LRB-3672/5
DAK:cjs&kjf:jf
2007 - 2008 LEGISLATURE
February 11, 2008 - Introduced by Representatives Moulton, Hixson, Davis,
Benedict, Sheridan, Petersen, Wood, Musser, Owens, Van Roy, Bies,
Ballweg, Strachota, Newcomer, Molepske, Nerison, Kerkman, A. Ott,
Seidel, M. Williams, Turner, Shilling, Townsend, Hines, Pope-Roberts,
Mursau, Jorgensen, Hintz, Kestell, Wieckert, Richards and Murtha,
cosponsored by Senators Erpenbach, Darling, Schultz, Robson, Decker,
Olsen, Lehman, Vinehout, Lassa, Kreitlow, Wirch, Risser, Hansen, Sullivan
and Jauch. Referred to Committee on Public Health.
AB793,1,5
1An Act to repeal 51.30 (4) (b) 8g. a., 51.30 (4) (b) 8g. b., 146.82 (2) (b), 146.82 (2)
2(d) and 146.82 (3) (c);
to renumber and amend 51.30 (4) (b) 8g. (intro.);
to
3amend 146.81 (4) and 655.275 (8); and
to create 51.30 (4) (b) 8g. am., 146.82
4(4) and 146.82 (5) of the statutes;
relating to: treatment records and patient
5health care records.
Analysis by the Legislative Reference Bureau
Under current law, certain records related to the health of a patient that are
prepared by or under the supervision of a health care provider (patient health care
records) are confidential and may be released only with the written consent of the
patient or of a person authorized by the patient. This consent (informed consent)
must detail the patient's name; the type of information to be disclosed; the types of
health care providers making the disclosure; the purpose of the disclosure; the
individual or entity to which disclosure may be made; the patient's signature or that
of the person authorized by the patient; the date of signature; and the time period
during which the consent is effective. Current law has numerous exceptions to the
confidentiality requirements that permit access to patient health care records
without the informed consent of the patient or of a person authorized by the patient.
A health care provider must record the name of the person or agency that receives
access, the date and time of the release, and the identification of the patient health
care records released. However, redisclosure of information obtained under one of
the exceptions is prohibited, unless authorized by a court or under an insurance
transaction that authorizes the disclosure of personal medical information about an
individual to an insurer.
This bill eliminates current restrictions on redisclosure of a patient health care
record that is obtained under one of the exceptions to the requirements of
confidentiality. The bill, instead, authorizes the redisclosure of a patient health care
record, if made by a covered entity (as defined in the bill) for a purpose for which a
release is otherwise permitted. The bill authorizes an entity that is not a covered
entity to redisclose a patient health care record only if the patient or a person
authorized by the patient provides informed consent, a court of record orders the
redisclosure, or the redisclosure is limited to the purpose for which the patient health
care record was initially received.
The bill permits a health care provider to release, without informed consent, a
portion, but not a copy, of a patient health care record, as follows:
1. If the patient or a person authorized by the patient is not incapacitated, is
physically available, and agrees to the release of that portion, to anyone.
2. If the patient and the person authorized by the patient are incapacitated or
not physically available or if an emergency makes it impracticable to obtain
agreement from the patient or person, and if the health care provider determines
that release is in the best interest of the patient, to (1) a member of the patient's
immediate family, another relative, a close personal friend, or an individual
identified by the patient, that portion of the patient health care record that is directly
relevant to involvement by the person in the patient's care; or (2) any person, that
portion of the patient health care record that is necessary to identify, locate, or notify
a member of the patient's immediate family or another person concerning the
patient's location, general condition, or death.
Under current law, records that are created in the course of providing services
to individuals for mental illness, developmental disabilities, alcoholism, or drug
dependence (treatment records) are confidential and may be released only with the
informed consent of the individual. The requirements for the informed consent are
similar to the informed consent requirements for patient health care records.
However, the confidentiality requirements for treatment records have numerous
exceptions that permit access without informed consent. One of these exceptions is
for release of treatment records to a health care provider in a related health care
entity, or any person acting under the supervision of the health care provider who is
involved with the individual's care, if necessary for the individual's current
treatment. Information that may be released under this exception is limited to the
individual's name, address and date of birth; the individual's treatment provider; the
date of service provided; the individual's medications, allergies, and diagnosis; and
other relevant demographic information necessary for the individual's current
treatment.
This bill changes the exception to the confidentiality requirements for
treatment records to allow access by any health care provider or person acting under
the supervision of the health care provider who is involved with an individual's care,
if necessary for the individual's current treatment. The bill expands information
that may be released under the exception to include diagnostic test results, as
defined in the bill, and symptoms.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB793, s. 1
1Section
1. 51.30 (4) (b) 8g. (intro.) of the statutes is renumbered 51.30 (4) (b)
28g. bm. and amended to read:
AB793,3,133
51.30
(4) (b) 8g. bm. To
health care providers in a related health care entity, a
4health care provider, or to any person acting under the supervision of
such a the 5health care provider who is involved with an individual's care, if necessary for the
6current treatment of the individual. Information that may be released under this
7subdivision is limited to the individual's name, address, and date of birth; the name
8of the individual's
mental health treatment provider
of services for mental illness,
9developmental disability, alcoholism, or drug dependence; the date of
mental health
10service any of those services provided; the individual's medications, allergies,
and 11diagnosis
, diagnostic test results, and symptoms; and other relevant demographic
12information necessary for the current treatment of the individual.
In this
13subdivision, "related health care entity" means one of the following:
AB793, s. 2
14Section
2. 51.30 (4) (b) 8g. a. of the statutes is repealed.
AB793, s. 3
15Section
3. 51.30 (4) (b) 8g. am. of the statutes is created to read:
AB793,3,1816
51.30
(4) (b) 8g. am. In this subdivision, "diagnostic test results" means the
17results of clinical testing of biological parameters, but does not mean the results of
18psychological or neuropsychological testing.
AB793, s. 4
19Section
4. 51.30 (4) (b) 8g. b. of the statutes is repealed.
AB793, s. 5
20Section
5. 146.81 (4) of the statutes is amended to read:
AB793,4,10
1146.81
(4) "Patient health care records" means all records related to the health
2of a patient prepared by or under the supervision of a health care provider,
including
3the records required under s. 146.82 (2) (d) and (3) (c), but not those records subject
4to s. 51.30, reports collected under s. 69.186, records of tests administered under s.
5252.15 (2) (a) 7., 343.305, 938.296 (4) or (5) or 968.38 (4) or (5), records related to sales
6of pseudoephedrine products, as defined in s. 961.01 (20c), that are maintained by
7pharmacies under s. 961.235, fetal monitor tracings, as defined under s. 146.817 (1),
8or a pupil's physical health records maintained by a school under s. 118.125. ``Patient
9health care records" also includes health summary forms prepared under s. 302.388
10(2).
AB793, s. 6
11Section
6. 146.82 (2) (b) of the statutes is repealed.
AB793, s. 7
12Section
7. 146.82 (2) (d) of the statutes is repealed.
AB793, s. 8
13Section
8. 146.82 (3) (c) of the statutes is repealed.
AB793, s. 9
14Section
9. 146.82 (4) of the statutes is created to read:
AB793,4,1615
146.82
(4) Release of a portion of a record to certain persons. (a) In this
16subsection:
AB793,4,1717
1. "Immediate family" has the meaning given in s. 350.01 (8m).
AB793,4,1818
2. "Incapacitated" has the meaning given in s. 50.94 (1) (b).
AB793,4,2119
(b) Notwithstanding sub. (1), a health care provider may release a portion, but
20not a copy, of a patient health care record, to the following, under the following
21circumstances:
AB793,4,2322
1. Any person, if the patient or a person authorized by the patient is not
23incapacitated, is physically available, and agrees to the release of that portion.
AB793,5,424
2. Any of the following, as applicable, if the patient and person authorized by
25the patient are incapacitated or are not physically available, or if an emergency
1makes it impracticable to obtain an agreement from the patient or from the person
2authorized by the patient, and if the health care provider determines, in the exercise
3of his or her professional judgment, that release of a portion of the patient health care
4record is in the best interest of the patient:
AB793,5,85
a. A member of the patient's immediate family, another relative of the patient,
6a close personal friend of the patient, or an individual identified by the patient, that
7portion that is directly relevant to the involvement by the member, relative, friend,
8or individual in the patient's care.
AB793,5,119
b. Any person, that portion that is necessary to identify, locate, or notify a
10member of the patient's immediate family or another person that is responsible for
11the care of the patient concerning the patient's location, general condition, or death.
AB793, s. 10
12Section
10. 146.82 (5) of the statutes is created to read:
AB793,5,1413
146.82
(5) Redisclosure. (a) In this subsection, "covered entity" has the
14meaning given in
45 CFR 160.103.
AB793,5,1815
(b) Notwithstanding sub. (1) and except as provided in s. 610.70 (5), a covered
16entity may redisclose a patient health care record it receives under this section
17without consent by the patient or person authorized by the patient if the redisclosure
18of the patient health care record is a release permitted under this section.
AB793,5,2119
(c) Notwithstanding sub. (1), an entity that is not a covered entity may
20redisclose a patient health care record it receives under this section only under one
21of the following circumstances:
AB793,5,2322
1. The patient or a person authorized by the patient provides informed consent
23for the redisclosure.
AB793,5,2424
2. A court of record orders the redisclosure.
AB793,6,2
13. The redisclosure is limited to the purpose for which the patient health care
2record was initially received.
AB793, s. 11
3Section
11. 655.275 (8) of the statutes is amended to read:
AB793,6,74
655.275
(8) Patient records. The council may obtain any information relating
5to any claim it reviews under this section that is in the possession of the
6commissioner or the board of governors. The council shall keep patient health care
7information records confidential as required by s. 146.82
(2) (b).
AB793, s. 12
8Section
12.
Effective dates. This act takes effect on the day after publication,
9except as follows:
AB793,6,1210
(1)
Treatment records. The treatment of section 51.30 (4) (b) 8g. (intro.), a.,
11am., and b. of the statutes takes effect on the first day of the 7th month beginning
12after publication, or on January 1, 2009, whichever is earlier.
