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May 21, 2013

Statutory Increase in Medical Records Fees (WI)

Gov. Scott Walker signed the budget act, 2011 Wisconsin Act 32, at a ceremony in Green Bay on Sunday, June 26, 2011.  The new state budget act increases the statutory fees that medical record custodians can charge for copies of patient health care records. The new fee rates took effect July 1, 2011.

Medical record custodian advocates sought repeal of the statutory fee schedule, but the State Bar of Wisconsin’s litigation section and other organizations opposed repealing the statutory fee schedule. Without a statutory limit or administrative rule, higher fees were expected. A compromise was reached which preserved the fee limits, but raised some of the fees.

Effective July 1, 2011, a health care provider may charge no more than the total of all the following fees (subject to the exceptions below):

(a) for paper copies, $1 per page for the first 25 pages, 75 cents per page for pages 26 to 50, 50 cents per page for pages 51 to 100, and 30 cents per page for pages 101 and above;

(b) for microfiche or microfilm copies, $1.50 per page;

(c) for a print of an X−ray, $10 per image;

(d) 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;

(e) actual shipping costs and any applicable taxes.

Health care providers continue to be prohibited from charging DHS more than the Social Security Administration reimburses for copies of patient health care records, if DHS requests copies of a patient’s health care records for use in determining eligibility for social security disability insurance or supplemental security income. The budget act also prohibits a health care provider from charging more than 25% of the applicable fees for providing one set of copies of a patient’s health care records if the patient is eligible for medical assistance.

Beginning on July 1, 2012, the budget act requires the state Department of Health Services (DHS) to annually adjust the dollar amounts by the percentage difference between the consumer price index for the preceding year and the consumer price index for the year before the preceding year.

©2013 von Briesen & Roper, s.c

About the Author

Lisa Gingerich is the Health Care Practice Group Leader. She advises health care systems, hospitals, physician groups, health care suppliers, and ambulatory surgery centers regarding antitrust, business affiliations, mergers and acquisitions, fraud and abuse, tax exemption and corporate compliance. 

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