Copying Fees Increased, Statute of Limitations Streamlined and Access to Patient Records
Changes That Streamline the Statutes
On July 1, 2009, Governor Doyle’s budget bill, WI Statute, Section 146.83(1d), contained provisions that streamlined the statutes governing patient records. Previously there were two statutes and an administrative code that regulated record copying costs.
In 2011, Governor Walker’s State Budget Act 32 made additional changes specific to copying costs of health care records and modification to the criteria pertaining to the availability of health care records for Medicaid patients. Those changes are included in this article.
Wis. Statutes. Sec. 146.83(1d)
Access to Patient Health Care Records
Any patient (or person authorized by the patient) may upon submitting a statement of informed consent inspect the health care records of a health care provider pertaining to that patient during regular business hours. There is no fee for the inspection.
If a patient or their authorized representative requests copies of the patient’s health care records, provides informed consent, and pays the applicable fees, the health care provider shall provide the patient or authorized person a copy of the patient’s health care records. This includes x-rays, treatment notes and any material pertaining to the patient’s dental health. An x-ray is defined as a page containing one or more radiographic images.
Wis. Statutes, Sec. 146.83(2)
Access to Patient Health Care Records
This statute also requires that at the time the health care provider accepts a person as their patient, they are to provide the patient with a statement informing them of their right to their health care records, paraphrasing the provisions of Section 146.83(1d) which indicates that a patient has a right to their records.
Cost of Providing Copies
The state budget act, 2011 Wisconsin Act 32, signed by Governor Walker increased the maximum statutory fees that a health care provider may charge for copies of patient health care records. Actual fees are determined by the health care provider, but cannot exceed these maximum charges.
The health care provider may charge for the copies, but no more than the total of all the following that apply for providing copies requested:
- $1 per page for the first 25 pages
- $0.75 cents per page for pages 26 to 50
- $0.50 cents per page for pages 51 to 100
- $0.30 cents per page for pages 101 and above
- $1.50 per page for microfiche or microfilm
- $10.00 for a print of an X-ray
- Actual shipping costs
- Sales tax, if applicable, may be added to the fees charged
- If the requester is not the patient or a person authorized by the patient: A single $8 charge for certification of copies and a single retrieval fee of $20 for all copies requested
- If a person or their authorized representative requests delivery of the copies within 7 or fewer days after making the request, and the health care provider delivers the copies within that time, a fee equal to 10% of the total fees may be added.
Section 146.83(1f)(d)1
Social Security Disability Insurance
If a person or person authorized requests copies for use in appealing a denial of social security disability insurance or supplemental security income, the health care provider may charge the patient or authorized person no more than the amount that the federal social security administration reimburses the department for copies of patient health care records.
Section 146.83(1f)(d)2
Medical Assistance
Changes per 2011 State Budget Act 32
A health care provider may not charge a fee for providing one set of copies of a patient’s records if the patient is eligible for medical assistance. The provider may require proof that the patient is eligible for medical assistance before providing the copies.
The provider may not charge more than 25% of the applicable fees listed above, for providing one set of copies of a patient’s health care record if the patient is eligible for medical assistance.
A health care provider may charge the full fees that are allowed if providing a second or additional set of copies of patient health care records for a patient who is eligible for medical assistance.
The Department of Health Services encourages health care providers to provide the records at as low a cost as possible when records are requested on behalf of indigents.
Section 146.83(1g)
Department of Health Services and/or Department of Corrections
If the provider is with the Department of Health Services or the Department of Corrections, the time limit and the requirement to provide one set of copies without charge if the patient is eligible for medical assistance does not apply.
Section 146.83(1h)(a)
Persons Other Than Patient or Authorized Person
Cost of Copying per 2011 State Budget Act 32
If a person other than a patient and other than a person authorized by the patient requests copies of a patient’s health care records, provides an informed consent and pays the applicable fees as listed below, the health care provider shall provide the person making the request, copies of the requested records.
The health care provider may charge for the copies, but no more than the total of all the following that apply for providing copies requested:
- $1 per page for the first 25 pages
- $0.75 cents per page for pages 26 to 50
- $0.50 cents per page for pages 51 to 100
- $0.30 cents per page for pages 101 and above
- $1.50 per page for microfiche or microfilm
- $10.00 for a print of an X-ray
- Actual shipping costs
- Sales tax, if applicable, may be added to the fees charged
- If the requester is not the patient or a person authorized by the patient: A single $8 charge for certification of copies and a single retrieval fee of $20 for all copies requested
- If a person or their authorized representative requests delivery of the copies within 7 or fewer days after making the request, and the health care provider delivers the copies within that time, a fee equal to 10% of the total fees may be added.
2003 WI Act 144 Section 102.13(2)(b)
Worker’s Compensation revised, 2009
A physician, chiropractor, podiatrist, psychologist, dentist, physician assistant, advanced practice nurse prescriber, hospital, or health service provider shall furnish a legible, certified duplicate of the written material requested under par, (a) upon payment of the actual costs of preparing the certified duplicate not to exceed the greater of 45 cents per page or $7.50 per request, plus the actual cost of postage.
Section 146.83(1k)
Digital or Electronic Format
The health care provider shall provide copies in a digital or electronic format unless the health care provider’s record system does not provide for the creation or transmission of records in that format. The provider will provide a written explanation for why copies cannot be provided in digital or electronic format which may be included with the paper copies.
Section 146.83(3)
Provider Requirements
The health care provider shall note:
- Time and date of request for records
- Name of person making the request for copies or to inspect the records
- Name of inspecting person
- Time and date of the inspection
- Identity of the records released and or inspected
Outstanding Dental Treatment Bill
Although it has not been included in the statute, providers should be aware that records cannot be withheld because an outstanding bill for treatment exists. If the patient requests records and has an outstanding fee, they can be told that payment in full as well as the charges for copies of the records will be expected at the time the records are picked up. If the patient or authorized person is not prepared to pay the outstanding bill when they come for the records, the records cannot be withheld.
Charge for Copying Records When Requested by an Attorney for the Purpose of Litigation
Wisconsin Statute 908.03(6m)(c) 3 indicates that the fees for copying records for the purpose of litigation are the same as listed above.
Click here for a sample consent form for release of dental information.