988 N.W.2d 627
Wis.2023Background
- Plaintiff Beatriz Banuelos requested her medical records in electronic form and directed UW Hospitals to transmit them to her attorneys.
- UW Hospitals (through its business associate Ciox) transmitted the records electronically and Ciox sent an invoice for $109.96 with per-page charges consistent with Wisconsin's paper-copy rates.
- Banuelos sued under Wis. Stat. § 146.83(3f), alleging the per-page charges for an electronic production exceeded what state law permits.
- The circuit court granted UW Hospitals' motion to dismiss; the court of appeals reversed, holding § 146.83(3f) does not permit fees for electronic copies.
- The Wisconsin Supreme Court affirmed the court of appeals: it concluded § 146.83(3f) does not authorize fees for electronic-format patient records and that Banuelos pleaded a viable claim.
- Dissenting opinions argued (1) the complaint alleges Ciox, a non–health-care-provider, charged and collected the fee (and § 146.83(3f) regulates only health care providers), and (2) statutory silence does not forbid private parties from charging — federal HITECH law, not state statute silence, governs electronic-record fees.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Wis. Stat. § 146.83(3f) permits charging fees for copies of patient records provided in electronic format | Because § 146.83(3f)(b) lists only paper, microfiche/microfilm, and x-ray formats, electronic-format fees are not authorized and thus are unlawful | The statute is silent about electronic copies; silence does not prohibit charges, so providers may charge for electronic copies (subject to federal law) | The Court held the statute does not permit fees for electronic-format records; Banuelos stated a claim |
| Whether Banuelos sufficiently alleged UW Hospitals — not only Ciox — imposed/collected the charged fee such that § 146.83(3f) applies | Banuelos alleges UW Hospitals, through its business associate Ciox, transmitted the records and included the invoice, so UW Hospitals can be held responsible | Dissent: complaint shows Ciox (a non‑provider) billed and collected; § 146.83(3f) regulates only health care providers, so claims against UW Hospitals fail | The majority treated the complaint as alleging UW Hospitals acted through Ciox and found the pleading adequate to survive dismissal |
| What role statutory history and federal law (HITECH) play in interpreting § 146.83(3f) | The 2009 statutory text had an express electronic‑copy charge that was later deleted; that deletion and later enactment support that the current statute does not authorize electronic‑copy fees | The HITECH Act already caps charges for electronic copies at labor cost; state silence means providers retain freedom to charge within federal limits | The Court relied on statutory text and history (deletion of prior electronic‑fee language) to conclude the state statute does not permit such fees; federal law was acknowledged but not decisive for the state‑statute interpretation |
Key Cases Cited
- State ex rel. Kalal v. Cir. Ct. for Dane Cnty., 271 Wis. 2d 633 (statutory‑interpretation canons)
- Townsend v. ChartSwap, LLC, 399 Wis. 2d 599 (statute regulates only health care providers)
- Heritage Farms, Inc. v. Markel Ins. Co., 339 Wis. 2d 125 (interpretation of mandatory "shall")
- Milwaukee Journal Sentinel v. City of Milwaukee, 341 Wis. 2d 607 (may not read language back into statute)
- Data Key Partners v. Permira Advisers LLC, 356 Wis. 2d 665 (motion‑to‑dismiss pleading standard)
- Ciox Health, LLC v. Azar, 435 F. Supp. 3d 30 (federal decision regarding HITECH guidance and electronic‑copy fees)