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) (1m)
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) (3m)
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)(a)5. 5. The impact on costs of advances in technology.
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) (2)Penalties.
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)1. 1. Requests or obtains confidential information under s. 146.82 or 146.83 (1) under false pretenses.
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)(a)3. 3. Violates s. 146.83 (4).
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 History History: 1991 a. 39; 1993 a. 445; 1999 a. 9, 79.
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) (1) In this section:
146.87(1)(a) (a) "Controlled substance" has the meaning given in s. 961.01 (4).
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(1)(c) (c) "Health care provider" has the meaning given in 42 USC 1320d (3).
146.87(1)(d) (d) "Practitioner" has the meaning given in s. 450.01 (17).
146.87(1)(e) (e) "Prescription order" has the meaning given in s. 450.01 (21).
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) (1) In this section:
146.89(1)(d) (d) "Governing body" means the governing body of any of the following:
146.89(1)(d)1. 1. A charter school, as defined in s. 115.001 (1).
146.89(1)(d)2. 2. A private school, as defined in s. 115.001 (3r), that participates in the Milwaukee Parental Choice Program under s. 119.23.
146.89(1)(g) (g) "School" means any of the following:
146.89(1)(g)1. 1. A public elementary school.
146.89(1)(g)2. 2. A charter school, as defined in s. 115.001 (1).
146.89(1)(g)3. 3. A private school, as defined in s. 115.001 (3r), that participates in the Milwaukee Parental Choice Program under s. 119.23.
146.89(1)(h) (h) "School board" has the meaning given in s. 115.001 (7).
146.89(1)(r) (r) "Volunteer health care provider" means an individual who is licensed as a physician under ch. 448, dentist or dental hygienist under ch. 447, registered nurse, practical nurse, or nurse-midwife under ch. 441, optometrist under ch. 449, or physician assistant under ch. 448, or pharmacist under ch. 450, who is certified as a dietitian under subch. V of ch. 448, or who is a nurse practitioner, as defined in s. 255.06 (1) (d), or who performs functions described for pharmacy technicians in rules promulgated by the pharmacy examining board, 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 or school specified under sub. (3).
146.89(2) (2)
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, school board, or governing body to the department of administration and that department approves the application. If the volunteer health care provider submits a joint application with a school board or governing body, the application shall include a statement by the school board or governing body that certifies that the volunteer health care provider has received materials that specify school board or governing body policies concerning the provision of health care services to students and has agreed to comply with the policies. 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, school board, or governing body 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, school board, or governing body to the department of administration. The department of administration shall provide renewal application forms that are developed by the department of health 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, except as provided in sub. (3m), 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) Under this section, the nonprofit agency may provide the following health care services:
146.89(3)(b)1. 1. Diagnostic tests.
146.89(3)(b)2. 2. Health education.
146.89(3)(b)3. 3. Information about available health care resources.
146.89(3)(b)4. 4. Office visits.
146.89(3)(b)5. 5. Patient advocacy.
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