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.
 Sen. 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.
Wisconsin Lawyer
