C.R.S. § 25-1-802: Patient records in custody of individual health-care providers - definitions.

(1) (a) Every patient record in the custody of a podiatrist, chiropractor, dentist, doctor of medicine, doctor of osteopathy, nurse, certified midwife, optometrist, occupational therapist, audiologist, acupuncturist, direct-entry midwife, or physical therapist required to be licensed under title 12; a naturopathic doctor required to be registered pursuant to article 250 of title 12; or a person practicing psychotherapy under article 245 of title 12, except records withheld in accordance with 45 CFR 164.524 (a), must be available to the patient or the patient's personal representative upon submission of a valid authorization for inspection of records, dated and signed by the patient, at reasonable times and upon reasonable notice. A summary of records pertaining to a patient's mental health problems may, upon written request accompanied by a 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 copy of the records, including radiographic studies, must be made available 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, or to a third person who requests the medical records upon submission of a HIPAA-compliant authorization, a valid subpoena, or a court order, and payment of 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 provider must provide 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) If a licensed health-care professional determines that a copy of a radiographic study, including an X ray, mammogram, CT scan, MRI, or other film, is not sufficient for diagnostic or other treatment purposes, the podiatrist, chiropractor, dentist, doctor of medicine, doctor of osteopathy, nurse, certified midwife, optometrist, audiologist, acupuncturist, direct-entry midwife, or physical therapist required to be licensed under title 12, or, subject to the provisions of section 25-1-801 (1)(a) and subsection (1)(a) of this section, the person practicing psychotherapy under article 245 of title 12, shall make the original of any radiographic study available to the patient, the patient's personal representative, a person authorized by the patient, or another health-care professional or facility as specifically directed by the patient, personal representative, authorized person, or health-care professional or facility pursuant to a HIPAA-compliant authorization and upon the payment of the reasonable fees for the radiographic study. If a practitioner releases an original radiographic study pursuant to this subsection (1)(b)(II), the practitioner is not responsible for any loss, damage, or other consequences as a result of the release. Any original radiographic study made available pursuant to this subsection (1)(b)(II) must be returned upon request to the lending practitioner within thirty days.

(III) The total sum of fees that a health-care provider 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) Subsection (1)(b)(III) of this section does not apply if a health-care provider 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.

(d) (I) The health-care provider 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 provider is unable to provide access to medical records within thirty days, as required by subsection (1)(d)(II) of this section, the health-care provider may extend the time frame for providing records by an additional thirty days, and the health-care provider 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)(d)(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)(d)(IV) must be delivered in the same format in which it was received. As used in this subsection (1)(d)(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.

(e) Nothing in subsection (1)(b), (1)(c), or (1)(d) of this section requires a health-care provider 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.

(2) Nothing in this section requires a person responsible for the diagnosis or treatment of sexually transmitted infections, substance use disorders, 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.

(3) As used in this section, "patient record" does not include a doctor's office notes.

(4) All requests by a patient or the patient's personal representative for inspection of his or her 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 health-care provider or his or her designated representative. The patient or the patient's personal representative shall acknowledge the inspection by dating and signing the record file. A health-care provider shall not charge a fee for the inspection of medical records.

(5) 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 a health-care provider.