146.82 Annotation
Patient billing records requested by the state in a fraud investigation under s. 46.25 [now s. 49.22] may be admitted into evidence under the exception to confidentiality found under sub. (2) (a) 3. State v. Allen,
200 Wis. 2d 301,
546 N.W.2d 517 (1996).
146.82 Annotation
This section does not restrict access to medical procedures and did not prevent a police officer from being present during an operation. State v. Thompson,
222 Wis. 2d 179,
585 N.W.2d 905 (Ct. App. 1998).
146.82 Annotation
The provision of confidentiality for patient health records is not an absolute bar to the release of information without the patient's informed consent. Sub. (2) provides numerous exceptions. Information of previous assaultive behavior by a nursing home resident was not protected by the physician-patient privilege and was subject to release by "lawful court order." Crawford v. Care Concepts, Inc. 2001 WI App 45,
243 Wis. 2d 119,
625 N.W.2d 876.
146.82 Annotation
Disclosure of patient health care records in Wisconsin. Lehner, WBB Aug. 1984.
146.82 Annotation
Confidentiality of Medical Records. Meili. Wis. Law. Feb. 1995.
146.83
146.83
Access to patient health care records. 146.83(1)(1) Except as provided in
s. 51.30 or
146.82 (2), any patient or other person may, upon submitting a statement of informed consent:
146.83(1)(a)
(a) Inspect the health care records of a health care provider pertaining to that patient at any time during regular business hours, upon reasonable notice.
146.83(1)(b)
(b) Receive a copy of the patient's health care records upon payment of fees, as established by rule under
sub. (3m).
146.83(1)(c)
(c) Receive a copy of the health care provider's X-ray reports or have the X-rays referred to another health care provider of the patient's choice upon payment of fees, as established by rule under
sub. (3m).
146.83(1m)(a)(a) A patient's health care records shall be provided to the patient's health care provider upon request and, except as provided in
s. 146.82 (2), with a statement of informed consent.
146.83(1m)(b)
(b) The health care provider under
par. (a) may be charged reasonable costs for the provision of the patient's health care records.
146.83(2)
(2) The health care provider shall provide each patient with a statement paraphrasing the provisions of this section either upon admission to an inpatient health care facility, as defined in
s. 50.135 (1), or upon the first provision of services by the health care provider.
146.83(3)
(3) The health care provider shall note the time and date of each request by a patient or person authorized by the patient to inspect the patient's health care records, the name of the inspecting person, the time and date of inspection and identify the records released for inspection.
146.83(3m)(a)(a) The department shall, by rule, prescribe fees that are based on an approximation of actual costs. The fees, plus applicable tax, are the maximum amount that a health care provider may charge under
sub. (1) (b) for duplicate patient health care records and under
sub. (1) (c) for duplicate X-ray reports or the referral of X-rays to another health care provider of the patient's choice. The rule shall also permit the health care provider to charge for actual postage or other actual delivery costs. In determining the approximation of actual costs for the purposes of this subsection, the department may consider all of the following factors:
146.83(3m)(a)1.
1. Operating expenses, such as wages, rent, utilities, and duplication equipment and supplies.
146.83(3m)(a)2.
2. The varying cost of retrieval of records, based on the different media on which the records are maintained.
146.83(3m)(a)3.
3. The cost of separating requested patient health care records from those that are not requested.
146.83(3m)(a)4.
4. The cost of duplicating requested patient health care records.
146.83(3m)(b)
(b) By January 1, 2006, and every 3 years thereafter, the department shall revise the rules under
par. (a) to account for increases or decreases in actual costs.
146.83(4)
(4) No person may do any of the following:
146.83(4)(a)
(a) Intentionally falsify a patient health care record.
146.83(4)(b)
(b) Conceal or withhold a patient health care record with intent to prevent or obstruct an investigation or prosecution or with intent to prevent its release to the patient, to his or her guardian appointed under
ch. 880, to his or her health care provider with a statement of informed consent, or under the conditions specified in
s. 146.82 (2), or to a person with a statement of informed consent.
146.83(4)(c)
(c) Intentionally destroy or damage records in order to prevent or obstruct an investigation or prosecution.
146.83 Annotation
Sub. (1) (b) does not preclude certification of a class action in a suit to recover unreasonable fees charged for copies of health care records. Cruz v. All Saints Healthcare System, Inc. 2001 WI App 67,
242 Wis. 2d 432,
625 N.W.2d 344.
146.835
146.835
Parents denied physical placement rights. A parent who has been denied periods of physical placement under
s. 767.24 (4) (b) or
767.325 (4) may not have the rights of a parent or guardian under this chapter with respect to access to that child's patient health care records under
s. 146.82 or
146.83.
146.835 History
History: 1987 a. 355.
146.836
146.836
Applicability. Sections 146.815,
146.82,
146.83 (4) and
146.835 apply to all patient health care records, including those on which written, drawn, printed, spoken, visual, electromagnetic or digital information is recorded or preserved, regardless of physical form or characteristics.
146.836 History
History: 1999 a. 78.
146.84
146.84
Violations related to patient health care records. 146.84(1)(1)
Actions for violations; damages; injunction. 146.84(1)(a)(a) A custodian of records incurs no liability under
par. (bm) for the release of records in accordance with
s. 146.82 or
146.83 while acting in good faith.
146.84(1)(b)
(b) Any person, including the state or any political subdivision of the state, who violates
s. 146.82 or
146.83 in a manner that is knowing and willful shall be liable to any person injured as a result of the violation for actual damages to that person, exemplary damages of not more than $25,000 and costs and reasonable actual attorney fees.
146.84(1)(bm)
(bm) Any person, including the state or any political subdivision of the state, who negligently violates
s. 146.82 or
146.83 shall be liable to any person injured as a result of the violation for actual damages to that person, exemplary damages of not more than $1,000 and costs and reasonable actual attorney fees.
146.84(1)(c)
(c) An individual may bring an action to enjoin any violation of
s. 146.82 or
146.83 or to compel compliance with
s. 146.82 or
146.83 and may, in the same action, seek damages as provided in this subsection.
146.84(2)(a)(a) Whoever does any of the following may be fined not more than $25,000 or imprisoned for not more than 9 months or both:
146.84(2)(a)2.
2. Discloses confidential information with knowledge that the disclosure is unlawful and is not reasonably necessary to protect another from harm.
146.84(2)(b)
(b) Whoever negligently discloses confidential information in violation of
s. 146.82 is subject to a forfeiture of not more than $1,000 for each violation.
146.84(2)(c)
(c) Whoever intentionally discloses confidential information in violation of
s. 146.82, knowing that the information is confidential, and discloses the information for pecuniary gain may be fined not more than $100,000 or imprisoned not more than 3 years and 6 months, or both.
146.84(3)
(3) Discipline of employees. Any person employed by the state or any political subdivision of the state who violates
s. 146.82 or
146.83, except a health care provider that negligently violates
s. 153.50 (6) (c), may be discharged or suspended without pay.
146.84(4)
(4) Exceptions. This section does not apply to any of the following:
146.84(4)(a)
(a) Violations by a nursing facility, as defined under
s. 49.498 (1) (i), of the right of a resident of the nursing facility to confidentiality of his or her patient health care records.
146.84(4)(b)
(b) Violations by a nursing home, as defined under
s. 50.01 (3), of the right of a resident of the nursing home to confidentiality of his or her patient health care records.
146.84 Annotation
Sub. (1) (b) does not preclude certification of a class action in a suit to recover unreasonable fees charged for copies of health care records. Cruz v. All Saints Healthcare System, Inc. 2001 WI App 67,
242 Wis. 2d 432,
625 N.W.2d 344.
146.885
146.885
Acceptance of assignment for medicare. The department shall annually provide aging units, as defined in
s. 46.82 (1) (a), with enrollment cards for and materials explaining the voluntary program that is specified in
s. 71.55 (10) (b), for distribution to individuals who are eligible or potentially eligible for participation in the program. The state medical society shall supply the department with the enrollment cards and the explanatory materials for distribution under this section.
146.885 History
History: 1989 a. 294,
359; Stats. 1989 s. 146.885;
1991 a. 235.
146.89
146.89
Volunteer health care provider program. 146.89(1)
(1) In this section, "volunteer health care provider" means an individual who is licensed as a physician under
ch. 448, dentist under
ch. 447, registered nurse, practical nurse or nurse-midwife under
ch. 441, optometrist under
ch. 449 or physician assistant under
ch. 448 or certified as a dietitian under
subch. V of ch. 448 and who receives no income from the practice of that health care profession or who receives no income from the practice of that health care profession when providing services at the nonprofit agency specified under
sub. (3).
146.89(2)(a)(a) A volunteer health care provider may participate under this section only if he or she submits a joint application with a nonprofit agency to the department of administration and that department approves the application. The department of administration shall provide application forms for use under this paragraph.
146.89(2)(b)
(b) The department of administration may send an application to the medical examining board for evaluation. The medical examining board shall evaluate any application submitted by the department of administration and return the application to the department of administration with the board's recommendation regarding approval.
146.89(2)(c)
(c) The department of administration shall notify the volunteer health care provider and the nonprofit agency of the department's decision to approve or disapprove the application.
146.89(2)(d)
(d) Approval of an application of a volunteer health care provider is valid for one year. If a volunteer health care provider wishes to renew approval, he or she shall submit a joint renewal application with a nonprofit agency to the department of administration. The department of administration shall provide renewal application forms that are developed by the department of health and family services and that include questions about the activities that the individual has undertaken as a volunteer health care provider in the previous 12 months.
146.89(3)
(3) Any volunteer health care provider and nonprofit agency whose joint application is approved under
sub. (2) shall meet the following applicable conditions:
146.89(3)(a)
(a) The volunteer health care provider shall provide services under
par. (b) without charge at the nonprofit agency, if the joint application of the volunteer health care provider and the nonprofit agency has received approval under
sub. (2) (a).
146.89(3)(b)
(b) The nonprofit agency may provide the following health care services:
146.89(3)(b)8.
8. Dental services, including simple tooth extractions and any necessary suturing related to the extractions, performed by a dentist who is a volunteer health provider.
146.89(3)(c)
(c) The nonprofit agency may not provide emergency medical services, hospitalization or surgery, except as provided in
par. (b) 8.
146.89(3)(d)
(d) The nonprofit agency shall provide health care services primarily to low-income persons who are uninsured and who are not recipients of any of the following:
146.89(4)
(4) Volunteer health care providers who provide services under this section are, for the provision of these services, state agents of the department of health and family services for purposes of
ss. 165.25 (6),
893.82 (3) and
895.46.
146.905
146.905
Reduction in fees prohibited. 146.905(1)
(1) Except as provided in
sub. (2), a health care provider, as defined in
s. 146.81 (1), that provides a service or a product to an individual with coverage under a disability insurance policy, as defined in
s. 632.895 (1) (a), may not reduce or eliminate or offer to reduce or eliminate coinsurance or a deductible required under the terms of the disability insurance policy.
146.905(2)
(2) Subsection (1) does not apply if payment of the total fee would impose an undue financial hardship on the individual receiving the service or product.
146.905 History
History: 1991 a. 250;
1995 a. 225.
146.91
146.91
Long-term care insurance. 146.91(1)
(1) In this section, "long-term care insurance" means insurance that provides coverage both for an extended stay in a nursing home and home health services for a person with a chronic condition. The insurance may also provide coverage for other services that assist the insured person in living outside a nursing home including but not limited to adult day care and continuing care retirement communities.
146.91(2)
(2) The department, with the advice of the council on long-term care insurance, the office of the commissioner of insurance, the board on aging and long-term care and the department of employee trust funds, shall design a program that includes the following:
146.91(2)(a)
(a) Subsidizing premiums for persons purchasing long-term care insurance, based on the purchasers' ability to pay.
146.91(2)(b)
(b) Reinsuring by the state of policies issued in this state by long-term care insurers.
146.91(2)(c)
(c) Allowing persons to retain liquid assets in excess of the amounts specified in
s. 49.47 (4) (b) 3g.,
3m. and
3r., for purposes of medical assistance eligibility, if the persons purchase long-term care insurance.
146.91(3)
(3) The department shall collect any data on health care costs and utilization that the department determines to be necessary to design the program under
sub. (2).
