<?xml version='1.0' encoding='utf-8'?>
<subtitle article="ghg" title_number="4" subtitle_number="4" title_name="Statistics and Records" subtitle_name="Personal Medical Records">
  <section article="ghg" article_name="Health - General" number="4-401" title_number="4" title_name="Statistics and Records" subtitle_number="4" subtitle_name="Personal Medical Records">
    <level label="a">
      <text>In this section, “provider” means:</text>
      <level label="1">
        <text>An acupuncturist;</text>
      </level>
      <level label="2">
        <text>A chiropractor;</text>
      </level>
      <level label="3">
        <text>A dentist;</text>
      </level>
      <level label="4">
        <text>A nurse;</text>
      </level>
      <level label="5">
        <text>An optometrist;</text>
      </level>
      <level label="6">
        <text>A physician;</text>
      </level>
      <level label="7">
        <text>A podiatrist; or</text>
      </level>
      <level label="8">
        <text>A person who is employed by or under contract with a hospital, nursing institution, or other health care provider.</text>
      </level>
    </level>
    <level label="b">
      <text>A provider may not knowingly or willfully destroy, damage, alter, obliterate, or otherwise obscure a medical record, hospital report, laboratory report, X-ray report, or other information about a patient in an effort to conceal the information from use as evidence in an administrative, civil, or criminal proceeding.</text>
    </level>
    <level label="c">
      <text>A provider who violates any provision of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 1 year or both.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="4-402" title_number="4" title_name="Statistics and Records" subtitle_number="4" subtitle_name="Personal Medical Records">
    <text>On admission of a patient, a hospital, related institution, or mental health outpatient clinic shall record on the medical record whether the patient is a veteran of the uniformed services.</text>
  </section>
  <section article="ghg" article_name="Health - General" number="4-403" title_number="4" title_name="Statistics and Records" subtitle_number="4" subtitle_name="Personal Medical Records">
    <level label="a">
      <level label="1">
        <text>In this section, a “health care provider” means:</text>
        <level label="i">
          <text>An acupuncturist;</text>
        </level>
        <level label="ii">
          <text>An audiologist;</text>
        </level>
        <level label="iii">
          <text>A chiropractor;</text>
        </level>
        <level label="iv">
          <text>A dietitian;</text>
        </level>
        <level label="v">
          <text>A dentist;</text>
        </level>
        <level label="vi">
          <text>An electrologist;</text>
        </level>
        <level label="vii">
          <text>A health care facility that is:</text>
          <level label="1">
            <text>A freestanding ambulatory care facility as defined under § 19–3B–01 of this article;</text>
          </level>
          <level label="2">
            <text>A freestanding medical facility as defined under § 19–3A–01 of this article;</text>
          </level>
          <level label="3">
            <text>A health care facility as defined under § 10–101 of this article;</text>
          </level>
          <level label="4">
            <text>A health maintenance organization as defined under § 19–701 of this article;</text>
          </level>
          <level label="5">
            <text>A hospital as defined under § 19–301 of this article;</text>
          </level>
          <level label="6">
            <text>A limited service hospital as defined under § 19–301 of this article;</text>
          </level>
          <level label="7">
            <text>A related institution as defined in § 19–301 of this article; and</text>
          </level>
          <level label="8">
            <text>A residential treatment center as defined under § 19–301 of this article;</text>
          </level>
        </level>
        <level label="viii">
          <text>A massage therapist;</text>
        </level>
        <level label="ix">
          <text>A mortician;</text>
        </level>
        <level label="x">
          <text>A nurse;</text>
        </level>
        <level label="xi">
          <text>A nutritionist;</text>
        </level>
        <level label="xii">
          <text>An occupational therapist;</text>
        </level>
        <level label="xiii">
          <text>An optometrist;</text>
        </level>
        <level label="xiv">
          <text>A physical therapist;</text>
        </level>
        <level label="xv">
          <text>A physician;</text>
        </level>
        <level label="xvi">
          <text>A podiatrist;</text>
        </level>
        <level label="xvii">
          <text>A professional counselor;</text>
        </level>
        <level label="xviii">
          <text>A psychologist;</text>
        </level>
        <level label="xix">
          <text>A social worker;</text>
        </level>
        <level label="xx">
          <text>A speech–language pathologist; and</text>
        </level>
        <level label="xxi">
          <text>A pharmacist.</text>
        </level>
      </level>
      <level label="2">
        <text>“Health care provider” includes an agent, employee, officer, or director of any entity listed under paragraph (1) of this subsection.</text>
      </level>
    </level>
    <level label="b">
      <text>Except for a minor patient, unless a patient is notified, a health care provider may not destroy a medical record or laboratory or X–ray report about a patient for 7 years after the record or report is made.</text>
    </level>
    <level label="c">
      <text>In the case of a minor patient, a medical record or laboratory or X–ray report about a minor patient may not be destroyed until the patient attains the age of majority plus 7 years, unless:</text>
      <level label="1">
        <text>The parent or guardian of the minor patient is notified; or</text>
      </level>
      <level label="2">
        <text>If the medical care documented in the record was provided under § 20–102(c) or § 20–103(c) of this article, the minor patient is notified.</text>
      </level>
    </level>
    <level label="d">
      <level label="1">
        <text>The notice under subsection (b) or (c) of this section shall:</text>
        <level label="i">
          <text>Be made by:</text>
          <level label="1">
            <text>First–class mail to the last known address of the patient; or</text>
          </level>
          <level label="2">
            <text>Subject to paragraph (2) of this subsection, e–mail to the last known e–mail address of:</text>
          </level>
          <level label="A">
            <text>The patient; or</text>
          </level>
          <level label="B">
            <text>If the patient is a minor and the medical care documented in the record was not provided under § 20–102(c) or § 20–103(c) of this article, the parent or guardian of the patient;</text>
          </level>
        </level>
        <level label="ii">
          <text>Include the date on which the record of the patient shall be destroyed; and</text>
        </level>
        <level label="iii">
          <text>Include a statement that the record or synopsis of the record, if wanted, must be retrieved at a designated location.</text>
        </level>
      </level>
      <level label="2">
        <text>If notice is provided under paragraph (1)(i)2 of this subsection and no response or delivery receipt is obtained from the e–mail address to which notice was provided, the health care provider shall provide notice under paragraph (1)(i)1 of this subsection at least 10 days before the date on which the record is to be destroyed.</text>
      </level>
    </level>
    <level label="e">
      <text>The health care provider shall make the record or report available for retrieval:</text>
      <level label="1">
        <text>By the patient or the parent or guardian of the minor patient within 60 days before the date of destruction; and</text>
      </level>
      <level label="2">
        <text>At the location designated in the notice of destruction of the record or report.</text>
      </level>
    </level>
    <level label="f">
      <text>After the death, retirement, surrender of the license, or discontinuance of the practice or business of a health care provider, the health care provider, the administrator of the estate, or a designee who agrees to provide for the maintenance of the medical records of the practice or business and who states, in writing to the appropriate health occupation board within a reasonable time, that the records will be maintained in compliance with this section, shall forward the notice required in this section before the destruction or transfer of medical records to:</text>
      <level label="1">
        <text>The patient; or</text>
      </level>
      <level label="2">
        <text>For a minor patient, the parent or guardian of the minor patient unless the medical care documented in the record was provided under § 20–102(c) or § 20–103(c) of this article.</text>
      </level>
    </level>
    <level label="g">
      <level label="1">
        <text>After consulting with the Maryland Hospital Association, the Maryland State Medical Society, and other interested parties, including consumers and payors, the Secretary shall adopt regulations governing the destruction of medical records.</text>
      </level>
      <level label="2">
        <text>The regulations adopted under this subsection shall:</text>
        <level label="i">
          <text>Specify the manner in which a health care provider shall maintain and store medical records to:</text>
          <level label="1">
            <text>Ensure confidentiality; and</text>
          </level>
          <level label="2">
            <text>Provide limited access to the medical records until the records are destroyed; and</text>
          </level>
        </level>
        <level label="ii">
          <text>Ensure that the method of destruction renders the medical records unreadable.</text>
        </level>
      </level>
      <level label="3">
        <text>The regulations adopted under this subsection may not:</text>
        <level label="i">
          <text>Require or encourage the destruction of medical records; or</text>
        </level>
        <level label="ii">
          <text>Be inconsistent with any provision of law applicable to the maintenance or destruction of medical records.</text>
        </level>
      </level>
    </level>
    <level label="h">
      <level label="1">
        <text>A health care provider or any other person who knowingly violates any provision of this subtitle is liable for actual damages.</text>
      </level>
      <level label="2">
        <level label="i">
          <text>In addition to any other penalties provided under this article, a health care facility that knowingly violates this section is subject to an administrative fine not exceeding $10,000 for all violations cited in a single day.</text>
        </level>
        <level label="ii">
          <level label="1">
            <text>In addition to any other penalties provided under this article, an individual who knowingly violates this section is subject to the fines provided in subsubparagraph 2 of this subparagraph if the individual is:</text>
          </level>
          <level label="A">
            <text>A health care provider, as defined under subsection (a)(1)(i) through (vi) or (viii) through (xx) of this section; or</text>
          </level>
          <level label="B">
            <text>An agent, employee, officer, or director of a health care provider.</text>
          </level>
          <level label="2">
            <text>The administrative fines applicable to an individual covered under subsubparagraph 1 of this subparagraph shall be assessed as follows:</text>
          </level>
          <level label="A">
            <text>The first fine assessed or first set of fines assessed concurrently for all violations cited in a single day may not exceed $1,000;</text>
          </level>
          <level label="B">
            <text>The second fine assessed or second set of fines assessed concurrently for all violations cited in a single day may not exceed $2,500; and</text>
          </level>
          <level label="C">
            <text>The third or subsequent fine assessed or third or subsequent set of fines assessed concurrently for all violations cited in a single day may not exceed $5,000.</text>
          </level>
        </level>
      </level>
    </level>
  </section>
</subtitle>