LaROCQUE, J.
¶1 Aurora Healthcare, Inc. and HealthPort Technologies, LLC (collectively "HealthPort" except as needed) appeal from non-final orders denying HealthPort's motion for summary judgment and denying its motion for reconsideration.
¶2 In April 2011, Moya was involved in a motor vehicle accident. She hired Welcenbach Law Offices, S.C. to handle her personal injury lawsuit. Attorney Robert Welcenbach had Moya sign HIPAA forms authorizing the release of her medical records
¶3 In March 2013, Moya filed a class action complaint alleging HealthPort violated WIS. STAT. § 146.83(3f) by charging her attorney the retrieval and certification fees. She argued that her attorney was a "person authorized by the patient" and therefore exempt from having to pay retrieval or certification fees. HealthPort filed a motion to dismiss the complaint, which was denied by the circuit court.
¶4 After discovery, HealthPort filed a motion for summary judgment asserting that the proper interpretation of WIS. STAT. §§ 146.81-146.83 clearly shows that Moya's attorney was not a "person authorized by the patient" because that term means a person who the patient has given the power to consent to release of her health care records to others. A client's signed HIPAA authorization only gives a personal injury attorney the right to obtain and view health care records, but not the right to have health care providers release those records to others. The circuit court denied HealthPort's motion, ruling that "person authorized by the patient" had different degrees of meaning. It held that the phrase meant authority "to consent to the release of records" under § 146.81(5), but under § 146.83, the phrase meant anyone who the patient gives "the authority to inspect the patient's health care records."
¶5 HealthPort subsequently filed a motion for reconsideration arguing that the recent amendment to WIS. STAT. § 146.83, adding subsection (1b), demonstrated that the circuit court's earlier interpretation of the statute was incorrect. Subsection (1b) made State Public Defenders a "person authorized by the patient" when the attorney has written informed consent:
WIS. STAT. § 146.83(1b). The circuit court denied the motion for reconsideration. HealthPort filed a petition to appeal from non-final orders, which we granted.
¶6 Our review on summary judgment decisions is de novo. See Green Spring Farms v. Kersten, 136 Wis.2d 304, 315-17, 401 N.W.2d 816 (1987). Here, the summary judgment involved the construction and interpretation of statutes, which presents legal issues we also review independently of the circuit court. See Mayo v. Boyd, 2014 WI App 37, ¶8, 353 Wis.2d 162, 844 N.W.2d 652. The purpose of statutory interpretation is to determine the intent of the legislature. Id. To do so, we start with the plain language of the statute and examine that language "in the context in which it is used; not in isolation but as part of a whole; in relation to the language of surrounding or closely-related statutes; and reasonably, to avoid absurd or unreasonable results." State ex rel. Kalal v. Circuit Court for Dane Cty., 2004 WI 58, ¶ 46, 271 Wis.2d 633, 681 N.W.2d 110.
¶7 The statutes requiring our interpretation are WIS. STAT. §§ 146.81-146.83. WISCONSIN STAT. § 146.81 defines words and phrases used in §§ 146.81-146.84. Subsection (5) defines "`[p]erson authorized by the patient'" as:
¶8 Wisconsin Stat. § 146.82 addresses the confidentiality of health care records. Subsection (1) provides in pertinent part: "All patient health care records shall remain confidential. Patient health care records may be released only to the persons designated in this section or to other persons with the informed consent of the patient or of a person authorized by the patient." Subsection (2) lists the circumstances in which patient health care records can be accessed without informed consent—none of which apply here. See § 146.82(2).
¶9 WISCONSIN STAT. § 146.83 addresses access to patient health care records and fees that can be charged for the records. The two pertinent subsections include (1b), which the legislature recently added to the statute. See 2013 Wis. Act 342 (April 23, 2014). Subsection (1b) provides: "Notwithstanding s. 146.81(5), in this section, a `person authorized by the patient' includes an attorney appointed to represent the patient under s. 977.08 if that attorney has written informed consent from the patient to view and obtain copies of the records." Subsections (3f)(a) & (b) require a health care provider to comply with proper requests and set forth the fees that can be charged for copies of medical records:
¶11 We start first with the plain language of the statute. State ex rel. Kalal, 271 Wis.2d 633, ¶46, 681 N.W.2d 110. WISCONSIN STAT. § 146.81(5) specifically defines "person authorized by the patient." The statute defines the phrase by listing the individuals who qualify as a "person authorized by the patient":
This list does not include personal injury attorneys whose clients have signed a HIPAA form. If the legislature intended to include attorneys who obtain clients' medical records in civil litigation, it certainly could have added attorneys to the list set forth in WIS. STAT. § 146.81(5). It did not. The legislature specifically defined the phrase "person authorized by the patient" and we are required to apply that definition as written. See State ex rel. Kalal, 271 Wis.2d 633, ¶45, 681 N.W.2d 110.
¶12 Moya argues her attorney falls under (5) above because she authorized her attorney "in writing" to get her medical records. But Moya's argument removes this part of the sentence and looks at it in isolation and out of the context from the rest of the sentence and statute. These statutes govern the use, disclosure, confidentiality, and release of protected health care information. WISCONSIN STAT. § 146.81(5) specifically defines those persons who may, instead of the patient, make the decision to authorize a health care provider to release confidential patient records. The legislature crafted a very specific list of individuals who fall into this group. Each individual listed by the legislature is a person who has the power derived from the patient (or the court) to make a decision about and request a health care provider release the patient's confidential records. Moya's attempt to extract the phrase "any person authorized in writing by the patient" from the context of § 146.81(5) and read it in isolation in order to give her attorney the power over the release of Moya's health care records runs contrary to the plain and contextual meaning of the language used by the legislature in crafting these statutes. See Teschendorf v. State Farm Ins. Cos., 2006 WI 89, ¶12, 293 Wis.2d 123, 717 N.W.2d 258 (proper statutory interpretation requires more than taking "`a single, isolated sentence or portion of a sentence'"—we must examine the entire statute in context; citation omitted); see also Schinner v. Schinner, 143 Wis.2d 81, 91-94, 420 N.W.2d 381
¶13 This analysis holds true in examining the specific definition set forth in WIS. STAT. § 146.81(5) when applying it to the fees statute itself, WIS. STAT. § 146.83(3f). The first thing § 146.81 says is that the definitions set forth in § 146.81 should be used in "ss. 146.81 to 146.84." See § 146.81. Thus, "person authorized by the patient" has to have the same meaning each time it is used throughout these statutes. The circuit court's conclusion that this phrase means what HealthPort argues it means in the definition section, but what Moya argues it means in the fees section violates basic rules of statutory construction and would result in an unreasonable and absurd interpretation. We must apply the definition of "person authorized by the patient" that the legislature specifically set forth in § 146.81(5) to § 146.83(3f) because the legislature clearly stated that this definition applies to § 146.83(3f). Accordingly, "person authorized by the patient" as used in § 146.83(3f)(b)4. and 5. means the same as it does in § 146.81(5): a person who has been authorized to consent to the release of a patient's health care records in place of the patient. This definition does not include Moya's attorney because it does not include attorneys who only have a HIPAA release from their client. A HIPAA release allows an attorney to obtain a copy of a client's medical records, but it does not give that attorney the power to consent to the release of Moya's confidential health care records. In other words, Moya gave her attorney the authority to get copies of her health care records, but she did not give her attorney authority to act on her behalf beyond that. The plain language and context of the definition of "person authorized by the patient" clearly shows that the legislature's intent was to protect the confidentiality of a patient's health care records, see WIS. STAT. § 146.82, and restrict the power to release health care records.
¶14 Our interpretation is further supported by the recent addition to WIS. STAT. § 146.83—subsection (1b). This subsection specifically added State Public Defender attorneys to the list of individuals who are a "person authorized by the patient" as long as the attorney gets written informed consent from the client. The legislature enacted this subsection with introductory language stating "Notwithstanding s. 146.81(5)." There is only one way to interpret the plain language of this subsection: WIS. STAT. § 146.81(5) does not include attorneys as a "person authorized by the patient." In other words, § 146.81(5) did not originally include attorneys who have a signed HIPAA release from their client as a person authorized by the patient. Notwithstanding the fact that attorneys with HIPAA releases do not qualify as a "person authorized by the patient," the legislature decided that State Public Defenders should be included, and therefore created § 146.83(1b) to do so—thereby exempting State Public Defenders from the certification and retrieval fees found in subsection § 146.83(3f). Moya argues that the State Public Defenders already were a "person authorized by the patient," and the amendment was necessary because companies like HealthPort refused to recognize this fact. If Moya's argument were correct, the legislature would not have used the "Notwithstanding s. 146.81(5)" language. Instead, the legislature would have amended the definition in § 146.81(5) to specifically include attorneys in the definitional list of "person authorized by the patient."
¶15 Moya also argues that her attorney should not have to pay the certification and retrieval fees simply because they ordered
¶16 Our review of the relevant statutes establishes that attorneys are not delineated in the list of individuals set forth in the definition of "person authorized by the patient" in WIS. STAT. § 146.81(5), the context of the statutory scheme indicates that "authorized" means having the power to consent to the release of the patient's records, and the recent amendment to WIS. STAT. § 146.83 adding subsection (1b) clearly shows attorneys do not fall under the definition of "person authorized by the patient." Accordingly, we conclude the circuit court misinterpreted the statute when it determined that Moya's signed HIPAA release made Moya's attorney a "person authorized by the patient" as that term is used in these statutes. We reverse the orders and remand with directions to grant HealthPort's motion for summary judgment.
Orders reversed and cause remanded with directions.
KESSLER, J. (dissenting).
¶17 I conclude that the Majority improperly ignores the plain language of WIS. STAT. §§ 146.81-146.83 and usurps the legislature's power by ignoring the plain language chosen by the legislature in § 146.81(5) and by adding exclusions that the legislature did not create in the statutes' definitions. The Majority uses a word in § 146.83 to create an exclusion in § 146.81(5) that the legislature did not impose. The effect of this leap of logic is a drastic limitation on the right of a competent adult patient to give informed consent to "any person" of the patient's choosing (here, the patient's attorney) to obtain copies of the patient's health care records at a statutorily-provided reduced cost to the patient. Consequently, I dissent.
¶18 The rules for statutory construction are well-established. Those rules are summarized by our supreme court in Kalal:
Id., 271 Wis.2d 633, ¶¶ 45-46, 681 N.W.2d 110 (emphasis added; citations and quotation marks omitted).
¶19 I begin with the plain language of WIS. STAT. § 146.81(5), in which "`[p]erson authorized by the patient'" is categorized accordingly:
(Emphasis added.) There are six categories of individuals who may be a "person authorized by the patient" to obtain confidential health records pertaining to the patient. The persons identified in § 146.81(5) fall into categories based either on clearly defined legal relationships to the patient or on the patient's personal choice. The persons with legal relationships include: (a) persons with legal authority to act on behalf of a minor (parent, guardian, legal custodian); (b) persons supervising a minor as a result of delinquency or criminal proceedings in accordance with certain statutes; and (c) persons to whom a court has given authority to act on behalf of the patient (guardian of an incompetent patient, personal representative of deceased patient). The patient's choice of a person to obtain the confidential records is recognized by acknowledging that (a) "any person authorized in writing by the patient" or (b) the spouse or domestic partner of a deceased patient may give consent to get these records. The legislature's language is clear and unambiguous. We need go no further to properly affirm the circuit court.
¶20 The Majority uses an addition to WIS. STAT. § 148.83(1b), the fee structure section of the medical records access scheme, to engraft limitations on the unambiguous inclusion in WIS. STAT. § 146.81(5) of "any person authorized in writing by the patient." To explain the mistake in that reasoning, I examine the context of §§ 146.81-146.83.
¶21 WISCONSIN STAT. § 146.81
¶22 WISCONSIN STAT. § 146.82 identifies persons and entities to whom health care records may be disclosed without informed consent from the patient. These provisions essentially allow sharing records within a health care provider entity, with health insurance payers and with certain
¶23 WISCONSIN STAT. § 146.83 establishes how much the entity providing the records may charge the person requesting copies of the records. The charges vary to some degree depending on the requesting entity. Section 146.83(3f) lists the charges the entity providing the records may require from the person or entity requesting the records:
(Emphasis added.) Here, there is no dispute that the patient signed a written consent that complied with statutory requirements, and authorized her attorney to obtain the records identified on the consent. The plain language of WIS. STAT. § 146.83(3f)(b) 4. and 5. allows a certification fee of $8.00 and a retrieval fee of $20.00 only if the requester is neither the patient nor a "`[p]erson authorized by the patient'" to obtain the records. Conversely stated, if the requester is the patient, or is a "`[p]erson authorized by the patient,'" these fees may not be charged. The Majority's conclusion to the contrary violates the rules of statutory construction established by our supreme court in Kalal and its related decisions.
¶24 To exclude a privately retained attorney from the WIS. STAT. § 146.81(5) definitions, the Majority relies on an amendment to WIS. STAT. § 146.83 which states:
¶26 The Majority attempts to justify its conclusion that the legislature meant what it did not say by making inferences based on what was not said. The introductory language of WIS. STAT. § 146.83(1b), "Notwithstanding s. 146.81(5)," is the basis of the Majority's inference that because the State Public Defender is not mentioned in § 146.81(5), the legislature really meant that "any person authorized by the patient" in § 146.81(5) actually means only persons specifically described. (Emphasis added.) The Majority claims that "[n]otwithstanding" means attorneys were not included in "any person authorized by the patient." See Majority, ¶ 14.
¶27 The Majority also opines that if the legislature meant to allow attorneys to obtain informed consent from their clients to get medical records, then the legislature would have amended WIS. STAT. § 146.81(5) instead. See Majority, ¶14. The analysis makes sense only if the Majority also concludes that the legislature did not understand the plain meaning of "any person" when it used that phrase years ago in § 146.81(5). "Any," an adjective, is "used to indicate one selected without restriction."
¶28 The Majority's conclusion here—that a private attorney with written informed consent from the patient is not a "`[p]erson authorized by the patient'"—ignores the plain language of WIS. STAT. § 146.81(5), which in no way limits the adult patient's choice of "any person" to obtain copies of his/her health care records. Moreover, WIS. STAT. § 146.83(1b), by the reference to WIS. STAT. § 977.08, allows a patient with appointed counsel to benefit from the savings provided by § 146.83(1b), while denying those cost savings to a patient with a privately retained counsel. Such a distinction has no support in the plain language of §§ 146.81-146.83, nor in logic, and possibly not even in the Wisconsin Constitution.
¶29 It is not the role of this court to add additional conditions to the plain language of a statute the legislature has enacted, nor may we ignore plain language the legislature has chosen. For all the foregoing reasons, I would affirm the circuit court.