This is the preview version of the Wisconsin State Legislature site.
Please see http://docs.legis.wisconsin.gov for the production version.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB1011,1 1Section 1 . 50.373 of the statutes is created to read:
AB1011,3,3 250.373 Video recording of surgical procedures. (1) Definitions. In this
3section:
AB1011,3,64 (a) “Conscious sedation” is a drug-induced depression of consciousness during
5which patients respond purposefully to verbal commands, either alone or
6accompanied by light tactile stimulation.
AB1011,4,3
1(b) “Deep sedation” is a drug-induced depression of consciousness during
2which patients cannot be easily aroused but respond purposefully following repeated
3or painful stimulation.
AB1011,4,64 (c) “Discharge instructions” means care instructions provided to a patient at
5or near the time of a patient's exit or release from a surgical facility after a surgical
6procedure.
AB1011,4,97 (d) “General anesthesia" means a temporary status commonly produced by the
8administration of certain intravenous drugs and inhaled gases that cause a patient
9to be unconscious and unable to feel pain during a medical procedure.
AB1011,4,1110 (e) “Guardian” means the person named by the court having the duty and
11authority of guardianship.
AB1011,4,1312 (f) “Health care provider" means a person or entity described under s. 146.81
13(1) (a) to (p) and includes any surgical facility.
AB1011,4,1614 (g) “Incapacitated" means unable to receive and evaluate information
15effectively or to communicate decisions to such an extent that an individual lacks the
16capacity to manage his or her health care decisions.
AB1011,4,1917 (h) “Legal custodian” means a person, other than a parent or guardian, or an
18agency to whom legal custody of the child has been transferred by a court, but does
19not include a person who has only physical custody of the child.
AB1011,4,2020 (i) “Patient health care records" has the meaning given in s. 146.81 (4).
AB1011,4,2221 (j) “Regional anesthesia” means use of local anesthetics to make a specific part
22of the body numb to prevent pain and allow for completion of a surgical procedure.
AB1011,4,2523 (k) “Surgical facility" means a hospital, as defined in s. 50.33 (2), an ambulatory
24surgical center, as defined in 42 CFR 416.2, or any other place where a surgical
25procedure is performed.
AB1011,5,2
1(L) “Surgical patient" means a patient who is scheduled to undergo a surgical
2procedure.
AB1011,5,63 (m) “Surgical practitioner" means a physician, surgeon, or osteopath under s.
4990.01 (28), an individual licensed to practice dentistry under ch. 447, and any other
5individual who holds a valid license or other credential that allows him or her to
6perform a surgical procedure.
AB1011,5,117 (n) “Surgical procedure” means a surgical procedure for which a patient is
8under conscious sedation, deep sedation, regional anesthesia, or general anesthesia.
9“Surgical procedure” includes a colonoscopy or similarly invasive procedure if
10performed under conscious sedation, deep sedation, regional anesthesia, or general
11anesthesia.
AB1011,5,1412 (o) “Surgical time out” means a final verification of details relating to a surgery,
13including at least confirmation of a surgical patient's identity, surgical site, and
14planned procedure.
AB1011,6,5 15(2) Option for recording. (a) 1. A surgical facility shall provide a surgical
16patient the option to have the surgical facility or the surgical facility's designee make
17a video recording of the patient's surgical procedure. For purposes of any recording
18of a surgical procedure made under this subdivision, the surgical facility or its
19designee shall make a continuous color video recording, including both audio and
20video and display of the time and date. The surgical facility or its designee may not
21interrupt the video recording within the surgical suite once started. Separate
22interactions outside of the surgical suite, including preoperative communications
23and surgical time outs under subd. 2, if outside of the surgical suite, and discharge
24instructions under subd. 3, if applicable, may be separately recorded. All areas of the
25surgical suite, including entrances and exits, must be in view on the recording and

1audible. The surgical facility or its designee shall begin the recording within the
2surgical suite of a surgical procedure under this subdivision when preparation of the
3surgical suite for that surgical patient's surgical procedure starts and continue the
4recording through the period of the cleanup after that procedure and until all activity
5in the surgical suite related to the procedure recorded is complete.
AB1011,6,106 2. Any procedure recording made under this subsection shall include a
7recording, under the standards described in subd. 1., of any preoperative
8communication regarding the surgical procedure between the surgical practitioner
9and the surgical patient and any surgical time out, regardless of where the
10preoperative communication or surgical time out takes place.
AB1011,6,1511 3. A surgical facility shall also provide a surgical patient the option to have his
12or her discharge instructions, as given by the patient's doctor or other health care
13provider, recorded. If a patient chooses to have his or her discharge instructions
14recorded, the recording may be audio only or videotaped, including audio, at the
15option of the surgical facility.
AB1011,6,1816 (b) 1. A surgical facility shall notify a surgical patient of the option to have a
17recording made under par. (a) and of the procedures, the fees, the conditions, the
18surgical practitioner's request option, and the advance request option.
AB1011,6,2219 2. If the surgical patient is a minor child, the surgical facility shall notify the
20minor child's parent, guardian, or legal custodian of the option to have a recording
21made under par. (a) and of the procedures, the fees, the conditions, the surgical
22practitioner's request option, and the advance request option.
AB1011,7,223 3. If a surgical patient is incapacitated, a surgical facility shall notify a person
24authorized by the patient under s. 146.81 (5), if available, or, if not, a relative of the

1patient of the option and information under subd. 1. and allow that person to make
2a decision regarding whether to have a recording made under par. (a).
AB1011,7,63 (c) A surgical practitioner who is scheduled to participate in a surgical patient's
4surgical procedure may request that the procedure be video recorded under the
5procedures described in this subsection. The surgical facility shall comply with the
6surgical practitioner's request if all of the following are true:
AB1011,7,127 1. The requesting surgical practitioner has informed the surgical patient or, if
8the patient is a minor, a parent, guardian, or legal custodian, of the surgical
9practitioner's request for video recording and the reason the surgical practitioner
10has requested that recording. If the patient is incapacitated, the requesting surgical
11practitioner shall inform a person authorized by the patient under s. 146.81 (5), if
12available, or, if not, a relative of the patient.
AB1011,7,1413 2. The surgical patient or other person informed under subd. 1. does not object
14to the video recording.
AB1011,7,1915 (d) A patient's doctor or other health care provider who will administer a
16patient's discharge instructions may request that the patient's discharge
17instructions, as given by the health care provider, be recorded under the procedures
18described in this subsection. The surgical facility shall comply with the health care
19provider's request if all of the following are true:
AB1011,7,2320 1. The requesting health care provider has informed the patient or, if
21applicable, a parent, guardian, legal custodian, or person authorized by the patient,
22of the health care provider's request for recording and the reason the health care
23provider has requested that recording.
AB1011,8,3
12. The surgical patient or, if applicable, the parent, guardian, legal custodian,
2person authorized by the patient under s. 146.81 (5), or relative of the patient does
3not object to the recording.
AB1011,8,144 (e) 1. Except as otherwise provided under this subsection, no surgical patient
5or person on behalf of a surgical patient may disclose, unless the surgical practitioner
6or other health care provider that is a subject of the recording waives confidentiality,
7the content of a recording created under this section except to health care providers
8providing care to the surgical patient, to immediate family members or a person
9authorized by the patient under s. 146.81 (5), or to an attorney or an attorney's staff
10for the purpose of obtaining legal advice. If legal action is taken, the surgical patient
11or an attorney for the surgical patient may disclose the recording to additional
12individuals if necessary for the case, but the recording shall be filed under seal if
13permitted by the court. In all other respects, recordings under this section shall be
14treated as patient health care records.
AB1011,8,2015 2. Notwithstanding the restrictions on disclosure under this paragraph, a
16surgical patient or a person on behalf of a surgical patient may disclose his or her
17discharge instructions to one or more persons designated by the surgical patient to
18assist the surgical patient with postsurgical care, and one person designated by the
19surgical patient may receive a free copy of the surgical patient's discharge
20instructions as set forth under sub. (10).
AB1011,9,621 3. Notwithstanding subds. 1. and 2. and sub. (10), a surgical facility or surgical
22practitioner may, if authorization is granted under sub. (3), use a copy of a recording
23made under this subsection for teaching or research purposes outside the network
24of the surgical facility and if the surgical patient's personal identifying information
25is redacted or if the surgical patient or other person authorized to request or consent

1to a recording under this subsection on behalf of the patient expressly consents, in
2writing, to the use and disclosure. Notwithstanding any other provision of this
3section, a surgical facility or surgical practitioner may, if not for teaching or research
4purposes outside of the network of the surgical facility, be permitted to use a
5recording made under this subsection without informed written confirmation under
6sub. (3) if the disclosure is otherwise permitted under s. 146.82 or 146.83.
AB1011,9,15 7(3) Written confirmation. Before proceeding with a recording under sub. (2),
8a surgical facility shall obtain from the surgical patient or other person authorized
9to request or consent to a recording under sub. (2) on behalf of the patient,
10confirmation, in writing, authorizing the recording of the surgical patient's surgical
11procedure. If a surgical facility or surgical practitioner intends to use a recording as
12described under sub. (2) (e) 3., the surgical facility shall provide written notice of that
13proposed use to the surgical patient or other person authorized to request or consent
14to a recording under sub. (2) on behalf of the patient, and obtain written
15authorization of that use of the recording.
AB1011,9,20 16(4) Equipment and technical assistance. A surgical facility shall have
17available appropriate recording equipment and technical assistance as determined
18by the department in rules promulgated under sub. (8) to comply with a surgical
19patient request for a recording of his or her surgical procedure or discharge
20instructions.
AB1011,9,23 21(5) Minors. If a surgical patient is a minor child, a parent, guardian, or legal
22custodian may request that a recording be made of the minor child's surgical
23procedure or discharge instructions under sub. (2) (a).
AB1011,9,25 24(6) Exception for emergencies. (a) Notwithstanding sub. (2), a surgical
25facility is not required to provide the option of a video recording or comply with a

1request for video recording under this section if the surgical practitioner determines
2in the exercise of his or her professional judgment that either of the following is true:
AB1011,10,33 1. Immediate surgery is necessary to avert death.
AB1011,10,64 2. Other circumstances exist such that video recording would cause a delay that
5would create a serious risk of substantial and irreversible impairment of one or more
6of the surgical patient's bodily functions.
AB1011,10,107 (b) The health care provider shall inform the surgical patient or, if applicable,
8other persons as described under sub. (2) (b) of the medical indications supporting
9the surgical practitioner's reasonable medical judgment that either of the emergency
10conditions under par. (a) exists.
AB1011,10,1511 (c) If a surgical practitioner determines under par. (a) that an emergency exists
12such that the surgical facility is not required to comply with a request for video
13recording of a surgical procedure, the surgical facility shall provide the surgical
14patient or, if applicable, other person under sub. (2) (b), with the option to have the
15patient's discharge instructions recorded as provided under sub. (2) (a) 3.
AB1011,10,21 16(7) Extensions for facility compliance. The department may in its discretion
17grant a surgical facility one or more 6-month extensions of the deadline for the
18facility to comply with the requirements of this section, but may not grant more than
19a total of 6 extensions. In order to qualify for an extension, a surgical facility shall
20provide the department with evidence of a compelling need, financial or otherwise,
21for additional time for compliance.
AB1011,11,3 22(8) Rules. (a) The department shall promulgate rules establishing standards
23for video recording of surgical procedures, recording of discharge instructions, and
24the use of recording equipment in the surgery and discharge settings to ensure such
25recordings are professional and of sufficient quality to accurately portray what takes

1place when discharge instructions are given or during a surgical procedure,
2including who enters and leaves and a view of the patient without requiring close-up
3views of the patient or the surgical procedure itself.
AB1011,11,64 (b) In addition to the rules required under par. (a), the department may
5promulgate rules, as necessary, to implement and administer this section, including
6any of the following:
AB1011,11,87 1. Establishing criteria and procedures for providing notice and the option for
8video recording under sub. (2).
AB1011,11,109 2. Implementing the requirements regarding preservation and destruction of
10recordings under sub. (9).
AB1011,11,1211 3. Establishing standards, procedures, and forms for advance requests for
12recording under sub. (12).
AB1011,11,1313 4. Implementing the forfeiture procedures under sub. (14).
AB1011,11,16 14(9) Preservation and destruction. (a) After the recording of a surgical
15procedure under this section is complete, the surgical facility shall promptly do all
16of the following:
AB1011,11,1917 1. Preserve the recording as part of the surgical patient's health care record,
18which may include a copy in the patient's health care record and any electronic
19backup of health care records kept in the normal course of business.
AB1011,11,2020 2. Preserve a separate additional electronic copy.
AB1011,11,2321 3. Except as provided under subds. 1. and 2., delete copies of the recording from
22the recording device or any other electronic device, including any memory card or
23flash drive.
AB1011,12,324 (b) The surgical facility shall preserve the copy in the surgical patient's health
25care record, including any backup copy, as it would other records in the patient's

1health care record as required by law. The surgical facility or its designee shall retain
2the additional copy required under par. (a) 2. for at least 7 years after the recording
3was first made.
AB1011,12,14 4(10) Fees. A surgical facility may charge a surcharge of up to $25 for each
5recording made of a surgical procedure or discharge instructions to offset the costs
6of creating and providing a recording. The surgical facility shall provide, upon
7request by the surgical patient, a person authorized by the surgical patient under s.
8146.81 (5), or a parent, guardian, or legal custodian of a minor surgical patient, one
9copy of each recording made under sub. (2) (a) 1. for which a request is made without
10additional charge. The surgical facility shall provide to the surgical patient, upon
11request by the surgical patient, one free copy of the discharge instructions for the
12surgical patient and up to one additional free copy of the discharge instructions for
13another person designated by the surgical patient. The surgical facility may charge
14fees as described under s. 146.83 (3f) (b) 3m. for additional copies of the recordings.
AB1011,12,21 15(11) Admissibility of recording. For purposes of admissibility in a civil or
16criminal action or proceeding, an audiovisual recording created under this section
17is a patient health care record under s. 146.81 and shall be treated as other patient
18health care records under ss. 908.03 (6m) and 909.02 (11). If certified by an
19appropriate record custodian, recordings under this section shall be admissible as
20evidence in any civil or criminal action or proceeding related to any alleged act or
21omission depicted in the recording.
AB1011,12,24 22(12) Advance requests for recording. (a) Definition. In this subsection,
23“principal" means an individual who executes an advance request for surgical
24procedure recording instrument.
AB1011,13,6
1(b) Advance requests for recording. 1. An individual who is of sound mind and
2has attained age 18 may voluntarily execute an advance request for surgical
3procedure recording instrument. An individual for whom an adjudication of
4incompetence and appointment of a guardian of the individual is in effect in this state
5is presumed not to be of sound mind for purposes of this subsection and for executing
6an advance request for surgical procedure recording instrument.
AB1011,13,87 2. The desires of a principal who is not incapacitated supersede the effect of his
8or her advance request for surgical procedure recording instrument at all times.
AB1011,14,129 3. The department shall prepare and provide copies of an advance request for
10surgical procedure recording instrument and accompanying information for
11distribution in quantities to health care professionals, hospitals and other surgical
12facilities, county clerks, and local bar associations and individually to private
13persons. The department shall determine the form of the request form and
14accompanying instructions. The department shall include on the form an option for
15requesting the recording of a specific single surgical procedure, an option for
16requesting the recording of discharge instructions after a surgical procedure, an
17option for requesting the recording of all future surgical procedures under this
18section, and an option for requesting the recording of discharge instructions after all
19future surgical procedures under this section. The department shall also include on
20the form a statement to the effect that a principal who exercises the option for
21recording agrees that, unless the surgical practitioner involved waives
22confidentiality, a recording created under this section is confidential and the
23principal or a person on behalf of the principal may disclose it only to health care
24providers providing care to the principal, to immediate family members or a person
25authorized by the patient under s. 146.81 (5), or to an attorney or an attorney's staff

1for the purpose of obtaining legal advice, and if legal action is taken, the principal
2or an attorney on behalf of the principal may disclose the recording to additional
3individuals if necessary for the case, but it must be filed under seal if permitted by
4the court. The form shall also include a statement that the principal or a person on
5behalf of a principal may disclose the principal's discharge instructions to one or
6more persons designated by the principal to assist with postsurgical care, and a
7statement that a surgical facility or surgical practitioner may, if express
8authorization is granted by the principal in writing, use a copy of a recording for
9teaching or research purposes outside of the network of the surgical facility if the
10principal's personal identifying information is redacted or if the principal or other
11person authorized on behalf of the principal expressly consents, in writing, to the use
12and disclosure.
AB1011,14,1413 (c) Advance request for recording; execution. A valid advance request for
14surgical procedure recording shall be all of the following:
AB1011,14,1515 1. In writing.
AB1011,14,1716 2. Dated and signed by the principal or by an individual who has attained age
1718, at the express direction and in the presence of the principal.
AB1011,14,1918 3. Signed in the presence of a witness who is an individual who has attained
19the age 18.
AB1011,14,2020 4. Voluntarily executed.
AB1011,14,2221 (d) Revocation. A principal may revoke his or her advance request for surgical
22procedure recording instrument at any time by doing any of the following:
AB1011,15,223 1. Canceling, defacing, obliterating, burning, tearing, or otherwise destroying
24the advance request for surgical procedure recording instrument or directing

1another in the presence of the principal to so destroy the advance request for surgical
2procedure recording instrument.
AB1011,15,53 2. Executing a statement, in writing, that is signed and dated by the principal,
4expressing the principal's intent to revoke the advance request for surgical procedure
5recording instrument.
AB1011,15,76 3. Verbally expressing the desire to revoke the advance request for surgical
7procedure recording instrument in the presence of a witness.
AB1011,15,108 4. Executing a subsequent advance request for surgical procedure recording
9instrument that replaces an existing advance request for surgical procedure
10recording instrument.
AB1011,15,14 11(13) Penalties. (a) Except as provided under sub. (6), a health care provider
12who knowingly refuses to comply with a surgical patient request to have his or her
13surgical procedure or discharge instructions recorded may be subject to a forfeiture
14of not more than $25,000 for each violation.
AB1011,15,1715 (b) Except as provided under sub. (6), a surgical facility that fails to provide a
16notice required under sub. (2) (b) may be subject to a forfeiture of not more than
17$25,000 for each violation.
AB1011,15,2118 (c) 1. Any person who negligently interferes with or violates a surgical patient's
19advance request for surgical procedures recording instrument created under sub.
20(12) without the consent of the principal shall be subject to a fine of at least $500 but
21not more than $1,000.
AB1011,16,222 2. Any person who intentionally interferes with or violates a surgical patient's
23advance request for surgical procedures recording instrument created under sub.
24(12), including intentionally concealing, canceling, defacing, obliterating, damaging,

1or destroying the instrument without the consent of the principal may be fined not
2more than $5,000.
AB1011,16,53 (d) 1. For purposes of this paragraph, “disclosure” means to effect the provision
4of access to, or the release, transfer, or divulging in any manner of information
5outside those persons or entities authorized under in this section.
AB1011,16,96 2. Except as otherwise authorized under this section, if a surgical practitioner
7or other health care provider discloses a recording made under this section, the
8standards and penalties for violations relating to patient health care records
9described under s. 146.84 shall apply.
AB1011,16,1610 3. A surgical patient, or another person on behalf of a surgical patient, who
11intentionally discloses a recording made under this section in violation of sub. (2) (e)
12may be fined not more than $3,000 per violation. If a person affirmatively discloses
13a recording made under this section on a social media platform, that disclosure shall
14constitute a single violation, regardless of whether the disclosure is subsequently
15redisclosed by other social media participants. Each subsequent disclosure on a
16separate platform shall be considered a separate violation.
AB1011,16,2217 4. Whoever threatens, with intent to extort money or any pecuniary advantage
18whatever, or with intent to compel the person so threatened to do any act against the
19person's will, to disseminate or to communicate to anyone, or, except as otherwise
20authorized under this section, does disseminate or communicate to anyone,
21information related to a recording under this section is guilty of a Class I felony. For
22the purpose of this subdivision, “information" has the meaning given in s. 943.31.
AB1011,17,3 23(14) Forfeiture procedure. (a) The department may directly assess
24forfeitures provided for under sub. (13). If the department determines that a
25forfeiture should be assessed for a particular violation, the department shall send a

1notice of assessment to the health care provider. The notice shall specify the amount
2of the forfeiture assessed, the violation and the statute or rule alleged to have been
3violated, and shall inform the hospital of the right to a hearing under par. (b).
AB1011,17,154 (b) A health care provider may contest an assessment of a forfeiture by sending,
5within 30 days after receipt of notice under par. (a), a written request for a hearing
6under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1).
7The administrator of the division may designate a hearing examiner to preside over
8the case and recommend a decision to the administrator under s. 227.46. The
9decision of the administrator of the division shall be the final administrative
10decision. The division shall commence the hearing within 60 days after receipt of the
11request for a hearing and shall issue a final decision within 30 days after the close
12of the hearing. Proceedings before the division are governed by ch. 227. In any
13petition for judicial review of a decision by the division, the party, other than the
14petitioner, who was in the proceeding before the division shall be the named
15respondent.
AB1011,17,2116 (c) All forfeitures shall be paid to the department within 30 days after receipt
17of notice of assessment or, if the forfeiture is contested under par. (b), within 30 days
18after receipt of the final decision after exhaustion of administrative review, unless
19the final decision is appealed and the order is stayed by court order. The department
20shall remit all forfeitures paid to the secretary of administration for deposit in the
21injured patients and families compensation fund under s. 655.27.
AB1011,17,2522 (d) The attorney general may bring an action in the name of the state to collect
23any forfeiture imposed under sub. (13) if the forfeiture has not been paid following
24the exhaustion of all administrative and judicial reviews. The only issue to be
25contested in any such action shall be whether the forfeiture has been paid.
AB1011,2
1Section 2. 146.81 (4) of the statutes is amended to read:
AB1011,18,172 146.81 (4) “Patient health care records" means all records related to the health
3of a patient prepared by or under the supervision of a health care provider; all
4recordings under s. 50.373 related to the surgical patient;
and all records made by
5an ambulance service provider, as defined in s. 256.01 (3), an emergency medical
6services practitioner, as defined in s. 256.01 (5), or an emergency medical responder,
7as defined in s. 256.01 (4p), in administering emergency care procedures to and
8handling and transporting sick, disabled, or injured individuals. “Patient health
9care records" includes billing statements and invoices for treatment or services
10provided by a health care provider and includes health summary forms prepared
11under s. 302.388 (2). “Patient health care records" does not include those records
12subject to s. 51.30, reports collected under s. 69.186, records of tests administered
13under s. 252.15 (5g) or (5j), 343.305, 938.296 (4) or (5) or 968.38 (4) or (5), records
14related to sales of pseudoephedrine products, as defined in s. 961.01 (20c), that are
15maintained by pharmacies under s. 961.235, fetal monitor tracings, as defined under
16s. 146.817 (1), or a pupil's physical health records maintained by a school under s.
17118.125.
AB1011,3 18Section 3 . 146.83 (3f) (b) 3m. of the statutes is created to read:
AB1011,18,2019 146.83 (3f) (b) 3m. Except as provided in s. 50.373, for a copy of a video
20recording of a surgical procedure or discharge instructions, $25 per copy.
AB1011,4 21Section 4 . 655.27 (1g) of the statutes is created to read:
AB1011,18,2322 655.27 (1g) Deposit of forfeitures. Forfeitures paid under s. 50.373 (13) shall
23be deposited in the fund under sub. (1).
AB1011,5 24Section 5 . Nonstatutory provisions.
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