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    Wisconsin Lawyer
    June 01, 1999

    Wisconsin Lawyer June 1999: Legislative Watch

    Legislative Watch

    Reining in the Cost of Medical Record Copies

    By Russ Decker

    I was astounded when a constituent and attorney from Phillips, Wis., told me how much a health care provider was charging for photocopies of medical records he requested on his client's behalf. He said that health care providers and copy service companies routinely charge his clients as much as $20 for one page of a medical record. I asked other attorneys and the story was similar ... $40 for 11 copies, $29 for 10 copies, and so on. This did not seem right, or fair, to me. Why should patients be charged such a high price for copies of their own health care records?

    Health care providers and copy service companies are able to charge such high prices because there are no market mechanisms to keep costs in check. If the price is too high at one hospital or clinic, a patient cannot choose another one from which to obtain copies of his or her medical records. In the medical records market, there is no competition and, therefore, no incentive for a health care provider to reduce the costs.

    Because of this monopolistic condition, I am authoring legislation, LRB 1223/2, which would rein in the high cost of medical record photocopies. Under my proposal, health care providers may not charge more than the "approximation of actual costs" for copies of patient medical records. The legislation will help ensure that the copying fee for medical records is commensurate with the actual cost of providing the records.

    Limiting copying fees for medical records is nothing new. Under the state's worker's compensation law, copies of medical records may not exceed the greater of 45 cents per page or $7.50 per request.1 The state's Rules of Evidence require fees for medical record photocopies to be set by administrative rule, based on an "approximation of actual costs."2 Under the rule, fees cannot exceed the greater of $8.40 per request or 45 cents per record page for the first 50 pages and 25 cents per record page for the remaining pages, and $4 for each X-ray copy. Health care providers do not charge these rates very often, though, because they interpret the law to mean that the rates only apply to medical records requested as part of a commenced court action. In most cases, requests for patient health care records occur prior to the filing of a lawsuit, and therefore are not subject to the rule according to many health care providers. I do not believe it is in the state's best interest to have persons file lawsuits to avoid excessive copying charges.

    My proposal simply applies the fee structure under existing rule to copies of medical records that are requested regardless of whether the records are part of a commenced court action. In addition, the proposed legislation requires that health care providers provide a copy of the patient medical record within 30 days after receipt of a statement of informed consent.

    DeckerSen. Russ Decker lives in the town of Weston and has represented the 29th District in the State Senate since 1990. He is the Senate's vice chair of the Joint Committee on Finance.

    Access to medical records is an important aspect of the legal profession. In personal injury cases, for example, medical records are needed to determine the validity of a claim and provide adequate compensation for the injured. Frequently, the ability of patients and their agents to obtain and review medical records in a timely manner resolves the dispute making the commencement of legal action unnecessary. By removing some of the obstacles that impede the acquisition of medical record copies, LRB 1223/2 will help promote the resolution of disputes without litigation.

    More importantly, though, is that LRB 1223/2 will help protect the rights of patients to access their medical records. Patients should not have to pay $20 for one photocopied page of their own medical record or wait months before they receive their records. All I am asking is for the health care provider to charge a reasonable cost for copies of medical records and to provide the records within a reasonable time. Seems reasonable, doesn't it?

    Endnotes

    1Wis. Stat. § 102.13(2)(b).

    2Wis. Stat. § 908.03(6m)(d); Wis. Admin. Rule HFS 117.


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