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Maximum fees for copies of health care records increase

Notice of the adjusted fees providers may charge for providing copies of health care records through June 30, 2014, has been published in the Wisconsin Administrative Register (fees noted on page 61). The maximum fees are adjusted annually pursuant to Wis. Stat. § 146.83 (3f) (c)2.

The adjusted fees are listed below with last year’s fees in parentheses for reference. These fees are the maximum fees providers may charge under Chapter 146 of the Wisconsin statutes. Providers have discretion over the actual fees they charge as long as those fees do not exceed the maximum allowed by law. Providers also may charge actual shipping costs and any applicable taxes. Information about exceptions to these fees, as well as the collection of sales tax when charging for copies of health care records, is noted below the fees.

Maximum Fees through June 30, 2014 — (last year’s fees noted for reference)

Paper copies

  • First 25 pages: $1.04/page ($1.02/page)
  • Pages 26-50: 77 cents/page (76 cents/page)
  • Pages 51-100: 52 cents/page (51 cents/page)
  • Pages 101 and above: 31 cents/page (30 cents/page)


Microfiche or Microfilm: $1.55/page ($1.52/page)

Print of an X-ray (per image): $10.32 ($10.15)

If the requestor is not the patient or a person authorized by the patient

  • Certification of copies: $8.26 ($8.12)
  • Retrieval fee: $20.65 ($20.30)

 
Exceptions
Providers may not charge a patient or person authorized by the patient more than 25 percent of the applicable fees for providing one set of copies of a patient’s health care records if the patient is eligible for medical assistance (MA). Previously, one set had to be provided free of charge. Providers may:

  • require proof that the patient is eligible for MA before providing copies at the reduced charge.
  • charge 100 percent of the applicable fee for additional copies of the MA-eligible patient’s health care records.

 
The reduced fee requirement does not apply if the physician or other health care professional is with the Wisconsin Department of Health Services (DHS) or the Wisconsin Department of Corrections.

Providers may not charge more than the federal Social Security Administration reimburses DHS for copies of patient health care records if:

  • DHS requests copies of the patient’s health care records for use in determining eligibility for social security income.
  • the health care records requested by a patient or person authorized are for use in appealing a denial of social security disability insurance or supplemental security income.

 
The above fees also do not apply to health care records requested by an employee, employer, worker’s compensation insurer, or the Wisconsin Department of Workforce Development or their representatives that are reasonably related to any injury for which the patient/employee claims compensation. Under Wis. Stat. § 102.13 (2) (b), the statute that governs charges in these circumstances, the actual costs to provide a certified copy of the records shall not exceed the greater of 45 cents per page or $7.50 per request, plus the actual costs for postage.

Sales Tax
According to the Wisconsin Department of Revenue (DOR), providers or entities charging for copies of health care records have conducted a sale subject to sales tax. The tax is imposed on the retailer (i.e., physician, health care professional or entity), who may in turn pass it on to the customer (i.e., requestor of records). If sales tax is not charged and collected from the customer, the retailer still is obligated to pay the sales tax to the DOR. See Wisconsin Tax Bulletin #61 — page 21.

According to the DOR, a retailer that charges for health care records requested in relation to a worker’s compensation claim is liable to the DOR for sales tax even if the worker’s compensation stature precludes the retailer from collecting the sales tax. Specifically, the DOR noted, “There is no provision in the worker’s compensation law that precludes the Department from collecting sales tax on photocopies from the retailer of such photocopies.” See Wisconsin Tax Bulletin #76 — page 14.

Sales tax on the sale of copies of health care records is collected via the business’ tax return. Providers and entities should consult with a private accountant or attorney for specific information about proper reporting and payment of such taxes. If the DOR determines that a physician or other health care professional or entity has failed to pay sales tax on fees collected for copies of health care records, the physician or other health care professional or entity would be required to pay the back taxes and may incur interest on those taxes as well as penalties.

Back to July 11, 2013 Medigram