N.J. Admin. Code § 13:42-8.3

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:42-8.3 - Access to copy of client record

(a) For purposes of this section, "authorized representative" means, but is not necessarily limited to, a person designated by the client or a court to exercise rights under this section. An authorized representative may be client's attorney or an agent of a third party payor with whom the client has a contract which provides that the third party payor be given access to records to assess a claim for monetary damages or reimbursement.

(b) A licensee may require the record request to be in writing. No later than 30 days from receipt of a request from a client or duly authorized representative, the licensee shall provide a copy of the client record and/or billing records, including reports relating to the client. Limitations on this requirement are set forth in (e) below and 13:42-8.6(b) and in N.J.A.C. 13:42-11.

(c) The licensee may elect to provide a summary of the record, as long as the summary adequately reflects the client's history and treatment, unless otherwise required by law.

(d) A licensee may charge a reasonable fee for the preparation of a summary and reproduction of records, which shall be no greater than an amount reasonably calculated to recoup the costs of transcription or copying.

(e) A licensee may withhold information contained in the client record from a client or the client's guardian if, in the reasonable exercise of his or her professional judgment, the licensee believes release of such information would adversely affect the client's health or welfare.

1. That record or the summary, with an accompanying explanation of the reasons for the original refusal, shall nevertheless be provided upon request of and directly to:

i. The client's attorney;

ii. Another licensed health care professional; or

iii. The client's health insurance carrier (except as may be limited by N.J.A.C. 13:42-11).

(f) Records maintained as confidential pursuant to 13:42-8.1(c) shall be released:

1. If requested or subpoenaed by the Board or the Office of the Attorney General in the course of any Board investigation;

2. Pursuant to an order of a court of competent jurisdiction;

3. Except as limited by 13:42-8.4, upon a waiver of the client or an authorized representative to release the client record to any person or entity, including to the Violent Crimes Compensation Board; or

4. In order to contribute appropriate client information to the client record maintained by a hospital, nursing home or similar licensed institution which is providing or has been asked to provide treatment to the client.

(g) The licensee's obligation hereunder to release information shall include the obligation to complete forms or reports required for third party reimbursement of client treatment expenses. The licensee may charge reasonable fees for completion of reports other than health insurance claim forms, for which no fee may be charged pursuant to 45:1-12.

(h) When a request is made for release of already completed reports to enable the client to receive ongoing care by another practitioner, the licensee shall not require prior payment for the professional services to which such reports relate as a condition for making such reports available. A licensee may, however, require advance payment for a report prepared for services as an expert witness.

N.J. Admin. Code § 13:42-8.3

Amended by R.2000 d.476, effective 12/4/2000.
See: 31 N.J.R. 3218(a), 32 N.J.R. 4260(a).
In (g)1, inserted "Board" preceding "investigation".
Amended by R.2004 d.140, effective 4/5/2004.
See: 35 N.J.R. 5039(a), 36 N.J.R. 1815(a).
In (a), deleted the former third sentence; in (b), amended the N.J.A.C. references; deleted former (e) and recodified former (f) as new (e) and amended the N.J.A.C. reference in 1iii; recodified former (g) through (i) as (f) through (h), and deleted "or for use in judicial proceedings" following "another practitioner" in new (h).