This bill adds a new section to chapter 70.02 RCW and amends multiple existing sections, including RCW 70.02.010 (definitions) and RCW 70.02.260 (reenacted and amended), to change how health care information is defined, requested, charged for, retained, and disclosed. It creates a new rule allowing a health care provider or facility to charge a reasonable fee and to withhold honoring an authorization until the fee is paid, subject to enumerated exceptions. The bill also establishes a specific $50 cap on fees that may be charged when a patient's health care information is stored electronically at the time of request and delivered in electronic format to the patient, the patient’s representative (including those authorized under RCW 70.02.130), a licensed attorney representing the patient, or a community‑ or system‑based advocate designated by the patient; that $50 limit also applies to third parties acting on behalf of providers (agents, vendors, business associates). Separate statutory “reasonable fee” limits for paper or other record duplicating and clerical searches remain specified (not to exceed $0.65 per page for the first 30 pages, $0.50 per page thereafter, and a clerical search/handling fee up to $15), with biennial CPI adjustments by the secretary of health, and a statutory exception allowing a provider to charge usual office visit rates if the provider personally performs required statutory editing. The bill also makes procedural and substantive changes to patient authorization and disclosure rules: it revises the content required for a valid written authorization, requires retention of authorizations and revocations, sets response deadlines to written requests for recorded health care information (a provider must act no later than 15 working days or, if delayed for unusual circumstances, provide a written reason and make the information available no later than 21 working days), and provides expiration rules for certain authorizations (for example, employer/financial‑institution disclosures expire after one year; authorizations for patients under Department of Corrections supervision expire at the end of supervision unless treatment requires continuing exchange). The bill revises rules for release of mental health information (including specifying categories of mental health records that must or may be released to specified authorities and the conditions for emergency disclosures), clarifies confidentiality and limited disclosure of sexually transmitted disease information in correctional and detention settings, directs the relevant authority to develop standard request and response forms for mental health service information limited to the minimum necessary consistent with HIPAA, and sets timing for enactment and expiration of certain sections (section 2 expires June 30, 2027; section 3 takes effect June 30, 2027). Some portions of the text and definitions are incomplete in the materials provided. The precise content of cross‑referenced exceptions (for example RCW 70.02.370 and specific federal HIPAA provisions), the full list of amended RCW subsections, and the identity of the referenced “authority” for form development are not contained in the extracted facts, so those details are uncertain from the provided text.

If enacted, the law will limit what health care providers, their vendors, and facilities can charge patients, patient representatives, attorneys, or patient-designated advocates for electronic copies of records to a maximum of $50 and caps paper copy/search charges at specified per-page and clerical rates that are adjusted every two years for inflation. Practically, providers and third-party agents will need to change billing and release procedures, may absorb some copying and retrieval costs for electronic requests, and must meet faster timelines for responding to record requests (generally within 15 working days) or provide a written delay with a firm availability date, while retaining the right to withhold records until fees are paid. The bill also increases routine disclosure duties for mental health agencies and correctional and jail health administrators by specifying who may receive commitment, discharge, and certain treatment information for public safety, legal, or care-coordination purposes, requires the state authority to create standard request and response forms that limit disclosures to the minimum necessary, and preserves strict confidentiality and penalties for improper disclosure of sexually transmitted disease information. Key implementation details are unclear from the available text—particularly how the new fee limits interact with federal HIPAA rules and the referenced RCW 70.02.370 exceptions—so agencies will likely need guidance to reconcile state caps, federal privacy obligations, and the other amended sections not included here.