part of the patient's medical record maintained by the health-care facility.

(5) Repealed.