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  • New state budget act increases medical record fees

    Adam Korbitz

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    New state budget act increases medical record 
feesJuly 14, 2011 – The new 2011-13 biennial state budget act increases the statutory fees that can be charged by record custodians for copies of patient health care records.

    Gov. Scott Walker signed the budget act, 2011 Wisconsin Act 32, at a ceremony in Green Bay on Sunday, June 26, 2011. The new, higher fees took effect July 1, 2011.

    Medical records fees were first set by statute two years ago, when Gov. Jim Doyle enacted the 2009-11 state budget act. Prior to that act, medical record fees were set by administrative rule.

    As originally proposed by Gov. Walker in March 2011, the budget bill would have completely repealed the existing statutory fee schedule and returned the determination of fees to the administrative rule process. However, the Legislature’s Joint Finance Committee modified Gov. Walker’s proposal to generally maintain the statutory fee schedule, but with increased fees.

    Repeal of the statutory fee schedule was sought by medical record custodians, such as hospitals. The State Bar of Wisconsin’s Litigation Section and other organizations opposed repealing the statutory fee schedule and returning the determination of fees to the administrative rule process, which likely would have resulted in fees even higher than those in the modified statutory schedule. Legislators on the Joint Finance Committee compromised, preserving the schedule in statute but raising some of the fees.

    Under Act 32 as signed by Gov. Walker, a health care provider may charge no more than the total of all the following fees:

    (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.

    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. In addition, the act requires the Legislative Reference Bureau to publish the adjusted amounts in the Wisconsin Administrative Register.

    The budget act also maintains previous law that prohibits a health care provider from charging DHS more than the amount that the federal 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 percent 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 (MA). (Previous to the changes made by the budget act, the statute prohibited a charge for one copy of an MA recipient's health records.)

    Continue to monitor WisBar.org and visit the State Bar’s Government Relations page for updated information on these issues.

    By Adam Korbitz, Government Relations Coordinator, State Bar of Wisconsin

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