(a)  Upon occurrence of an action or decision of any third party that adversely affects a patient and that is based in whole or in part upon that patient’s confidential healthcare information (including, but not limited to, the following actions or decisions: (1) Denial of an application for an insurance policy; (2) Issuance of an insurance policy with other than standard and uniform restrictions; (3) Rejection, in whole or in part, of any claim for insurance benefits; (4) Denial of an employment application or termination of employment when that denial or termination is for health reasons) and upon the written request of that patient or his or her authorized representative (or, if that patient is deceased, then his or her heir or beneficiary or their authorized representative, or his or her estate), a third party shall transfer copies of all of that patient’s confidential healthcare information in its possession to a physician designated in that written request. Prior to making this transfer, a third party may require payment of its actual cost of retrieval, duplication, and forwarding of that information.

Terms Used In Rhode Island General Laws 5-37.3-5

  • Authorized representative: means :

    (i)  A person empowered by the patient/client to assert or to waive the confidentiality, or to disclose or consent to the disclosure of confidential information, as established by this chapter. See Rhode Island General Laws 5-37.3-3

  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Confidential healthcare information: means all information relating to a patient's healthcare history, diagnosis, condition, treatment, or evaluation obtained from a healthcare provider who has treated the patient. See Rhode Island General Laws 5-37.3-3
  • Healthcare provider: means any person licensed by this state to provide or lawfully providing healthcare services, including, but not limited to, a physician, hospital, intermediate-care facility or other healthcare facility, dentist, nurse, optometrist, podiatrist, physical therapist, psychiatric social worker, pharmacist, or psychologist, and any officer, employee, or agent of that provider acting in the course and scope of his or her employment or agency related to or supportive of health services. See Rhode Island General Laws 5-37.3-3
  • Patient: means a person who receives healthcare services from a healthcare provider. See Rhode Island General Laws 5-37.3-3
  • person: may be construed to extend to and include co-partnerships and bodies corporate and politic. See Rhode Island General Laws 43-3-6
  • Physician: means a person registered or licensed to practice allopathic or osteopathic medicine in this state under Rhode Island general laws. See Rhode Island General Laws 5-37.3-3
  • Third party: means a person other than the patient to whom the confidential healthcare information relates and other than a healthcare provider. See Rhode Island General Laws 5-37.3-3

(b)  A physician receiving confidential healthcare information pursuant to subsection (a) may review, interpret, and disclose any or all of that information to the person at whose request that information was transferred, as that physician deems in his or her professional judgment to be in the best interests of the patient to whom that information relates.

(c)  After reviewing his or her confidential healthcare information pursuant to this section, a patient or his or her authorized representative may request the third party to amend or expunge any part he or she believes is in error, or request the addition of any recent relevant information. Upon receiving such a request, the third party shall notify the healthcare provider who initially forwarded that information to the third party, and when that healthcare provider concurs with that request, the third party shall return that information to that healthcare provider for modification. Prior to making that return, a third party may require payment of its actual cost of notice, duplication, and return of that information. Except upon court order, the third party shall not itself modify that information. A patient, after requesting and reviewing his or her confidential healthcare information, has the right, in any case, to place into the file, at his or her own cost, a statement of reasonable length of his or her view as to the correctness or relevance of existing information or as to the addition of new information. That statement or copies of the statement shall at all times accompany that part of the information in contention.

(d)  A person or his or her authorized representative has the right, when there is an unreasonable refusal to change the records as provided in this section, to apply to the district court to amend or expunge any part of his or her confidential healthcare information in a third party’s possession that he or she believes to be erroneous.

History of Section.
P.L. 1978, ch. 297, § 1; P.L. 1979, ch. 221, § 1.