HB 409 — An Act amending the act of October 24, 2018 (P.L.719, No.112), known as the Patient Test Result Information Act, further providing for definitions, for test results and for duties of Department of Health.

PRINTER'S NO.   381

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 409
                                                Session of
                                                  2025

     INTRODUCED BY KOSIEROWSKI, HILL-EVANS, VENKAT, DONAHUE, SANCHEZ,
        FREEMAN, NEILSON, RABB, WARREN, GIRAL, PROBST, STEELE, OTTEN,
        D. WILLIAMS, MAYES, KENYATTA, GUENST, MERSKI AND BOYD,
        JANUARY 29, 2025

     REFERRED TO COMMITTEE ON HEALTH, JANUARY 29, 2025


                                     AN ACT
 1   Amending the act of October 24, 2018 (P.L.719, No.112), entitled
 2      "An act providing for notification of patient test results to
 3      be sent directly to a patient or the patient's designee; and
 4      providing for duties of the Department of Health," further
 5      providing for definitions, for test results and for duties of
 6      Department of Health.
 7      The General Assembly of the Commonwealth of Pennsylvania
 8   hereby enacts as follows:
 9      Section 1.    Sections 2, 3 and 4 of the act of October 24,
10   2018 (P.L.719, No.112), known as the Patient Test Result
11   Information Act, are amended to read:
12   Section 2.   Definitions.
13      The following words and phrases when used in this act shall
14   have the meanings given to them in this section unless the
15   context clearly indicates otherwise:
16      "Chronic condition."     An illness that frequently recurs or
17   persists for a period in excess of three months.
18      "Diagnostic imaging service."     A medical imaging test
19   performed on a patient that is intended to diagnose the presence
 1   or absence of a disease, including, but not limited to, a
 2   malignancy. The term does not include a nonimaging study,
 3   including an electrocardiogram, standard electrocardiogram
 4   treadmill stress test, cardiac monitor, pulmonary function test
 5   or similar test.
 6      "Diagnostic radiograph."     A projectional radiograph that
 7   acquires an image or digital image with x-rays to produce a high
 8   contrast, two-dimensional image, otherwise known as an x-ray.
 9      "Health care practitioner."      As defined in section 103 of the
10   act of July 19, 1979 (P.L.130, No.48), known as the Health Care
11   Facilities Act.
12      ["Significant abnormality."      A finding by a diagnostic
13   imaging service of an abnormality or anomaly which would cause a
14   reasonably prudent person to seek additional or follow-up
15   medical care within three months.]
16   Section 3.      Test results.
17      [(a)    General rule.--When, in the judgment of the entity
18   performing a diagnostic imaging service, a significant
19   abnormality may exist, the entity performing the diagnostic
20   imaging service shall directly notify the patient or the
21   patient's designee by providing notice that the entity has
22   completed a review of the test performed on the patient and has
23   sent results to the health care practitioner who ordered the
24   diagnostic imaging service. The notice shall include all of the
25   following:
26             (1)   The name of the ordering health care practitioner.
27             (2)   The date the test was performed.
28             (3)   The date the results were sent to the ordering
29      health care practitioner.
30             (4)   The following statements:

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 1            You are receiving this notice as a result of a
 2            determination by your diagnostic imaging service that
 3            further discussions of your test results are warranted
 4            and would be beneficial to you.
 5            The complete results of your test or tests have been or
 6            will be sent to the health care practitioner that ordered
 7            the test or tests. It is recommended that you contact
 8            your health care practitioner to discuss your results as
 9            soon as possible.
10            (5)   The contact information necessary for the patient to
11      obtain a full report.]
12      (a.1)   Written notice at time of service.--The entity
13   performing the diagnostic imaging service shall provide written
14   notice to the patient or the patient's designee at the time of
15   the diagnostic imaging service. The notice shall include the
16   following statement:
17            Your test results will be made available to you once the
18            results are ready. You can access your test results
19            online through your electronic health record (EHR)
20            patient portal. If you do not have access to your online
21            patient portal, you can request that your test results be
22            delivered to you by mail. You may be charged a reasonable
23            fee for the administrative costs of mailing the test
24            results.
25      (b)   Exceptions.--The following shall be exempted from the
26   requirements of subsection [(a)] (a.1):
27            (1)   Routine obstetrical ultrasounds used to monitor the
28      development of a fetus.
29            (2)   Diagnostic imaging services performed on a patient
30      who is being treated on an inpatient basis [or] in an

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 1      emergency [room] department or observation unit of a
 2      hospital.
 3             (3)   Diagnostic radiographs.
 4             (4)   Diagnostic imaging services performed on a patient
 5      with a chronic condition if the patient has previously
 6      received notice of the chronic condition.
 7             (5)   Diagnostic imaging services test results provided to
 8      a patient or a patient's designee at the time of the test.
 9      [(c)    Time.--Except as provided under subsection (d)(2)(v),
10   no later than 20 days after the date the results were sent to
11   the ordering health care practitioner as provided under
12   subsection (a)(3), the entity performing the diagnostic imaging
13   service shall provide the patient or patient's designee with the
14   notice under subsection (a).
15      (d)    Method of transmittal.--
16             (1)   The notice under subsection (a) shall be provided in
17      a manner deemed acceptable by the patient or the patient's
18      designee.
19             (2)   A notice provided under subsection (a) shall be
20      presumed to comply with this act if:
21                   (i)    mailed in a properly addressed and stamped
22             letter through the United States Postal Service;
23                   (ii)    sent electronically by e-mail;
24                   (iii)    sent by automatic alert from an electronic
25             medical record system that the notice under subsection
26             (a) has been posted to the patient's electronic medical
27             record that is presently viewable;
28                   (iv)    sent by facsimile; or
29                   (v)    provided directly to the patient at the time of
30             service, so long as the patient acknowledges the receipt

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 1            of the results and signs the patient's medical record
 2            accordingly.
 3      (e)   Construction.--
 4            (1)   Nothing in this act shall be construed to require an
 5      entity to provide a patient or patient's designee the notice
 6      under subsection (a) if the results are provided to the
 7      patient or patient's designee by the health care practitioner
 8      at the time of the test.
 9            (2)   Nothing in this act shall be construed to prohibit
10      an entity from providing a patient with:
11                  (i)    the summary of a diagnostic imaging service
12            report, otherwise known as an impression or conclusion;
13            or
14                  (ii)    the complete results of the diagnostic imaging
15            service provided to the ordering health care
16            practitioner.]
17      (f)   Disclosure of test results.--Except as provided under
18   subsection (g), the following test results and any other related
19   results shall not be disclosed to a patient as part of the
20   patient's electronic health record, and in the case of a
21   clinical laboratory test result or pathology report shall not be
22   disclosed by the person or entity that administers and controls
23   the patient's electronic health record, until one full business
24   day has elapsed after the results are finalized, unless the
25   ordering health care practitioner directs the release of the
26   results before the end of that period:
27            (1)   Pathology reports or radiology reports that have a
28      reasonable likelihood of showing a finding of malignancy.
29            (2)   Tests that could reveal genetic markers.
30      (g)   Exception.--The prohibition under subsection (f) shall

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 1   not apply if the test results are provided to a patient or the
 2   patient's designee at the time of the test.
 3      (h)    Policies and procedures.--A health care facility,
 4   clinical laboratory or an entity performing a diagnostic imaging
 5   service shall develop and implement policies and procedures for
 6   providing patient test results in accordance with this section.
 7      (i)    Face-to-face requirements.--Nothing in this act shall be
 8   construed to repeal any law of this Commonwealth that requires a
 9   health care practitioner to conduct a face-to-face meeting or
10   counseling session with a patient prior to a test result being
11   disclosed to the patient or being posted in the patient's
12   electronic health record.
13   Section 4.      Duties of Department of Health.
14      (a)    Reviews and complaints.--The Department of Health
15   shall[:
16             (1)   in accordance with law, conduct compliance reviews
17      as part of the inspection performed by the department or an
18      accrediting organization and investigate complaints filed
19      relating to the requirements of section 3; and
20             (2)   establish a complaint procedure, which shall be made
21      available on the department's publicly accessible Internet
22      website.] conduct compliance reviews on health care
23      facilities and clinical laboratories licensed or permitted by
24      the department.
25      (b)    Limitation.--The Department of Health shall limit the
26   scope of the compliance reviews under subsection (a) to
27   determining whether policies and procedures have been developed
28   and implemented in accordance with section 3(h).
29      Section 2.      This act shall take effect in 60 days.



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