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Wisconsin Sets Statutory Fee Schedules for Copies of Health Care Records

Hinshaw Health Law Alert

May 24, 2010
Hinshaw Health Law Alert

The most recent Wisconsin state budget, 2009 Wisconsin Act 28 (“the Act”), changed the fees that may be charged for copies of health care records by setting a statutory fee schedule. The schedule became effective July 1, 2009. Regulations promulgated by the Wisconsin Department of Health Services previously determined the maximum fees a health care provider could charge for copies of X-ray reports or patient health care records and were repealed in favor of the statutory schedules set forth below.

Fees for Requests by Patients or Persons Authorized by the Patient

Health care providers cannot charge more than the total of all of the following that apply:

However, if a patient or person authorized by him or her requests copies of the patient's health care records under the relevant subsection of the Act for use in appealing a denial of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the health care provider may charge the patient or person authorized by him or her no more than the amount that the Social Security Administration reimburses the Department of Health Services for copies of patient health care records. If a patient is eligible for medical assistance, a health care provider such as the Wisconsin Department of Corrections may not, with some statutory exceptions, charge a fee for the first set of copies of a patient’s health records it provides. However, the health care provider may require that a patient or person authorized by him or her provide proof that the patient is eligible for medical assistance before providing copies without charge, and may charge any applicable fees for providing a second or additional set of copies of patient health care records for a patient who is eligible for medical assistance.

When a request is made by a person other than a patient or a person authorized by him or her, as defined by Wis. Stat. § 146, the health care provider may charge the same fees noted above, as well as a $5 fee for certification of copies, and a single charge of $15 for processing and handling all copies requested. 

As with record requests directly from a patient, if a requestor seeks copies of a patient's health care records for the purpose of determining eligibility for SSDI or SSI, the health care provider may charge no more than the amount that the Social Security Administration reimburses for copies of patient health care records.

For more information, please contact Angela M. Rust or your regular Hinshaw attorney.

This alert has been prepared by Hinshaw & Culbertson LLP to provide information on recent legal developments of interest to our readers. It is not intended to provide legal advice for a specific situation or to create an attorney-client relationship.

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