Finally, the bill changes the fee structure for reproduction fees for medical
records requested in worker's compensation matters, applying the same fee
structure used for reproduction of medical records in other contexts in place of the
special fee structure for worker's compensation matters that exists under current
law.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB937,1 1Section 1 . 102.13 (2) (b) of the statutes is amended to read:
AB937,3,102 102.13 (2) (b) A physician, chiropractor, podiatrist, psychologist, dentist,
3physician assistant, advanced practice nurse prescriber, hospital, or health service

1provider shall furnish a legible, certified duplicate of the written material requested
2under par. (a) in paper format upon payment of the actual costs of preparing the
3certified duplicate, not to exceed the greater of 45 cents per page or $7.50 per request,
4plus the actual costs of postage, or shall furnish a legible, certified duplicate of that
5material in electronic format upon payment of $26 per request
fees established under
6s. 146.83 (3f) (b)
. Any person who refuses to provide certified duplicates of written
7material in the person's custody that is requested under par. (a) shall be liable for
8reasonable and necessary costs and, notwithstanding s. 814.04 (1), reasonable
9attorney fees incurred in enforcing the requester's right to the duplicates under par.
10(a).
AB937,2 11Section 2 . 146.81 (2) (f) of the statutes is amended to read:
AB937,3,1512 146.81 (2) (f) The signature of the patient or the person authorized by
13representative of the patient and, if signed by a person authorized by representative
14of
the patient, the relationship of that person representative to the patient or the
15authority of the person representative.
AB937,3 16Section 3 . 146.81 (5) of the statutes is renumbered 146.81 (5) (intro.) and
17amended to read:
AB937,3,1918 146.81 (5) (intro.) “Person authorized by Representative of the patient" means
19the any of the following:
AB937,3,21 20(a) The parent, or guardian, or legal custodian of a minor patient, as defined
21in s. 48.02 (8) and (11), the of a patient who is a minor.
AB937,4,2 22(b) The person vested with supervision of the a patient who is a child under s.
23938.183 or 938.34 (4d), (4h), (4m), or (4n), the guardian of a patient adjudicated
24incompetent in this state, the personal representative, spouse, or domestic partner

1under ch. 770 of a deceased patient, any person authorized in writing by the patient
2or a
.
AB937,4,11 3(e) A health care agent designated by the an adult patient as a principal under
4ch. 155 if the patient has been found to be incapacitated under s. 155.05 (2), except
5as limited by the power of attorney for health care instrument. If no spouse or
6domestic partner survives a deceased patient, “person authorized by the patient"
7also means an adult member of the deceased patient's immediate family, as defined
8in s. 632.895 (1) (d). A court may appoint a temporary guardian for a patient believed
9incompetent to consent to the release of records under this section as the person
10authorized by the patient to decide upon the release of records, if no guardian has
11been appointed for the patient.
AB937,4 12Section 4 . 146.81 (5) (c) of the statutes is created to read:
AB937,4,1413 146.81 (5) (c) A person who has legal authority to act on behalf of an adult
14patient in making decisions related to health care.
AB937,5 15Section 5 . 146.81 (5) (d) of the statutes is created to read:
AB937,4,1716 146.81 (5) (d) The personal representative, or special administrator, who has
17the authority to act on behalf of a deceased patient or a deceased patient's estate.
AB937,6 18Section 6 . 146.81 (5) (f) of the statutes is created to read:
AB937,4,2019 146.81 (5) (f) A temporary guardian appointed for a patient as described in s.
20146.813 (1).
AB937,7 21Section 7 . 146.81 (5) (g) of the statutes is created to read:
AB937,4,2322 146.81 (5) (g) An individual who is treated as a personal representative under
2345 CFR 164.502 (g).
AB937,8 24Section 8 . 146.813 of the statutes is created to read:
AB937,5,5
1146.813 Representatives of the patient. (1) Temporary guardian. A court
2may appoint a temporary guardian for a patient who is believed to be incompetent
3to consent to the release of records under s. 146.82 as the representative of the
4patient for the purpose of deciding upon the release of records, if no guardian has
5been appointed for the patient.
AB937,5,10 6(2) Exception to representatives of the patient. Notwithstanding s. 146.81
7(5), a health care provider, in its discretion, may elect not to consider a person who
8would otherwise be a representative of the patient by definition as a representative
9of the patient if the health care provider believes any of the following circumstances
10exist:
AB937,5,1211 (a) The patient has been or may be subjected to domestic violence, abuse, or
12neglect by the person who meets the definition under s. 146.81 (5).
AB937,5,1613 (b) Considering the person who meets the definition under s. 146.81 (5) as a
14representative of the patient could endanger the patient and, in the exercise of the
15health care provider's professional judgment, it is not in the best interest of the
16patient to consider that person a representative of the patient.
AB937,9 17Section 9 . 146.819 (2) (a) of the statutes is amended to read:
AB937,5,2118 146.819 (2) (a) Provide written notice, by 1st class mail, to each patient or
19person authorized by representative of the patient whose records will be maintained,
20at the last-known address of the patient or person representative, describing where
21and by whom the records shall be maintained.
AB937,10 22Section 10 . 146.819 (3) (a) of the statutes is amended to read:
AB937,6,823 146.819 (3) (a) Provide notice to each patient or person authorized by
24representative of the patient whose records will be deleted or destroyed, that the
25records pertaining to the patient will be deleted or destroyed. The notice shall be

1provided at least 35 days prior to deleting or destroying the records, shall be in
2writing and shall be sent, by 1st class mail, to the last-known address of the patient
3to whom the records pertain or the last-known address of the person authorized by
4representative of the patient. The notice shall inform the patient or person
5authorized by
representative of the patient of the date on which the records will be
6deleted or destroyed, unless the patient or person representative retrieves them
7before that date, and the location where, and the dates and times when, the records
8may be retrieved by the patient or person representative.
AB937,11 9Section 11 . 146.819 (3) (b) of the statutes is amended to read:
AB937,6,1510 146.819 (3) (b) Publish, under ch. 985, a class 3 notice in a newspaper that is
11published in the county in which the health care provider's or decedent's health care
12practice was located, specifying the date on which the records will be deleted or
13destroyed, unless the patient or person authorized by representative of the patient
14retrieves them before that date, and the location where, and the dates and times
15when, the records may be retrieved by the patient or person representative.
AB937,12 16Section 12 . 146.82 (1) of the statutes is amended to read:
AB937,6,2517 146.82 (1) Confidentiality. All patient health care records shall remain
18confidential. Patient health care records may be released only to the persons
19designated in this section or to other persons with the informed consent of the patient
20or of a person authorized by representative of the patient. This subsection does not
21prohibit reports made in compliance with s. 253.12 (2), 255.40, or 979.01; records
22generated and disclosed to the controlled substances board pursuant to s. 961.385;
23testimony authorized under s. 905.04 (4) (h); or releases made for purposes of health
24care operations, as defined in 45 CFR 164.501, and as authorized under 45 CFR 164,
25subpart E.
AB937,13
1Section 13. 146.82 (4) (b) 1. of the statutes is amended to read:
AB937,7,42 146.82 (4) (b) 1. Any person, if the patient or a person authorized by
3representative of the patient is not incapacitated, is physically available, and agrees
4to the release of that portion.
AB937,14 5Section 14 . 146.82 (4) (b) 2. (intro.) of the statutes is amended to read:
AB937,7,126 146.82 (4) (b) 2. (intro.) Any of the following, as applicable, if the patient and
7person authorized by representative of the patient are incapacitated or are not
8physically available, or if an emergency makes it impracticable to obtain an
9agreement from the patient or from the person authorized by representative of the
10patient, and if the health care provider determines, in the exercise of his or her
11professional judgment, that release of a portion of the patient health care record is
12in the best interest of the patient:
AB937,15 13Section 15 . 146.82 (5) (b) of the statutes is amended to read:
AB937,7,1814 146.82 (5) (b) Notwithstanding sub. (1) and except as provided in s. 610.70 (5),
15a covered entity may redisclose a patient health care record it receives under this
16section without consent by the patient or person authorized by representative of the
17patient if the redisclosure of the patient health care record is a release permitted
18under this section.
AB937,16 19Section 16 . 146.82 (5) (c) 1. of the statutes is amended to read:
AB937,7,2120 146.82 (5) (c) 1. The patient or a person authorized by representative of the
21patient provides informed consent for the redisclosure.
AB937,17 22Section 17. 146.83 (1b) of the statutes is amended to read:
AB937,8,223 146.83 (1b) Notwithstanding s. 146.81 (5), in this section, a “person authorized
24by
representative of the patient" includes an attorney appointed to represent the

1patient under s. 977.08 if that attorney has written informed consent from the
2patient to view and obtain copies of the records.
AB937,18 3Section 18 . 146.83 (1c) of the statutes is amended to read:
AB937,8,74 146.83 (1c) Except as provided in s. 51.30 or 146.82 (2), any patient or person
5authorized by
representative of the patient may, upon submitting a statement of
6informed consent, inspect the health care records of a health care provider pertaining
7to that patient at any time during regular business hours, upon reasonable notice.
AB937,19 8Section 19 . 146.83 (1f) (am) of the statutes is amended to read:
AB937,8,159 146.83 (1f) (am) If a patient or person authorized by representative of the
10patient requests copies of the patient's health care records under this section for use
11in appealing a denial of social security disability insurance, under 42 USC 401 to 433,
12or supplemental security income, under 42 USC 1381 to 1385, the health care
13provider may charge the patient or person authorized by representative of the
14patient no more than the amount that the federal social security administration
15reimburses the department for copies of patient health care records.
AB937,20 16Section 20 . 146.83 (1f) (cm) of the statutes is amended to read:
AB937,9,217 146.83 (1f) (cm) Except as provided in sub. (1g), a health care provider may not
18charge a patient or a person authorized by representative of the patient more than
1925 percent of the applicable fee under sub. (3f) for providing one set of copies of a
20patient's health care records under this section if the patient is eligible for medical
21assistance, as defined in s. 49.43 (8). A health care provider may require that a
22patient or person authorized by representative of the patient provide proof that the
23patient is eligible for medical assistance before providing copies under this
24paragraph at a reduced charge. A health care provider may charge 100 percent of

1the applicable fee under sub. (3f) for providing a 2nd or additional set of copies of
2patient health care records for a patient who is eligible for medical assistance.
AB937,21 3Section 21 . 146.83 (3) of the statutes is amended to read:
AB937,9,74 146.83 (3) The health care provider shall note the time and date of each request
5by a patient or person authorized by representative of the patient to inspect the
6patient's health care records, the name of the inspecting person, the time and date
7of inspection and identify the records released for inspection.
AB937,22 8Section 22 . 146.83 (3f) (b) 1., 2., 3., 4., 5. and 6. of the statutes are amended
9to read:
AB937,9,1310 146.83 (3f) (b) 1. For paper copies: $1 or copies provided via portable electronic
11data storage device, $1.10
per page for the first 25 pages; 75 82 cents per page for
12pages 26 to 50; 50 54 cents per page for pages 51 to 100; and 30 32 cents per page for
13pages 101 and above.
AB937,9,1514 2. For copies of records generated from microfiche or microfilm copies, $1.50
15$1.62 per page, regardless of the delivery method.
AB937,9,1616 3. For a print of an X-ray, $10 $10.84 per image.
AB937,9,1817 4. If the requester is not the patient or a person authorized by representative
18of
the patient, for certification of copies, a single $8 $8.69 charge.
AB937,9,2019 5. If the requester is not the patient or a person authorized by representative
20of
the patient, a single retrieval fee of $20 $21.73 for all copies requested.
AB937,9,2121 6. Actual shipping costs, an electronic delivery fee, and any applicable taxes.
AB937,23 22Section 23 . 146.83 (3f) (b) 1m. of the statutes is created to read:
AB937,9,2423 146.83 (3f) (b) 1m. For an electronic copy secured from a medical provider's
24electronic health record and delivered via electronic mail or secure Internet portal,

1the fees as provided under this paragraph, but the per page fees under subd. 1. may
2not exceed $300 per record, plus any applicable taxes.
AB937,24 3Section 24 . 146.83 (3f) (b) 3m. of the statutes is created to read:
AB937,10,54 146.83 (3f) (b) 3m. For a digital copy of an X-ray, MRI, or other image set not
5stored on paper, $30.00 per study.
AB937,25 6Section 25 . 146.83 (3f) (c) 2. of the statutes is amended to read:
AB937,10,147 146.83 (3f) (c) 2. On each July 1, beginning on July 1, 2012 2018, the
8department shall adjust the dollar amounts specified under par. (b) by the
9percentage difference between the consumer price index for the 12-month period
10ending on December 31 of the preceding year and the consumer price index for the
1112-month period ending on December 31 of the year before the preceding year. The
12department shall notify the legislative reference bureau of the adjusted amounts and
13the legislative reference bureau shall publish the adjusted amounts in the Wisconsin
14Administrative Register.
AB937,10,1515 (End)
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