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Vol. 72, No. 6, June 1999 |
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 med-ical 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.
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