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Maximum fees for copies of health care records increases

The maximum fees health care providers may charge for providing copies of health care records are adjusted annually based on the consumer price index. (See Wis. Stat. § 146.83 (3f) (c) 2 for specific details.) The 2014-2015 maximum fees were published recently and include a small increase.

Maximum fees effective through June 30, 2015
(Last year’s fees are noted in parentheses for reference.)

  • Paper copies:
    • First 25 pages: $1.06/page ($1.04/page)
    • Pages 26-50: 78 cents/page (77 cents/page)
    • Pages 51-100: 53 cents/page (52 cents/page)
    • Pages 101 and above: 31 cents/page (No Change)
  • Microfiche or Microfilm: $1.57/page ($1.55/page)
  • Print of an X-ray (per image): $10.47 ($10.32)

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

  • Certification of copies: $8.38 ($8.26)
  • Retrieval fee: $20.96 ($20.65)

Keep in mind that these fees are not mandatory. Health care providers have discretion over the actual fees they charge as long as those fees do not exceed the maximum allowed by law. Other fees a health care provider may charge for copies of health care records include actual shipping costs and any applicable taxes.

Medical Assistance (MA): Health care 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 MA. Health care providers may require proof that the patient is eligible for MA before providing copies at the reduced charge and 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 health care provider is the Department of Health Services (DHS) or the Wisconsin Department of Corrections.

Social Security: Health care providers may not charge more than the federal Social Security Administration reimburses DHS for copies of patient health care records if: (1) DHS requests copies of the patient’s health care records for use in determining eligibility for social security income or (2) 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.

Worker’s Compensation: Under Wis. Stat. § 102.13 (2) (b), fees for a certified copy of 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 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), health care 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., health care provider 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 is still 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’s tax return. Health care providers and entities should consult with a private accountant or attorney for specific information on proper reporting and payment of such taxes. If the DOR determines that a health care provider or entity has failed to pay sales tax on fees collected for copies of health care records, the health care provider or entity would be required to pay the back taxes and may incur interest on those taxes, as well as penalties.

Back to August 14, 2014 Medigram