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SB-0467, As Passed Senate, April 27, 2006

SUBSTITUTE FOR

SENATE BILL NO. 467

A bill to amend 1978 PA 368, entitled

"Public health code,"

by amending sections 16221, 17020, and 17520 (MCL 333.16221,

333.17020, and 333.17520), section 16221 as amended by 2004 PA

214 and sections 17020 and 17520 as added by 2000 PA 29, and by

adding sections 17020a, 17520a, and 20170a.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1 Sec. 16221. The department may investigate activities

2 related to the practice of a health profession by a licensee, a

3 registrant, or an applicant for licensure or registration. The

4 department may hold hearings, administer oaths, and order

5 relevant testimony to be taken and shall report its findings to

6 the appropriate disciplinary subcommittee. The disciplinary

1 subcommittee shall proceed under section 16226 if it finds that 1

2 or more of the following grounds exist:

3 (a) A violation of general duty, consisting of negligence or

4 failure to exercise due care, including negligent delegation to

5 or supervision of employees or other individuals, whether or not

6 injury results, or any conduct, practice, or condition that

7 impairs, or may impair, the ability to safely and skillfully

8 practice the health profession.

9 (b) Personal disqualifications, consisting of 1 or more of

10 the following:

11 (i) Incompetence.

12 (ii) Subject to sections 16165 to 16170a, substance abuse as

13 defined in section 6107.

14 (iii) Mental or physical inability reasonably related to and

15 adversely affecting the licensee's ability to practice in a safe

16 and competent manner.

17 (iv) Declaration of mental incompetence by a court of

18 competent jurisdiction.

19 (v) Conviction of a misdemeanor punishable by imprisonment

20 for a maximum term of 2 years; a misdemeanor involving the

21 illegal delivery, possession, or use of a controlled substance;

22 or a felony. A certified copy of the court record is conclusive

23 evidence of the conviction.

24 (vi) Lack of good moral character.

25 (vii) Conviction of a criminal offense under sections 520b to

26 520g of the Michigan penal code, 1931 PA 328, MCL 750.520b to

27 750.520g. A certified copy of the court record is conclusive

1 evidence of the conviction.

2 (viii) Conviction of a violation of section 492a of the

3 Michigan penal code, 1931 PA 328, MCL 750.492a. A certified copy

4 of the court record is conclusive evidence of the conviction.

5 (ix) Conviction of a misdemeanor or felony involving fraud in

6 obtaining or attempting to obtain fees related to the practice of

7 a health profession. A certified copy of the court record is

8 conclusive evidence of the conviction.

9 (x) Final adverse administrative action by a licensure,

10 registration, disciplinary, or certification board involving the

11 holder of, or an applicant for, a license or registration

12 regulated by another state or a territory of the United States,

13 by the United States military, by the federal government, or by

14 another country. A certified copy of the record of the board is

15 conclusive evidence of the final action.

16 (xi) Conviction of a misdemeanor that is reasonably related

17 to or that adversely affects the licensee's ability to practice

18 in a safe and competent manner. A certified copy of the court

19 record is conclusive evidence of the conviction.

20 (xii) Conviction of a violation of section 430 of the

21 Michigan penal code, 1931 PA 328, MCL 750.430. A certified copy

22 of the court record is conclusive evidence of the conviction.

23 (c) Prohibited acts, consisting of 1 or more of the

24 following:

25 (i) Fraud or deceit in obtaining or renewing a license or

26 registration.

27 (ii) Permitting the license or registration to be used by an

1 unauthorized person.

2 (iii) Practice outside the scope of a license.

3 (iv) Obtaining, possessing, or attempting to obtain or

4 possess a controlled substance as defined in section 7104 or a

5 drug as defined in section 7105 without lawful authority; or

6 selling, prescribing, giving away, or administering drugs for

7 other than lawful diagnostic or therapeutic purposes.

8 (d) Unethical business practices, consisting of 1 or more of

9 the following:

10 (i) False or misleading advertising.

11 (ii) Dividing fees for referral of patients or accepting

12 kickbacks on medical or surgical services, appliances, or

13 medications purchased by or in behalf of patients.

14 (iii) Fraud or deceit in obtaining or attempting to obtain

15 third party reimbursement.

16 (e) Unprofessional conduct, consisting of 1 or more of the

17 following:

18 (i) Misrepresentation to a consumer or patient or in

19 obtaining or attempting to obtain third party reimbursement in

20 the course of professional practice.

21 (ii) Betrayal of a professional confidence.

22 (iii) Promotion for personal gain of an unnecessary drug,

23 device, treatment, procedure, or service.

24 (iv) Either of the following:

25 (A) A requirement by a licensee other than a physician that

26 an individual purchase or secure a drug, device, treatment,

27 procedure, or service from another person, place, facility, or

1 business in which the licensee has a financial interest.

2 (B) A referral by a physician for a designated health

3 service that violates section 1877 of part D of title XVIII of

4 the social security act, 42 USC 1395nn, or a regulation

5 promulgated under that section. Section 1877 of part D of title

6 XVIII of the social security act, 42 USC 1395nn, and the

7 regulations promulgated under that section, as they exist on June

8 3, 2002, are incorporated by reference for purposes of this

9 subparagraph. A disciplinary subcommittee shall apply section

10 1877 of part D of title XVIII of the social security act, 42 USC

11 1395nn, and the regulations promulgated under that section

12 regardless of the source of payment for the designated health

13 service referred and rendered. If section 1877 of part D of title

14 XVIII of the social security act, 42 USC 1395nn, or a regulation

15 promulgated under that section is revised after June 3, 2002, the

16 department shall officially take notice of the revision. Within

17 30 days after taking notice of the revision, the department shall

18 decide whether or not the revision pertains to referral by

19 physicians for designated health services and continues to

20 protect the public from inappropriate referrals by physicians. If

21 the department decides that the revision does both of those

22 things, the department may promulgate rules to incorporate the

23 revision by reference. If the department does promulgate rules to

24 incorporate the revision by reference, the department shall not

25 make any changes to the revision. As used in this subparagraph,

26 "designated health service" means that term as defined in section

27 1877 of part D of title XVIII of the social security act, 42 USC

1 1395nn, and the regulations promulgated under that section and

2 "physician" means that term as defined in sections 17001 and

3 17501.

4 (v) For a physician who makes referrals pursuant to section

5 1877 of part D of title XVIII of the social security act, 42 USC

6 1395nn, or a regulation promulgated under that section, refusing

7 to accept a reasonable proportion of patients eligible for

8 medicaid and refusing to accept payment from medicaid or medicare

9 as payment in full for a treatment, procedure, or service for

10 which the physician refers the individual and in which the

11 physician has a financial interest. A physician who owns all or

12 part of a facility in which he or she provides surgical services

13 is not subject to this subparagraph if a referred surgical

14 procedure he or she performs in the facility is not reimbursed at

15 a minimum of the appropriate medicaid or medicare outpatient fee

16 schedule, including the combined technical and professional

17 components.

18 (f) Beginning June 3, 2003, the department ~~of consumer and~~

19 ~~industry services~~ shall prepare the first of 3 annual reports on

20 the effect of this amendatory act on access to care for the

21 uninsured and medicaid patients. The department shall report on

22 the number of referrals by licensees of uninsured and medicaid

23 patients to purchase or secure a drug, device, treatment,

24 procedure, or service from another person, place, facility, or

25 business in which the licensee has a financial interest.

26 (g) Failure to report a change of name or mailing address

27 within 30 days after the change occurs.

1 (h) A violation, or aiding or abetting in a violation, of

2 this article or of a rule promulgated under this article.

3 (i) Failure to comply with a subpoena issued pursuant to

4 this part, failure to respond to a complaint issued under this

5 article or article 7, failure to appear at a compliance

6 conference or an administrative hearing, or failure to report

7 under section 16222 or 16223.

8 (j) Failure to pay an installment of an assessment levied

9 pursuant to the insurance code of 1956, 1956 PA 218, MCL 500.100

10 to 500.8302, within 60 days after notice by the appropriate

11 board.

12 (k) A violation of section 17013 or 17513.

13 (l) Failure to meet 1 or more of the requirements for

14 licensure or registration under section 16174.

15 (m) A violation of section 17015 or 17515.

16 (n) A violation of section 17016 or 17516.

17 (o) Failure to comply with section 9206(3).

18 (p) A violation of section 5654 or 5655.

19 (q) A violation of section 16274.

20 (r) A violation of section 17020, or 17020a, 17520, or

21 17520a.

22 (s) A violation of the medical records access act, 2004 PA

23 47, MCL 333.26261 to 333.26271.

24 (t) A violation of section 17764(2).

25 Sec. 17020. (1) Except as otherwise provided for a test

26 performed under section 5431 and except as otherwise provided by

27 law, beginning ~~upon the expiration of 6 months after the~~

1 ~~effective date of the amendatory act that added this section~~

2 September 15, 2000, a physician or an individual to whom the

3 physician has delegated authority to perform a selected act,

4 task, or function under section 16215 shall not order a

5 presymptomatic or predictive genetic test without first obtaining

6 the written, informed consent of the test subject, pursuant to

7 this section.

8 (2) For purposes of subsection (1), written, informed

9 consent consists of a signed writing executed by the test subject

10 or the legally authorized representative of the test subject that

11 confirms that the physician or the individual acting under the

12 delegatory authority of the physician has explained, and the test

13 subject or the legally authorized representative of the test

14 subject understands, at a minimum, all of the following:

15 (a) The nature and purpose of the presymptomatic or

16 predictive genetic test.

17 (b) The effectiveness and limitations of the presymptomatic

18 or predictive genetic test.

19 (c) The implications of taking the presymptomatic or

20 predictive genetic test, including, but not limited to, the

21 medical risks and benefits.

22 (d) The future uses of the sample taken from the test

23 subject in order to conduct the presymptomatic or predictive

24 genetic test and the information obtained from the presymptomatic

25 or predictive genetic test.

26 (e) The meaning of the presymptomatic or predictive genetic

27 test results and the procedure for providing notice of the

1 results to the test subject.

2 (f) Who will have access to the sample taken from the test

3 subject in order to conduct the presymptomatic or predictive

4 genetic test and the information obtained from the presymptomatic

5 or predictive genetic test, and the test subject's right to

6 confidential treatment of the sample and the information.

7 (3) ~~Within 6 months after the effective date of the~~

8 ~~amendatory act that added this section~~ Before September 15,

9 2000, the department of community health, in consultation with

10 the Michigan board of medicine, the Michigan board of osteopathic

11 medicine and surgery, at least 1 physician who is board certified

12 by the American board of medical genetics, and appropriate

13 professional organizations, shall develop and distribute a model

14 informed consent form for purposes of this section that

15 practitioners may adopt. The department of community health shall

16 include in the model form at least all of the information

17 required under subsection (2). The department of community health

18 shall distribute the model form to physicians and other

19 individuals subject to this section upon request and at no

20 charge. The department of community health shall review the model

21 form at least annually for 5 years after the first model form is

22 distributed, and shall revise the model form if necessary to make

23 the form reflect the latest developments in medical genetics.

24 (4) The department of community health, in consultation with

25 the entities described in subsection (3), may also develop and

26 distribute a pamphlet that provides further explanation of the

27 information included in the model informed consent form.

1 (5) If a test subject or his or her legally authorized

2 representative signs a copy of the model informed consent form

3 developed and distributed under subsection (3), the physician or

4 individual acting under the delegatory authority of the physician

5 shall give the test subject a copy of the signed informed consent

6 form and shall include the original signed informed consent form

7 in the test subject's medical record.

8 (6) If a test subject or his or her legally authorized

9 representative signs a copy of the model informed consent form

10 developed and distributed under subsection (3), the test subject

11 is barred from subsequently bringing a civil action for damages

12 against the physician, or an individual to whom the physician

13 delegated the authority to perform a selected act, task, or

14 function under section 16215, who ordered the presymptomatic or

15 predictive genetic test, based on failure to obtain informed

16 consent for the presymptomatic or predictive genetic test.

17 (7) A physician's duty to inform a patient under this

18 section does not require disclosure of information beyond what a

19 reasonably well-qualified physician licensed under this article

20 would know.

21 (8) Except as otherwise provided in subsection (9), as used

22 in this section and section 17020a:

23 (a) "Genetic information" means information about a gene,

24 gene product, or inherited characteristic which information is

25 derived from a genetic test.

26 (b) "Genetic test" means the analysis of human DNA, RNA,

27 chromosomes, and those proteins and metabolites used to detect

1 heritable or somatic disease-related genotypes or karyotypes for

2 clinical purposes. A genetic test must be generally accepted in

3 the scientific and medical communities as being specifically

4 determinative for the presence, absence, or mutation of a gene or

5 chromosome in order to qualify under this definition. Genetic

6 test does not include a routine physical examination or a routine

7 analysis, including, but not limited to, a chemical analysis, of

8 body fluids, unless conducted specifically to determine the

9 presence, absence, or mutation of a gene or chromosome.

10 (c) "Predictive genetic test" means a genetic test performed

11 for the purpose of predicting the future probability that the

12 test subject will develop a genetically related disease or

13 disability.

14 (d) "Presymptomatic genetic test" means a genetic test

15 performed before the onset of clinical symptoms or indications of

16 disease.

17 (9) For purposes of subsection (8)(b), the term "genetic

18 test" does not include a procedure performed as a component of

19 biomedical research that is conducted pursuant to federal common

20 rule under 21 ~~C.F.R.~~ CFR parts 50 and 56 and 45 ~~C.F.R.~~ CFR

21 part 46.

22 Sec. 17020a. (1) The fact that a presymptomatic or

23 predictive genetic test has been ordered and conducted under

24 section 17020 and the results of that test are privileged and

25 confidential. Except as otherwise provided by law, a person shall

26 not disclose that a test has been ordered or conducted or the

27 results of that test for purposes other than treatment, payment,

1 or health care operations as provided under the health insurance

2 portability and accountability act of 1996, Public Law 104-191,

3 and regulations promulgated under that act, 45 CFR parts 160 and

4 164, without first obtaining written authorization from the test

5 subject or his or her legally authorized representative as

6 provided under this section.

7 (2) For purposes of subsection (1), written authorization

8 shall be on a form that identifies to whom the information is to

9 be disclosed and includes the following notice:

10 NOTICE OF RIGHTS WITH REGARD TO

11 GENETIC TESTING AND INFORMATION

12 Michigan law restricts requests by health insurers, nonprofit

13 health care corporations, health maintenance organizations, and

14 employers for individuals to submit to genetic testing, to

15 disclose genetic information, or to disclose whether genetic

16 testing has been conducted or the results of that genetic

17 testing. Individuals who have questions about their rights may

18 seek legal advice.

19 (3) For purposes of subsection (1), a general consent or

20 authorization given for the release of medical records or other

21 medical information does not constitute written authorization for

22 disclosure under this section. The informed consent form required

23 under section 17020 for the performance of genetic testing shall

24 satisfy the written authorization requirements for disclosure

25 under this section if that informed consent form identifies to

26 whom the genetic information is being provided, includes the

1 notice described under subsection (2), and requires a separate

2 signature for disclosure than the signature required for the

3 performance of the genetic testing. If the test subject or his or

4 her legally authorized representative provides written

5 authorization under this section, the person shall do each of the

6 following:

7 (a) Provide the test subject with a copy of the signed

8 written authorization.

9 (b) Maintain the original signed written authorization in

10 the test subject's medical record.

11 (c) Provide the test subject and the person to whom the

12 information is being disclosed with the following notice:

13 RESTRICTIONS ON FURTHER DISCLOSURE OF

14 GENETIC TESTING AND INFORMATION

15 This information is privileged and confidential. This information

16 is being provided to you in accordance with Michigan law and

17 shall not be further disclosed without a separate written

18 authorization from the test subject or his or her legally

19 authorized representative. A general consent or authorization

20 for the release of medical records or other information is not

21 sufficient to authorize the disclosure of genetic testing and

22 information.

23 (4) If a test subject consents to the performance of a

24 genetic test for the sole purpose of assisting in the recovery or

25 identification of human remains from a disaster or assisting in

1 the identification of living or deceased missing persons by

2 matching forensic DNA profiles in the event of an emergency or

3 disaster, those results as well as the DNA profiles shall only be

4 disclosed and used for those identification purposes, are not

5 public records, are not subject to court subpoena, and are not

6 discoverable in a legal proceeding. Consent provided for testing

7 and DNA profiling under this subsection is not consent for

8 secondary research utilizing those results or DNA profiles or any

9 other use except for the identification of living or deceased

10 missing persons.

11 Sec. 17520. (1) Except as otherwise provided for a test

12 performed under section 5431 and except as otherwise provided by

13 law, beginning ~~upon the expiration of 6 months after the~~

14 ~~effective date of the amendatory act that added this section~~

15 September 15, 2000, a physician or an individual to whom the

16 physician has delegated authority to perform a selected act,

17 task, or function under section 16215 shall not order a

18 presymptomatic or predictive genetic test without first obtaining

19 the written, informed consent of the test subject, pursuant to

20 this section.

21 (2) For purposes of subsection (1), written, informed

22 consent consists of a signed writing executed by the test subject

23 or the legally authorized representative of the test subject that

24 confirms that the physician or the individual acting under the

25 delegatory authority of the physician has explained, and the test

26 subject or the legally authorized representative of the test

27 subject understands, at a minimum, all of the following:

1 (a) The nature and purpose of the presymptomatic or

2 predictive genetic test.

3 (b) The effectiveness and limitations of the presymptomatic

4 or predictive genetic test.

5 (c) The implications of taking the presymptomatic or

6 predictive genetic test, including, but not limited to, the

7 medical risks and benefits.

8 (d) The future uses of the sample taken from the test

9 subject in order to conduct the presymptomatic or predictive

10 genetic test and the information obtained from the presymptomatic

11 or predictive genetic test.

12 (e) The meaning of the presymptomatic or predictive genetic

13 test results and the procedure for providing notice of the

14 results to the test subject.

15 (f) Who will have access to the sample taken from the test

16 subject in order to conduct the presymptomatic or predictive

17 genetic test and the information obtained from the presymptomatic

18 or predictive genetic test, and the test subject's right to

19 confidential treatment of the sample and the information.

20 (3) ~~Within 6 months after the effective date of the~~

21 ~~amendatory act that added this section~~ Before September 15,

22 2000, the department of community health, in consultation with

23 the Michigan board of medicine, the Michigan board of osteopathic

24 medicine and surgery, at least 1 physician who is board certified

25 by the American board of medical genetics, and appropriate

26 professional organizations, shall develop and distribute a model

27 informed consent form for purposes of this section that

1 practitioners may adopt. The department of community health shall

2 include in the model form at least all of the information

3 required under subsection (2). The department of community health

4 shall distribute the model form to physicians and other

5 individuals subject to this section upon request and at no

6 charge. The department of community health shall review the model

7 form at least annually for 5 years after the first model form is

8 distributed, and shall revise the model form if necessary to make

9 the form reflect the latest developments in medical genetics.

10 (4) The department of community health, in consultation with

11 the entities described in subsection (3), may also develop and

12 distribute a pamphlet that provides further explanation of the

13 information included in the model informed consent form.

14 (5) If a test subject or his or her legally authorized

15 representative signs a copy of the model informed consent form

16 developed and distributed under subsection (3), the physician or

17 individual acting under the delegatory authority of the physician

18 shall give the test subject a copy of the signed informed consent

19 form and shall include the original signed informed consent form

20 in the test subject's medical record.

21 (6) If a test subject or his or her legally authorized

22 representative signs a copy of the model informed consent form

23 developed and distributed under subsection (3), the test subject

24 is barred from subsequently bringing a civil action for damages

25 against the physician, or an individual to whom the physician

26 delegated the authority to perform a selected act, task, or

27 function under section 16215, who ordered the presymptomatic or

1 predictive genetic test, based on failure to obtain informed

2 consent for the presymptomatic or predictive genetic test.

3 (7) A physician's duty to inform a patient under this

4 section does not require disclosure of information beyond what a

5 reasonably well-qualified physician licensed under this article

6 would know.

7 (8) Except as otherwise provided in subsection (9), as used

8 in this section and section 17520a:

9 (a) "Genetic information" means information about a gene,

10 gene product, or inherited characteristic which information is

11 derived from a genetic test.

12 (b) "Genetic test" means the analysis of human DNA, RNA,

13 chromosomes, and those proteins and metabolites used to detect

14 heritable or somatic disease-related genotypes or karyotypes for

15 clinical purposes. A genetic test must be generally accepted in

16 the scientific and medical communities as being specifically

17 determinative for the presence, absence, or mutation of a gene or

18 chromosome in order to qualify under this definition. Genetic

19 test does not include a routine physical examination or a routine

20 analysis, including, but not limited to, a chemical analysis, of

21 body fluids, unless conducted specifically to determine the

22 presence, absence, or mutation of a gene or chromosome.

23 (c) "Predictive genetic test" means a genetic test performed

24 for the purpose of predicting the future probability that the

25 test subject will develop a genetically related disease or

26 disability.

27 (d) "Presymptomatic genetic test" means a genetic test

1 performed before the onset of clinical symptoms or indications of

2 disease.

3 (9) For purposes of subsection (8)(b), the term "genetic

4 test" does not include a procedure performed as a component of

5 biomedical research that is conducted pursuant to federal common

6 rule under 21 ~~C.F.R.~~ CFR parts 50 and 56 and 45 ~~C.F.R.~~ CFR

7 part 46.

8 Sec. 17520a. (1) The fact that a presymptomatic or

9 predictive genetic test has been ordered and conducted under

10 section 17520 and the results of that test are privileged and

11 confidential. Except as otherwise provided by law, a person shall

12 not disclose that a test has been ordered or conducted or the

13 results of that test for purposes other than treatment, payment,

14 or health care operations as provided under the health insurance

15 portability and accountability act of 1996, Public Law 104-191,

16 and regulations promulgated under that act, 45 CFR parts 160 and

17 164, without first obtaining written authorization from the test

18 subject or his or her legally authorized representative as

19 provided under this section.

20 (2) For purposes of subsection (1), written authorization

21 shall be on a form that identifies to whom the information is to

22 be disclosed and includes the following notice:

23 NOTICE OF RIGHTS WITH REGARD TO

24 GENETIC TESTING AND INFORMATION

25 Michigan law restricts requests by health insurers, nonprofit

26 health care corporations, health maintenance organizations, and

1 employers for individuals to submit to genetic testing, to

2 disclose genetic information, or to disclose whether genetic

3 testing has been conducted or the results of that genetic

4 testing. Individuals who have questions about their rights may

5 seek legal advice.

6 (3) For purposes of subsection (1), a general consent or

7 authorization given for the release of medical records or other

8 medical information does not constitute written authorization for

9 disclosure under this section. The informed consent form required

10 under section 17020 for the performance of genetic testing shall

11 satisfy the written authorization requirements for disclosure

12 under this section if that informed consent form identifies to

13 whom the genetic information is being provided, includes the

14 notice described under subsection (2), and requires a separate

15 signature for disclosure than the signature required for the

16 performance of the genetic testing. If the test subject or his or

17 her legally authorized representative provides written

18 authorization under this section, the person shall do each of the

19 following:

20 (a) Provide the test subject with a copy of the signed

21 written authorization.

22 (b) Maintain the original signed written authorization in

23 the test subject's medical record.

24 (c) Provide the test subject and the person to whom the

25 information is being disclosed with the following notice:

26 RESTRICTIONS ON FURTHER DISCLOSURE OF

1 GENETIC TESTING AND INFORMATION

2 This information is privileged and confidential. This information

3 is being provided to you in accordance with Michigan law and

4 shall not be further disclosed without a separate written

5 authorization from the test subject or his or her legally

6 authorized representative. A general consent or authorization for

7 the release of medical records or other information is not

8 sufficient to authorize the disclosure of genetic testing and

9 information.

10 (4) If a test subject consents to the performance of a

11 genetic test for the sole purpose of assisting in the recovery or

12 identification of human remains from a disaster or assisting in

13 the identification of living or deceased missing persons by

14 matching DNA profiles in the event of an emergency or disaster,

15 those results as well as the DNA profiles shall only be disclosed

16 and used for those identification purposes, are not public

17 records, are not subject to court subpoena, and are not

18 discoverable in a legal proceeding. Consent provided for testing

19 and DNA profiling under this subsection is not consent for

20 secondary research utilizing those results or DNA profiles or any

21 other use except for the identification of living or deceased

22 missing persons.

23 Sec. 20170a. (1) All reports, records, and data pertaining

24 to genetic testing or other genetic information are privileged

25 and confidential. Except as otherwise provided by law, a health

26 facility or agency shall not disclose the test results of a

1 presymptomatic or predictive genetic test or the fact that such a

2 test was ordered for purposes other than treatment, payment, or

3 health care operations as provided under the health insurance

4 portability and accountability act of 1996, Public Law 104-191,

5 and regulations promulgated under that act, 45 CFR parts 160 and

6 164, without first obtaining written authorization from the test

7 subject or his or her legally authorized representative as

8 required under section 17020a or 17520a.

9 (2) If the test subject or the legally authorized

10 representative agrees to the disclosure of information relating

11 to his or her genetics or the presymptomatic or predictive

12 genetic testing, or both, he or she shall provide the health

13 facility or agency with the requisite written authorization.

14 (3) If the test subject or his or her legally authorized

15 representative provides written authorization for disclosure

16 under this section, the health facility or agency shall do each

17 of the following:

18 (a) Provide the test subject with a copy of the signed

19 written authorization.

20 (b) Maintain the original signed written authorization in

21 the test subject's medical record.

22 (c) Provide the test subject and the person to whom the

23 information is being disclosed with the following notice:

24 RESTRICTIONS ON FURTHER DISCLOSURE OF

25 GENETIC TESTING AND INFORMATION

26 This information is privileged and confidential. This information

1 is being provided to you in accordance with Michigan law and

2 shall not be further disclosed without a separate written

3 authorization from the test subject or his or her legally

4 authorized representative. A general consent or authorization for

5 the release of medical records or other information is not

6 sufficient to authorize the disclosure of genetic testing and

7 information.

8 (4) If a test subject consents to the performance of a

9 genetic test for the sole purpose of assisting in the recovery or

10 identification of human remains from a disaster or assisting in

11 the identification of living or deceased missing persons by

12 matching DNA profiles in the event of an emergency or disaster,

13 those results as well as the DNA profiles shall only be disclosed

14 and used for those identification purposes, are not public

15 records, are not subject to court subpoena, and are not

16 discoverable in a legal proceeding. Consent provided for testing

17 and DNA profiling under this subsection is not consent for

18 secondary research utilizing those results or DNA profiles or any

19 other use except for the identification of living or deceased

20 missing persons.

21 (5) Except as otherwise provided in subsection (6), as used

22 in this section: