146.82(4)(b)1.
1. Any person, if the patient or a person authorized by the patient is not incapacitated, is physically available, and agrees to the release of that portion.
146.82(4)(b)2.
2. Any of the following, as applicable, if the patient and person authorized by the patient are incapacitated or are not physically available, or if an emergency makes it impracticable to obtain an agreement from the patient or from the person authorized by the patient, and if the health care provider determines, in the exercise of his or her professional judgment, that release of a portion of the patient health care record is in the best interest of the patient:
146.82(4)(b)2.a.
a. A member of the patient's immediate family, another relative of the patient, a close personal friend of the patient, or an individual identified by the patient, that portion that is directly relevant to the involvement by the member, relative, friend, or individual in the patient's care.
146.82(4)(b)2.b.
b. Any person, that portion that is necessary to identify, locate, or notify a member of the patient's immediate family or another person that is responsible for the care of the patient concerning the patient's location, general condition, or death.
146.82(5)(b)
(b) Notwithstanding
sub. (1) and except as provided in
s. 610.70 (5), a covered entity may redisclose a patient health care record it receives under this section without consent by the patient or person authorized by the patient if the redisclosure of the patient health care record is a release permitted under this section.
146.82(5)(c)
(c) Notwithstanding
sub. (1), an entity that is not a covered entity may redisclose a patient health care record it receives under this section only under one of the following circumstances:
146.82(5)(c)1.
1. The patient or a person authorized by the patient provides informed consent for the redisclosure.
146.82(5)(c)3.
3. The redisclosure is limited to the purpose for which the patient health care record was initially received.
146.82 History
History: 1979 c. 221;
1983 a. 398;
1985 a. 29,
241,
332,
340;
1987 a. 40,
70,
127,
215,
233,
380,
399;
1989 a. 31,
102,
334,
336;
1991 a. 39;
1993 a. 16,
27,
445,
479;
1995 a. 98,
169,
417;
1997 a. 35,
114,
231,
272,
292,
305;
1999 a. 32,
78,
83,
114,
151;
2001 a. 38,
59,
69,
105;
2003 a. 281;
2005 a. 187,
344,
387,
388,
434;
2007 a. 20 s.
9121 (6) (a);
2007 a. 45,
106,
108,
130.
146.82 Annotation
Because under s. 905.04 (4) (f) there is no privilege for chemical tests for intoxication, results of a test taken for diagnostic purposes are admissible in an OMVWI trial without patient approval. City of Muskego v. Godec,
167 Wis. 2d 536,
482 N.W.2d 79 (1992).
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),
95-0792.
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),
97-2744.
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 45,
243 Wis. 2d 119,
625 N.W.2d 876,
99-0863.
146.82 Annotation
In the event of a release of confidential health information in violation of HIPAA or this section, the proper remedy is not suppression of the released information. Neither HIPAA nor this section provides for suppression of evidence as a remedy for a violation. Suppression is warranted only when evidence has been obtained in violation of a defendant's constitutional rights or if a statute specifically provides for suppression as a remedy. State v. Straehler, 2008 WI App 14, ___ Wis. 2d ___,
745 N.W.2d 431,
07-0822.
146.82 Annotation
This section does not reach beyond protection of health care records. A nurse's verbal statements based upon her observations are not protected by this section. State v. Straehler, 2008 WI App 14, ___ Wis. 2d ___,
745 N.W.2d 431,
07-0822.
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.
146.82 Annotation
Balancing Federal and Wisconsin Medical Privacy Laws. Hartin. Wis. Law. June 2003.
146.82 Annotation
Attorney access to and use of medical records. Stone. Wis. Law. Aug. 2003
146.82 Annotation
Attorney access to medical records. Stone. Wis. Law. Oct. 2003
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 Cross-reference
Cross Reference: See also ch.
DHS 117, Wis. adm. code.
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, 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,
00-1473.
146.83 Annotation
The party asserting the health care services review privilege under sub. (1m) bears the burden of establishing 2 conditions: 1) the investigation must be part of a program organized and operated to improve the quality of health care at the hospital, and 2) the person conducting the investigation must be acting on behalf of, or as part of a group with relatively constant membership, officers, a purpose, and a set of regulations. The privilege did not apply to an investigation conducted by an individual doctor, and not the hospital's peer review committee, that was initiated by the hospital to report a problem to the supervisor of the residency program in which the defendant resident was enrolled, and not to improve the quality of health care at the hospital. Phelps v. Physicians Insurance Company of Wisconsin, Inc. 2005 WI 85,
282 Wis. 2d 69,
698 N.W.2d 643,
03-0580.
146.835
146.835
Parents denied physical placement rights. A parent who has been denied periods of physical placement under
s. 767.41 (4) (b) or
767.451 (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;
2005 a. 443 s.
265.
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,
00-1473.
146.87
146.87
Federal registration numbers for prescribers of controlled substances. 146.87(1)(b)
(b) "Federal registration number" means the registration number required under
21 USC 822 for practitioners who prescribe controlled substances.
146.87(2)
(2) Beginning on the first day on which small health plans are required to comply with a U.S. Department of Health and Human Services regulation under
42 USC 1320d-2 (b) that requires use of a unique identifier for health care providers, no person may do any of the following:
146.87(2)(a)
(a) Require that a practitioner include his or her federal registration number on a prescription order for a drug or device that is not a controlled substance.
146.87(2)(b)
(b) Disclose a practitioner's federal registration number without the practitioner's consent for any purpose other than complying with or enforcing federal or state law related to controlled substances.
146.87(2)(c)
(c) Use a federal registration number to identify or monitor the prescribing practices of a practitioner, except for the purpose of complying with or enforcing federal or state law related to controlled substances.
146.87(3)
(3) A person who violates this section may be required to forfeit not more than $10,000 for each violation.
146.87 History
History: 2003 a. 272.
146.89
146.89
Volunteer health care provider program. 146.89(1)(d)
(d) "Governing body" means the governing body of any of the following:
