Title: Moya v. Healthport Technologies, LLC

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2017 WI 45 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2014AP2236 
COMPLETE TITLE: 
Carolyn Moya, 
          Plaintiff-Respondent-Petitioner, 
     v. 
Aurora Healthcare, Inc. and Healthport 
Technologies, LLC, 
          Defendants-Appellants. 
 
 
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
366 Wis. 2d 541, 874 N.W. 2d 336 
(2016 WI App 5 – Published) 
 
 
OPINION FILED: 
May 4, 2017 
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
October 20, 2016 
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit 
 
COUNTY: 
Milwaukee 
 
JUDGE: 
Karen E. Christenson 
 
 
 
JUSTICES: 
 
 
CONCURRED: 
      
 
DISSENTED: 
ZIEGLER, J. dissents (opinion filed). 
 
NOT PARTICIPATING: BRADLEY, R. G., J. and KELLY, J. did not 
participate.    
 
 
 
ATTORNEYS: 
 
For the plaintiff-respondent-petitioners, there was a brief 
by Robert J. Welcenbach and Welcenbach Law Offices, S.C., 
Milwaukee, and oral argument by Robert J. Welcenbach. 
 
For the defendants-appellants, there was a brief by John 
Franke, Daniel A. Manna and Gass, Weber and Mullins, LLC, 
Milwaukee, and oral argument by John Franke. 
 
 
 
 
 
2017 WI 45
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.   2014AP2236 
(L.C. No. 
13-CV-2642) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Carolyn Moya, 
 
          Plaintiff-Respondent-Petitioner, 
 
     v. 
 
Aurora Healthcare, Inc. and Healthport 
Technologies, LLC, 
 
          Defendants-Appellants. 
 
 
 
FILED 
 
MAY 4, 2017 
 
Diane M. Fremgen 
Clerk of Supreme Court 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Reversed and 
remanded for further proceedings.   
 
¶1 
MICHAEL J. GABLEMAN, J.   This is a review of a 
published decision of the court of appeals that reversed the 
Milwaukee County circuit court's1 denial of Aurora Healthcare, 
Inc. and Healthport Technologies, LLC's (collectively referred 
to as "Healthport") motion for summary judgment and remanded the 
case with directions to grant Healthport's motion for summary 
                                                 
1 The Honorable Karen E. Christenson presiding. 
No.  2014AP2236   
 
2 
 
judgment.  Moya v. Aurora Healthcare, Inc., 2016 WI App 5, 366 
Wis. 2d 541, 874 N.W.2d 336. 
¶2 
Today, we are asked to interpret the meaning of the 
phrase "person authorized by the patient" in Wis. Stat. 
§ 146.83(3f)(b)4.-5. (2013-14),2 which exempts a "patient or a 
person authorized by the patient" from paying certification 
charges and retrieval fees for obtaining copies of the patient's 
health care records.  More particularly, we are asked to 
determine whether an attorney whose client authorized him via a 
HIPAA3 release form to obtain her health care records may benefit 
from this fee exemption.  Because the phrase "person authorized 
by the patient" is defined in Wis. Stat. § 146.81(5) to include 
"any person authorized in writing by the patient," we hold that 
an attorney authorized by his or her client in writing via a 
HIPAA release form to obtain the client's health care records is 
a 
"person 
authorized 
by 
the 
patient" 
under 
Wis. 
Stat. 
§ 146.83(3f)(b)4.-5. and is therefore exempt from certification 
charges 
and 
retrieval 
fees 
under 
these 
subdivisions.  
Consequently, the decision of the court of appeals is reversed, 
and the case is remanded for further proceedings consistent with 
this opinion. 
                                                 
2 All subsequent references to the Wisconsin Statutes are to 
the 2013-14 version unless otherwise indicated. 
3 HIPAA 
stands 
for 
Health 
Insurance 
Portability 
and 
Accountability Act.  A HIPAA release form is a type of form 
wherein a patient consents to the release of his or her health 
care information to a third party. 
No.  2014AP2236   
 
3 
 
¶3 
We 
begin 
with 
a 
brief 
factual 
background 
and 
description of the procedural history.  We then set forth the 
standard of review and the relevant rules for statutory 
interpretation.  We then conclude that Carolyn Moya's ("Moya") 
attorney is a "person authorized by the patient" under Wis. 
Stat. § 146.83(3f)(b)4.-5. and is therefore exempt from the 
certification charge and retrieval fee authorized by that 
statute.  Next, we address Healthport's arguments that the 
doctrines of voluntary payment and waiver bar Moya's claim.   
I.  FACTUAL BACKGROUND AND PROCEDURAL HISTORY 
A.  The Statutes Governing Access to Health Care Records 
¶4 
Access to patient health care records is governed by 
Wis. Stat. § 146.83.  Under subsec. (3f), a health care provider 
shall, subject to exceptions that are inapplicable here, provide 
copies of a patient's health care records "if a person requests 
copies of a patient's health care records, provides informed 
consent, 
and 
pays 
the 
applicable 
fees 
under 
par. 
(b)."  
§ 146.83(3f)(a). 
¶5 
Pursuant to para. (b), health care providers may 
impose certain costs on the person requesting health care 
records under para. (a):  
(b) Except as provided in sub. (1f), a health 
care provider may charge no more than the total of all 
of the following that apply for providing the copies 
requested under par. (a):   
1. For paper copies:  $1 per page for the first 
25 pages; 75 cents per page for pages 26 to 50; 50 
cents per page for pages 51 to 100; and 30 cents per 
page for pages 101 and above.   
No.  2014AP2236   
 
4 
 
2. For microfiche or microfilm copies, $1.50 per 
page.   
3. For a print of an X-ray, $10 per image.   
4. If the requester is not the patient or a 
person authorized by the patient, for certification of 
copies, a single $8 charge.   
5. If the requester is not the patient or a 
person authorized by the patient, a single retrieval 
fee of $20 for all copies requested.   
6. Actual 
shipping 
costs 
and 
any 
applicable 
taxes.   
Wis. Stat. § 146.83(3f)(b) (emphasis added).  According to subd. 
4. and subd. 5., the patient and a person authorized by the 
patient are exempt from the certification charge and retrieval 
fee.  This statute, though, does not provide a definition for a 
"person authorized by the patient." 
¶6 
Instead, a "person authorized by the patient" is 
defined in Wis. Stat. § 146.81(5) as 
the parent, guardian, or legal custodian of a minor 
patient, as defined in s. 48.02 (8) and (11), the 
person vested with supervision of the child under s. 
938.183 or 938.34 (4d), (4h), (4m), or (4n), the 
guardian of a patient adjudicated incompetent in this 
state, the person representative, spouse, or domestic 
partner under ch. 770 of a deceased patient, any 
person authorized in writing by the patient or a 
health care agent designated by the patient as a 
principal under ch. 155 if the patient has been found 
to be incapacitated under s. 155.05 (2), except as 
limited by the power of attorney for health care 
instrument.  If no spouse or domestic partner survives 
a deceased patient, "person authorized by the patient" 
also means an adult member of the deceased patient's 
immediate family, as defined in s. 632.895 (1)(d).  A 
court may appoint a temporary guardian for a patient 
believed incompetent to consent to the release of 
records under this section as the person authorized by 
No.  2014AP2236   
 
5 
 
the patient to decide upon the release of records, if 
no guardian has been appointed for the patient. 
(Emphasis added).  Because this definition uses the disjunctive 
"or," see Hull v. State Farm Mut. Auto. Ins., 222 Wis. 2d 627, 
638, 586 N.W.2d 863 (1998) ("'[O]r' should be interpreted 
disjunctively."), in order to be a person authorized by the 
patient under Wis. Stat. § 146.83(3f)(b)4.-5., and therefore 
enjoy exemption from the certification charge and retrieval fee, 
a person must fall into only one of the above categories of 
persons.  One of the categories in the above definition is "any 
person authorized in writing by the patient," and it is this 
category on which Moya relies in arguing that her attorney is a 
"person authorized by the patient" under § 146.83(3f)(b)4.-5. 
B.  Moya's Class Action Lawsuit 
¶7 
This case comes to us by way of a class action lawsuit 
filed by Moya on behalf of not only herself but all other 
similarly 
situated 
persons 
who 
have 
been 
billed 
the 
certification charge and retrieval fee by Healthport for 
obtaining their own healthcare records.  The class action arose 
from Moya's personal injury claim4 in which Moya hired Welcenbach 
Law Offices, S.C. to represent her and the law firm had to pay 
the certification charge and retrieval fee, despite the fact 
that Moya had authorized the law firm in writing to obtain those 
records.   
                                                 
4 Moya's personal injury claim arose from a car accident in 
2011 from which she sustained injuries.  This claim has since 
been settled. 
No.  2014AP2236   
 
6 
 
¶8 
Moya authorized her attorney, Robert Welcenbach, to 
obtain her health care records by signing HIPAA release forms 
giving to Welcenbach Law Offices, S.C. "authoriz[ation] to 
receive [her] health information."   
¶9 
Atty. Welcenbach subsequently submitted requests for 
Moya's health care records,5 and Healthport, when fulfilling the 
requests, imposed certification charges and retrieval fees 
pursuant to Wis. Stat. § 146.83(3f)(b)4.-5.  Atty. Welcenbach 
paid the certification charges and retrieval fees and passed the 
associated costs to Moya by deducting the costs from the 
settlement proceeds resulting from her personal injury claim.6   
¶10 At the time Healthport invoiced Atty. Welcenbach, he 
paid the costs, and he did not specifically dispute them.  
However, he had on multiple previous occasions disputed the 
imposition of such costs in other cases. 
                                                 
5 Atty. Welcenbach submitted his request to Moya's health 
care provider, Aurora Healthcare, Inc. ("Aurora"), but Aurora 
and Healthport have an agreement whereby Healthport handles 
Aurora's health care records requests.   
6 The total deducted from Moya's settlement proceeds for 
these costs was $294.70. 
Contrary to the assertion made by the dissent, the fact 
that Atty. Welcenbach passed these costs along to Moya was not a 
factor in arriving at our conclusion that Atty. Welcenbach is a 
person authorized by the patient for purposes of Wis. Stat. 
§ 146.83(3f)(b)4.-5.  See dissent, ¶62 n.3.  Our determination 
that Atty. Welcenbach is a person so authorized is derived from 
our application of the plain language of the statute and nothing 
more. 
No.  2014AP2236   
 
7 
 
¶11 In 
response 
to 
Healthport's 
imposition 
of 
the 
certification charges and retrieval fees, Moya filed this class 
action lawsuit.  She argues that Healthport violated Wis. Stat. 
§ 146.83(3f)(b)4.-5. when it imposed the certification charges 
and retrieval fees because her attorney is a "person authorized 
by the patient," thereby exempting her attorney from paying the 
certification charges and retrieval fees.   
¶12 Healthport moved to dismiss Moya's complaint for 
failure to state a claim, and the circuit court7 denied 
Healthport's motion.  Healthport filed an answer, and the 
parties 
underwent 
limited 
discovery. 
 
After 
the 
limited 
discovery, Healthport filed a motion for summary judgment asking 
the circuit court to dismiss Moya's claim with prejudice.  The 
circuit court8 denied Healthport's motion.  Healthport filed a 
motion for reconsideration, and the circuit court9 again denied 
Healthport's motion. 
¶13 Healthport filed an interlocutory appeal, and the 
court of appeals reversed the circuit court's denial of 
Healthport's motion for summary judgment and remanded the case 
with instructions to grant Healthport's motion.  Moya, 366 
Wis. 2d 541, ¶1.  The court of appeals determined that Moya's 
attorney was not a "person authorized by the patient" and 
                                                 
7 The Honorable William W. Brash III presiding. 
8 The Honorable Karen E. Christenson presiding. 
9 The Honorable Pedro A. Colon presiding. 
No.  2014AP2236   
 
8 
 
therefore Healthport could impose the certification charges and 
retrieval fees on Moya's attorney.  Id., ¶16.  Judge Kessler 
dissented stating that she would uphold the circuit court's 
denial of Healthport's motion for summary judgment and would 
conclude that Healthport could not impose the certification 
charge 
and 
retrieval 
fee. 
 
Id., 
¶¶28-29 
(Kessler, 
J., 
dissenting). 
¶14 Moya petitioned this court for review, which we 
granted in order to determine whether her attorney is a "person 
authorized by the patient" and thus exempt from paying the 
certification charge and the retrieval fee found in Wis. Stat. 
§ 146.83(3f)(b)4.-5. 
II.  STANDARD OF REVIEW 
¶15 "Whether the circuit court properly granted summary 
judgment is a question of law that this court reviews de novo."  
Racine County v. Oracular Milwaukee, Inc., 2010 WI 25, ¶24, 323 
Wis. 2d 682, 
781 
N.W.2d 88 
(quoting 
Hocking 
v. 
City 
of 
Dodgeville, 2009 WI 70, ¶7, 318 Wis. 2d 681, 768 N.W.2d 552).  
Summary judgment must be granted "if the pleadings, depositions, 
answers to interrogatories, and admissions on file, together 
with the affidavits, if any, show that there is no genuine issue 
as to any material fact and that the moving party is entitled to 
a judgment as a matter of law."  Wis. Stat. § 802.08(2).  In 
making this determination, this court applies a two-step test.  
Green Spring Farms v. Kersten, 136 Wis. 2d 304, 314–15, 401 
N.W.2d 816 (1987).  Under the first step, this court asks if the 
plaintiff stated a claim for relief.  Id. at 315.  Under the 
No.  2014AP2236   
 
9 
 
second step, this court applies the summary judgment statute and 
asks if any factual issues exist that preclude summary judgment.  
Id. 
¶16 "We review questions of statutory interpretation and 
application independently, but benefiting from the discussions 
of the circuit court and the court of appeals."  State v. 
Grunke, 2008 WI 82, ¶10, 311 Wis. 2d 439, 752 N.W.2d 769. 
III.  DISCUSSION 
A.  The Rules of Statutory Interpretation 
¶17 "[T]he purpose of statutory interpretation is to 
determine what the statute means so that it may be given its 
full, proper, and intended effect."  State ex rel. Kalal v. 
Circuit Court for Dane Cty., 2004 WI 58, ¶44, 271 Wis. 2d 633, 
681 N.W.2d 110.  Statutory interpretation begins with the text 
of the statute.  Id., ¶45 (quoting Seider v. O'Connell, 2000 WI 
76, ¶43, 236 Wis. 2d 211, 612 N.W.2d 659).  If the text of the 
statute is plain and unambiguous, our inquiry stops there.  Id. 
(quoting Seider, 236 Wis. 2d 211, ¶43).   
¶18 If the text is ambiguous, we must look beyond the text 
to other, extrinsic sources of information, such as legislative 
history, to interpret the statute.  Id., ¶46.  "[A] statute is 
ambiguous if it is capable of being understood by reasonably 
well-informed persons in two or more senses."  Id., ¶47.  Even 
without ambiguity, though, we may consult extrinsic sources to 
confirm our understanding of the plain language of a statute.  
Id., ¶51. 
No.  2014AP2236   
 
10 
 
¶19 "Statutory language is given its common, ordinary, and 
accepted meaning, except that technical or specially-defined 
words 
or 
phrases 
are 
given 
their 
technical 
or 
special 
definitional meaning."  Id., ¶45.  We also look to the context:  
"[S]tatutory language is interpreted 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."  Id., ¶46.   
B.  Interpretation of "Any Person Authorized in Writing by the 
Patient" 
¶20 Moya argues that "any person authorized in writing by 
the patient" in Wis. Stat. § 146.81(5) is "defined broadly by 
the legislature" and that the plain meaning of the statutory 
language requires nothing more than a person and a written 
authorization from the patient.  Thus, Moya's attorney qualifies 
as a "person authorized in writing by the patient" simply 
because he is a person and has a written authorization from Moya 
in the nature of the HIPAA release form.  Healthport, on the 
other hand, argues that the context of § 146.81(5) indicates 
that the person authorized in writing by the patient must (in 
addition to having authorization to obtain health care records) 
also be authorized to make health care decisions on behalf of 
the patient.  In response to this argument, Moya says Healthport 
can achieve this definition only by adding its own language to 
the statute. 
¶21 After examining the language of the statute and 
applying the well-established rules of statutory interpretation, 
No.  2014AP2236   
 
11 
 
we agree with Moya.  The context of the statutory definition of 
"person authorized by the patient" provided in § 146.81(5) 
indicates that "any person authorized in writing by the patient" 
is a stand-alone category, separate and apart from the remaining 
categories, containing no limitations beyond those expressly 
written.  We base our determination in this regard on the 
punctuation and conjunctions given in the statute and see these 
categories as follows: 
(1) "[T]he parent, guardian, or legal custodian of a minor 
patient, as defined in s. 48.02 (8) and (11)"; 
(2) "the person vested with supervision of the child under 
s. 938.138 or 938.34 (4d), (4h), (4m), or (4n)"; 
(3) "the guardian of a patient adjudicated incompetent in 
this state"; 
(4) "the personal representative, spouse, or domestic 
partner under ch. 770 of a deceased patient"; 
(5) "any person authorized in writing by the patient or"; 
(6) "a health care agent designated by the patient as a 
principal under ch. 155 if the patient has been found 
to be incapacitated under s. 155.05(2), except as 
limited by the power of attorney for health care 
instrument." 
(7) "If no spouse or domestic partner survives a deceased 
patient, 'person authorized by the patient' also means 
an adult member of the deceased patient's immediate 
family, as defined in s. 632.895(1)(d)."   
(8) "A court may appoint a temporary guardian for a 
patient believed incompetent to consent to the release 
of records under this section as the person authorized 
by the patient to decide upon the release of the 
records, if no guardian has been appointed for the 
patient." 
Wis. Stat. § 146.81(5) (emphasis added).   
No.  2014AP2236   
 
12 
 
¶22 Thus, the phrase "any person authorized in writing by 
the patient" must be interpreted as its own category of persons 
authorized 
by 
the 
patient. 
 
The 
statutory 
language 
is 
unambiguous in that it requires only a person with a written 
authorization from the patient.  The plain meaning of the 
statute 
does 
not 
require 
that 
the 
authorization 
be 
an 
authorization to make health care decisions on behalf of the 
patient.  Thus, when the phrase "person authorized by the 
patient" is used in Wis. Stat. § 146.83(3f)(b)4.-5. in the 
context of obtaining copies of health care records, it includes 
"any person authorized in writing by the patient" to obtain such 
records.  The definition requires no additional authorization 
for such person to qualify for the exemption from the 
certification charge and retrieval fee. 
¶23 Healthport argues that this conclusion is inconsistent 
with the general principle that we interpret an item in a list 
consistently with the remaining items in the list.  See State v. 
Popenhagen, 2008 WI 55, ¶46, 309 Wis. 2d 601, 749 N.W.2d 611.  
From this general principle, Healthport urges us to conclude 
that "any person authorized in writing by the patient" must have 
the ability to make health care decisions on the patient's 
behalf.  Healthport's argument runs as follows:  Because each of 
the other categories of persons in the definition of "person 
authorized by the patient" in Wis. Stat. § 146.81(5) has the 
authority to make health care decisions on behalf of the 
patient, the fifth category listed above must have that 
No.  2014AP2236   
 
13 
 
authority as well in order to qualify as a "person authorized by 
the patient."   
¶24 This argument is unpersuasive in light of the relevant 
statutory context.  Examining the various categories in the 
definition of "person authorized by the patient" in Wis. Stat. 
§ 146.81(5) demonstrates that the legislature did not specify 
that each must have the authority to make health care decisions 
for the patient.  Instead, the legislature placed varying 
parameters on each distinct category.  For example, in the first 
category, the legislature chose to limit it to the parent, 
guardian, or legal custodian of a minor patient.  Therefore, a 
parent, guardian, or legal custodian of a minor is automatically 
a "person authorized by the patient" wherever that phrase 
appears in Wis. Stat. §§ 146.81-.84; nothing else is necessary 
to qualify and no other limitation is imposed.  Other 
categories, however, are narrower.  For example, the eighth 
category is specifically limited to a temporary guardian 
appointed by a court to "decide upon the release of records" for 
an incompetent patient.  At least for this category, having 
specific authorization to make health care decisions for the 
incompetent patient is a requirement.   
¶25 We cite these instances of circumscription within the 
statute not as demonstrations of the legislature's collective 
facility with language but, rather, to bolster our understanding 
that, when the legislature chooses to say "any person authorized 
in writing by the patient," we must interpret these words 
without the kind of limitation proposed by Healthport.  Cf. 
No.  2014AP2236   
 
14 
 
Indus. to Indus., Inc. v. Hillsman Modular Molding, Inc., 2002 
WI 51, ¶19, 252 Wis. 2d 544, 644 N.W.2d 236.  Put simply, had 
the legislature intended to place parameters of the kind 
Healthport suggests on a person authorized in writing by the 
patient, "it would have done so."  Id.  It did not, and so we do 
not.10 
¶26 Healthport argues that interpreting the category "any 
person authorized in writing by the patient" without the 
additional requirement that the authorization be for making 
health care decisions creates chaos and inconsistency throughout 
the statutory scheme.  Without constancy as to what the 
authorization must be for, Healthport argues that the definition 
of a "person authorized by the patient" would change each time 
it is used throughout the statute.  However, it is enough to 
refute this argument to note that, contrary to what Healthport 
argues, the definition of a "person authorized by the patient" 
remains constant throughout the statutes governing access to 
health care records.  Instead of creating chaos, permitting the 
specific nature of the authorization allows for flexibility.  In 
                                                 
10 According to the dissent, such an interpretation is one 
done in a vacuum, not taking into account the context in which 
the words are written.  
E.g., dissent, 
¶41.  However, 
interpreting the text to also contain the words "to consent to 
the release of the patient's health care records" ignores the 
immediate context of the text we are asked to interpret here 
because it does not take into account the distinction between 
"any person authorized in writing by the patient" and the other 
categories of persons used in the statute. 
No.  2014AP2236   
 
15 
 
all cases, we simply look to the written authorization to 
determine what the patient has authorized the person to do. 
¶27 Because the definition of "any person authorized in 
writing by the patient" does not specify what the person must be 
authorized to do, the written authorization necessary for an 
attorney to qualify will depend on the function the attorney 
seeks to perform.  In other words, why an attorney might need 
written authorization may be different in different contexts.  
For example, to perform the function of a "person authorized by 
the 
patient" 
in 
some 
contexts, 
the 
attorney 
might 
need 
authorization to make certain decisions on behalf of the 
patient.  See, e.g., Wis. Stat. § 146.82(1) (informed consent to 
release records may be given by a "person authorized by the 
patient").  But in other contexts, the attorney would only need 
authorization to receive copies of health care records.  That is 
the case in Wis. Stat. § 146.83(3f), the statute governing 
requests for copies of such records.  Regardless of the context, 
what mattered to the legislature in defining "person authorized 
by the patient" to include "any person authorized in writing by 
the patient" is that the person does have written authorization 
from the patient to perform the relevant function. 
¶28 Past iterations of the statute support our conclusion 
that the plain meaning of "any person authorized in writing by 
the patient" is exactly what it says.  See County of Dane v. 
LIRC, 2009 WI 9, ¶27, 315 Wis. 2d 293, 759 N.W.2d 571 (quoting 
Richards v. Badger Mut. Ins., 2008 WI 52, ¶22, 309 Wis. 2d 541, 
749 N.W.2d 581) (statutory context includes past iterations of 
No.  2014AP2236   
 
16 
 
the statute).  When the legislature first enacted the statute in 
1979, Wis. Stat. § 146.81(5) defined "person authorized by the 
patient" as 
the parent, guardian or legal custodian of a minor 
patient, as defined in s. 48.02 (9) and (11), the 
guardian of a patient adjudged incompetent, as defined 
in s. 880.01 (3) and (4), the personal representative 
or spouse of a deceased patient or any person 
authorized in writing by the patient. 
In this version of the statute, "any person authorized in 
writing by the patient," as evidenced by the use of "or," is the 
last category of persons considered a "person authorized by the 
patient."  We see from our reading of the 1979 statute that "any 
person authorized in writing by the patient" has always been a 
distinct category of persons——one without limitation other than 
a requirement of authorization in writing from the patient. 
¶29 Nevertheless, Healthport argues that a 2014 amendment 
to the statutes governing health care records, Wis. Stat. 
§ 146.83(1b), provides context that shows that the legislature 
intended to exclude attorneys from the definition of a "person 
authorized by the patient."  The 2014 addition of § 146.83(1b) 
states, "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[11] if that attorney has 
written informed consent from the patient to view and obtain 
copies 
of 
the 
records." 
 
According 
to 
Healthport, 
the 
                                                 
11 Wisconsin Stat. § 977.08 relates to the appointment of a 
state public defender. 
No.  2014AP2236   
 
17 
 
legislature's 
use 
of 
"[n]otwithstanding" 
shows 
that 
the 
legislature, in § 146.83(1b), included a certain type of 
attorney——public defenders——as a person authorized by the 
patient to receive health care records in spite of a general 
exclusion of attorneys from Wis. Stat. § 146.81(5).   
¶30 While the legislature may have intended to expressly 
include public defenders, we decline Healthport's implicit 
invitation to add limiting language to Wis. Stat. § 146.81(5).  
The legislature, with its use of "any person," chose not to 
place a limit on who could be authorized in writing by the 
patient under § 146.81(5), and we give effect to the enacted 
text.  See Bruno v. Milwaukee County, 2003 WI 28, ¶14, 260 
Wis. 2d 633, 
660 
N.W.2d 656 
(refusing 
to 
add 
additional 
requirements to the definition of "retirement" because those 
additional requirements were not mentioned in the text).  And 
more to the point, nothing about the express inclusion of public 
defenders leads us to conclude the legislature intended to 
exclude other attorneys.12   
                                                 
12 Healthport has failed to establish that the doctrine of 
expressio unius est exclusio alterius (the expression of one 
thing is the exclusion another) applies here because nothing 
indicates that the legislature considered attorneys other than 
public defenders when enacting the language of Wis. Stat. 
§ 146.83(1b).  See Wis. Citizens Concerned for Cranes & Doves v. 
DNR, 2004 WI 40, ¶17 n.11, 270 Wis. 2d 318, 677 N.W.2d 612 
("This rule may be applied only where there is some evidence 
that the legislature intended it to apply."). 
(continued) 
No.  2014AP2236   
 
18 
 
¶31 In sum, Moya's attorney qualifies as a "person 
authorized by the patient" because he is a person, he has a 
written authorization from Moya via the HIPAA release form, and 
Moya, the patient, signed the HIPAA release form to provide her 
attorney the authorization to receive her health care records.  
Therefore, as a person authorized by the patient, Moya's 
attorney is exempt from the certification charges and retrieval 
fees Healthport imposed under Wis. Stat. § 146.83(3f)(b)4.-5. 
C.  The Doctrine of Voluntary Payment Does Not Apply 
¶32 Healthport argues that the doctrine of voluntary 
payment bars Moya's class action lawsuit and thereby entitles 
Healthport to summary judgment; however, we conclude that the 
doctrine of voluntary payment does not apply.   
¶33 "The voluntary payment doctrine places upon a party 
who wishes to challenge the validity or legality of a bill for 
payment the obligation to make the challenge either before 
voluntarily making payment, or at the time of voluntarily making 
payment."  Putnam v. Time Warner Cable of Se. Wis., Ltd. P'ship, 
2002 WI 108, ¶13, 255 Wis. 2d 447, 649 N.W.2d 626.  "[T]he 
voluntariness in the doctrine goes to the willingness of a 
                                                                                                                                                             
The dissent also seems to be looking for "attorneys" to be 
expressly and specifically listed persons authorized by the 
patient.  See, e.g., dissent, ¶42.  However, if we are to look 
for such narrow categories, who then would qualify?  The answer 
is no one because no category of persons is so specifically 
listed in the statute.   
No.  2014AP2236   
 
19 
 
person to pay a bill without protest as to its correctness or 
legality."  Id., ¶15. 
¶34 It 
is 
axiomatic 
that 
we 
give 
effect 
to 
the 
legislature's expressed intent when we interpret statutes.  
Kalal, 271 Wis. 2d 633, ¶44.  Here, we determined that the 
legislature's expressed intent that a person with a written 
authorization from a patient does not have to pay the 
certification charge or retrieval fee for obtaining health care 
records.  Thus, "[a]pplication of the common law voluntary 
payment doctrine would undermine the manifest purposes of [Wis. 
Stat. § 146.83(3f)]."  MBS-Certified Pub. Accountants, LLC v. 
Wis. Bell, Inc., 2012 WI 15, 
¶4, 338 Wis. 2d 647, 809 
N.W.2d 857.  Consequently, we cannot apply it in this case to 
bar Moya's claim. 
D.  The Doctrine of Waiver Does Not Apply 
¶35 Healthport also argues that Moya's class action 
lawsuit is barred by the doctrine of waiver.  We disagree.   
¶36 "Waiver 
has 
been 
defined 
as 
a 
voluntary 
and 
intentional relinquishment of a known right."  Attoe v. State 
Farm Mut. Auto. Ins., 36 Wis. 2d 539, 545, 153 N.W.2d 575 
(1967).  Waiver can be done through conduct.  Id.   
¶37 Healthport argues that Moya waived her ability to 
obtain her health care records at a lower cost because she chose 
to authorize her attorney to obtain her health care records 
instead of requesting them herself, thereby voluntarily and 
intentionally relinquishing her right not to be charged the 
certification charge and retrieval fee.  As with the application 
No.  2014AP2236   
 
20 
 
of the doctrine of voluntary payment, we decline to apply the 
doctrine of waiver to subvert the legislature's intent.  To 
conclude that the doctrine of waiver applies would require us to 
conclude that Moya's attorney has to pay the certification 
charge and retrieval fee.  However, we conclude that Moya's 
attorney does not have to pay the certification charge or 
retrieval fee because he is a "person authorized by the 
patient."  Thus, the doctrine of waiver does not apply to bar 
Moya's class action lawsuit.   
IV.  CONCLUSION 
¶38 Because the phrase "person authorized by the patient" 
is defined in Wis. Stat. § 146.81(5) to include "any person 
authorized in writing by the patient," we hold that an attorney 
authorized by his or her client in writing via a HIPAA release 
form to obtain the client's health care records is a "person 
authorized by the patient" under Wis. Stat. § 146.83(3f)(b)4.-5. 
and is therefore exempt from certification charges and retrieval 
fees under those subdivisions.   
By the Court.—The decision of the court of appeals is 
reversed and the case is remanded for proceedings consistent 
with this opinion. 
¶39 REBECCA GRASSL BRADLEY and DANIEL KELLY, JJ., did not 
participate. 
 
No.  2014AP2236.akz 
 
1 
 
¶40 ANNETTE KINGSLAND ZIEGLER, J.   (dissenting).  The 
question before this court is whether a personal injury attorney 
who obtains his or her client's written consent to receive 
copies of the client's health care records is a "person 
authorized by the patient" under Wis. Stat. § 146.83(3f)(b), 
such that the attorney need not pay certification and retrieval 
fees when requesting copies of the records from a health care 
provider.  The circuit court concluded that such an attorney is 
exempt from the fees as a "person authorized by the patient."   
The court of appeals in examining the same statutory language 
answered this question in the negative, concluding that a 
"person authorized by the patient" within the meaning of Wis. 
Stat. §§ 146.81(5) and 146.83(3f)(b) is a person who has "the 
power to consent to the release of the patient's records," not a 
person who merely has the power to receive those records.  Moya 
v. Aurora Healthcare, Inc., 2016 WI App 5, ¶16, 366 Wis. 2d 541, 
874 N.W.2d 336 (emphasis added).  This court reverses that court 
of appeals' determination today purportedly because the language 
is clear.  I write because when utilizing traditional methods of 
statutory interpretation, examining the text, its context and 
construction, the plain meaning demonstrates that "person 
authorized by the patient" has a less expansive meaning than my 
colleagues have adopted.   
¶41 The court concludes that an attorney authorized by his 
or her client in writing to obtain the client's health care 
records is a "person authorized by the patient" under Wis. Stat. 
§§ 146.81(5) and 146.83(3f)(b).  In so doing it explains that it 
No.  2014AP2236.akz 
 
2 
 
is relying on the "plain meaning" of the statute.  I acknowledge 
that the interpretation of the statutes adopted by this court is 
defensible if one only looks at those words in a vacuum.  The 
conclusion of the court of appeals, however, is also supported 
by the text.  How do we know which interpretation is correct?  
Each interpretation relies on the language of the statute, yet 
the court of appeals and this court reach opposite conclusions.  
I endeavor to wade through a more thorough statutory analysis in 
order to reach a conclusion. 
¶42 As a practical matter, it certainly makes sense that 
the legislature might choose to exempt personal injury attorneys 
from the challenged fees.  These attorneys act as advocates for 
their clients and perhaps should be able to obtain the records 
without the fee.  However, these lawyers are not listed in Wis. 
Stat. § 146.81(5), the statute that defines "person authorized 
by the patient," nor are they exempt under Wis. Stat. 
§ 146.83(1b), whereby the legislature determined that public 
defenders need not pay the fee.  These lawyers do not fall into 
the class of persons listed in § 146.81(5) as they are not 
otherwise legally poised to essentially become the decision-
maker for the patient when the patient cannot legally act on his 
or her behalf.  Section 146.81(5) defines "person authorized by 
the patient" in part to be: 
[T]he parent, guardian, or legal custodian of a minor 
patient, as defined in s. 48.02(8) and (11), the 
person vested with supervision of the child under 
s. 938.183 or 938.34(4d), (4h), (4m), or (4n), the 
guardian of a patient adjudicated incompetent in this 
state, 
the 
personal 
representative, 
spouse, 
or 
domestic partner under ch. 770 of a deceased patient, 
No.  2014AP2236.akz 
 
3 
 
any person authorized in writing by the patient or a 
health care agent designated by the patient as a 
principal under ch. 155 if the patient has been found 
to be incapacitated under s. 155.05(2), except as 
limited by the power of attorney for health care 
instrument. 
§ 146.81(5).  Notably absent in this provision are lawyers who 
advocate on a patient's behalf in a lawsuit.1  While it may make 
sense to exempt these lawyers from paying fees, the choice is 
not the court's to make; it is within the province of the 
legislature.  I must examine the text of the statute at issue 
using fundamental tools of statutory construction to determine 
which of two interpretations of the phrase "person authorized by 
the patient" was intended by the legislature; as put by Aurora 
Healthcare, 
Inc., 
and 
Healthport 
Technologies, 
LLC 
("Healthport"), these two interpretative options are: (1) "any 
person authorized in writing by the patient to obtain the 
patient's health care records"; or (2) "any person authorized in 
writing by the patient to consent to the release of the 
patient's health care records."  In so doing I look to the 
surrounding text and examine that text in light of the canons of 
construction, not just part of the statutory text, in a vacuum.  
It is . . . a solemn obligation of the judiciary to 
faithfully give effect to the laws enacted by the 
legislature, and to do so requires a determination of 
statutory meaning.  Judicial deference to the policy 
choices enacted into law by the legislature requires 
that statutory interpretation focus primarily on the 
                                                 
1 Those attorneys advocate on behalf of the client/patient 
and may receive authority from a client to, for example, settle 
a case; importantly, however, such attorneys, unlike those 
persons in Wis. Stat. § 146.81(5), are not standalone decision-
makers who act with or without the patient's consent.  
No.  2014AP2236.akz 
 
4 
 
language 
of 
the 
statute. 
 
We 
assume 
that 
the 
legislature's intent is expressed in the statutory 
language. . . . It 
is 
the 
enacted 
law, 
not 
the 
unenacted intent, that is binding on the public.  
Therefore, the purpose of statutory interpretation is 
to determine what the statute means so that it may be 
given its full, proper, and intended effect. 
State ex rel. Kalal v. Circuit Court for Dane Cty., 2004 WI 58, 
¶44, 271 Wis. 2d 633, 681 N.W.2d 110.   
¶43 Given the above charge, I write to examine the 
statutes at issue and the court's reasoning, considering the 
disputed statutory text in context and in light of fundamental 
canons of construction.  For reasons I will explain, the 
interpretation adopted by the court today fails to adhere to 
fundamental principles of statutory construction and in fact 
renders the overall statutory scheme virtually meaningless.  
Ultimately, I would conclude, like the court of appeals, that 
the text of the statutes requires a conclusion that Moya's 
personal injury attorney is not a "person authorized by the 
patient" under Wis. Stat. § 146.83(3f)(b).  The lawyer at issue 
is not within the definition of "person authorized by the 
patient" in Wis. Stat. § 146.81(5) nor is he or she exempt from 
payment of fees under § 146.83(1b) as are other lawyers.  Thus, 
I must respectfully dissent. 
I 
¶44 I begin by setting forth established principles of 
statutory interpretation.  Statutory interpretation is governed  
first and foremost by the principle that "[t]he words of a 
governing text are of paramount concern, and what they convey, 
in their context, is what the text means."  Antonin Scalia & 
No.  2014AP2236.akz 
 
5 
 
Bryan A. Garner, Reading Law: The Interpretation of Legal Texts 
56 
(2012) 
(denominating 
this 
rule 
the 
"Supremacy-of-Text 
Principle").  Judges should "determin[e] the application of a 
governing text to given facts on the basis of how a reasonable 
reader, fully competent in the language, would have understood 
the text at the time it was issued."  Id. at 33.  This approach 
recognizes that "[t]he law is what the law says,"  Bank One 
Chicago, N.A. v. Midwest Bank & Trust Co., 516 U.S. 264, 279 
(1996) (Scalia, J., concurring in part and concurring in the 
judgment), and that  "[a]n interpreter who bypasses or downplays 
the text becomes a lawmaker without obeying the constitutional 
rules for making law."  Frank H. Easterbrook, Textualism and the 
Dead Hand, 66 Geo. Wash. L. Rev. 1119, 1120 (1998). 
¶45 Proper 
statutory 
interpretation 
rests 
on 
the 
fundamental premise that "[n]othing but conventions and contexts 
cause a symbol or sound to convey a particular idea."  Scalia & 
Garner, supra, at xxvii (emphases added). 
The enactment of a law is a form of communication 
through language——from the law-giver to those affected 
by the law, as well as to those who must enforce, 
apply, 
or 
interpret 
the 
law. 
 
This 
sort 
of 
communication is only possible if the participants 
have a set of shared practices and conventions that 
permit them to convey meaning to each other.  At the 
most basic level, intelligible communication requires 
that both parties attach the same meaning to the same 
sounds or signs.  Furthermore, we often need to be 
able to tell which of several possible meanings is 
intended by considering the context in which a word is 
used. Our shared practices and conventions also go 
beyond word meanings.  The rules of grammar and 
syntax, for example, represent shared conventions that 
assist us in decoding the communications of others.  
No.  2014AP2236.akz 
 
6 
 
John F. Manning & Matthew C. Stephenson, Legislation and 
Regulation 222 (2010). 
¶46 These twin pillars of interpretation, context and 
convention, 
are 
indispensable 
to 
the 
functioning 
of 
the 
judiciary.  Convention is sometimes realized in part through the 
implementation of certain "canons of construction," which are 
"rules of thumb that that help courts determine the meaning of 
legislation."  Connecticut Nat'l Bank v. Germain, 503 U.S. 249, 
253 (1992).  A number of these canons will be discussed in more 
detail below.   
¶47 Context, on the other hand, includes (1) "the purpose 
of the text," which must be "gathered only from the text itself, 
consistently with the other aspects of its context"; (2) "a 
word's historical associations acquired from recurrent patterns 
of past usage"; and (3) "a word's immediate syntactic setting——
that is, the words that surround it in a specific utterance."  
Scalia & Garner, supra, at 33 (emphasis omitted) (citing 
I.A. Richards, Interpretation in Teaching viii (1938)).   
¶48 Application of these principles——an unrelenting focus 
on the meaning of the text, discovered through a careful 
examination of context and the application, where necessary, of 
canons of construction——promotes "certainty, predictability, 
objectivity, reasonableness, rationality, and regularity, which 
are the objects of the skilled interpreter's quest."  Id. at 34 
(citing Frederick J. de Sloovère, Textual Interpretation of 
Statutes, 11 N.Y.U. L.Q. Rev. 538, 541 (1934)).  I now turn to 
No.  2014AP2236.akz 
 
7 
 
the issue of statutory interpretation at the heart of this 
appeal and, in analyzing it, employ this methodology. 
II 
¶49 Wisconsin Stat. § 146.83(3f)(a) explains that, with 
certain exceptions, "if a person requests copies of a patient's 
health care records, provides informed consent, and pays the 
applicable fees under par. (b), the health care provider shall 
provide the person making the request copies of the requested 
records." 
 
Wis. 
Stat. 
§ 146.83(3f)(a). 
 
Wisconsin 
Stat. 
§ 146.83(3f)(b), in turn, establishes the "applicable fees," 
including, as relevant here, the following two fees: (1) "If the 
requester is not the patient or a person authorized by the 
patient, for certification of copies, a single $8 charge"; and 
(2) "If the requester is not the patient or a person authorized 
by the patient, a single retrieval fee of $20 for all copies 
requested."  Wis. Stat. § 146.83(3f)(b)4.-5. (emphases added).  
In this case, Carolyn Moya's ("Moya") personal injury attorney 
obtained written consent from Moya to receive copies of her 
health care records.  Moya claims her attorney is therefore a 
"person authorized by the patient" and thus exempt from these 
fees. 
¶50 "Person authorized by the patient" is defined in Wis. 
Stat. § 146.81(5) as follows:  
[T]he parent, guardian, or legal custodian of a minor 
patient, as defined in s. 48.02(8) and (11), the 
person vested with supervision of the child under s. 
938.183 or 938.34(4d), (4h), (4m), or (4n), the 
guardian of a patient adjudicated incompetent in this 
state, 
the 
personal 
representative, 
spouse, 
or 
domestic partner under ch. 770 of a deceased patient, 
No.  2014AP2236.akz 
 
8 
 
any person authorized in writing by the patient or a 
health care agent designated by the patient as a 
principal under ch. 155 if the patient has been found 
to be incapacitated under s. 155.05(2), except as 
limited by the power of attorney for health care 
instrument.  If no spouse or domestic partner survives 
a deceased patient, "person authorized by the patient" 
also means an adult member of the deceased patient's 
immediate family, as defined in s. 632.895(1)(d).  A 
court may appoint a temporary guardian for a patient 
believed incompetent to consent to the release of 
records under this section as the person authorized by 
the patient to decide upon the release of records, if 
no guardian has been appointed for the patient.  
§ 146.81(5) (emphasis added).   
¶51 Moya and the court rely on the emphasized text for 
their conclusion that Moya's attorney fits the definition of 
"person authorized by the patient."  At the outset, it should be 
noted that it is not clear whether the phrase "any person 
authorized in writing by the patient" in Wis. Stat. § 146.81(5) 
is a standalone category or whether it is connected to the 
following phrase, namely "or a health care agent designated by 
the patient as a principal under ch. 155 if the patient has been 
found to be incapacitated under s. 155.05(2)."  § 146.81(5).  
Healthport contends that this court need not resolve this issue, 
and I agree.  As I will demonstrate, whether read as 
constituting its own category or read in conjunction with the 
phrase that follows it, the phrase "any person authorized in 
writing by the patient" does not include Moya's attorney. 
¶52 More generally, it is apparent that the mention of 
lawyers is completely absent from this statutory definition and, 
instead, the categories of individuals in the statute have the 
commonality of those people who can legally act and make 
No.  2014AP2236.akz 
 
9 
 
decisions when the patient cannot; that is not what a personal 
injury lawyer does.  Lawyers are not like the other categories 
of individuals listed.  While lawyers may advocate on behalf of 
their clients, they are ultimately subject to their clients' 
direction.  The categories of individuals in Wis. Stat. 
§ 146.81(5), on the other hand, are composed of individuals who 
stand in the shoes of a patient and make decisions for the 
patient, but are not those who simply advocate for a client at 
the client's direction. 
III 
¶53 Also important is a recognition that, as noted by 
Healthport, the definition of "person authorized by the patient" 
provided in Wis. Stat. § 146.81(5) does not clearly define the 
nature of the "authori[ty]" provided by the patient to the 
person authorized by the patient.  The circuit court determined 
that, for purposes of Wis. Stat. § 146.83(3f)(b), the authority 
was the authority to inspect a patient's health care records.  
Moya, 366 Wis. 2d 541, ¶4.  The court of appeals concluded that 
the authority was the authority to consent to the release of a 
patient's health care records.  Id., ¶16.    
¶54 Review of Wis. Stat. § 146.81(5) makes apparent that 
the definition of "person authorized by the patient" provided 
therein has a common focus on categories of people who are 
authorized by law to act as the patient, not just act because 
the patient vested them with limited authority to obtain 
records.  Those included in the statutory definition include 
those such as "the parent . . . of a minor patient," for 
No.  2014AP2236.akz 
 
10 
 
instance, or "the guardian of a patient adjudicated incompetent 
in this state," but the statute does not explicitly describe 
what type of authority these people possess.  § 146.81(5).  The 
kind of authority vested by law in these people is far different 
than the kind of obligations a lawyer takes on in representing a 
person in a lawsuit.  These people listed are those who could 
sign a release that would authorize the lawyer to get the 
records.  The lawyer, unlike those listed in § 146.81(5), could 
not, for example, sign the form on behalf of the patient as all 
these individuals could do.   
¶55 These observations are relevant to the plain meaning 
of "any person authorized in writing by the patient" in Wis. 
Stat. § 146.81(5).  A person who states "I have been authorized 
in writing" has said nothing about what she has been authorized 
to do.  For example, a person who has been authorized in writing 
to speak on a patient's behalf is technically a "person 
authorized in writing by the patient," see § 146.81(5), but no 
one would argue that this type of person would fulfill the 
definition of "person authorized by the patient" in Wis. Stat. 
§ 146.83(3f)(b).  Those listed in the statute, however, have in 
common, for example, the authority vested in them by law.  In 
sum, examination of the phrase "any person authorized in writing 
by the patient" in § 146.81(5) in isolation is not sufficient to 
decide this case. 
¶56 The court defines the nature of the authority in Wis. 
Stat. § 146.81(5) differently depending on in which portion of 
No.  2014AP2236.akz 
 
11 
 
chapter 146 that phrase is used.2  So because, in the context of 
Wis. Stat. § 146.83(3f), the "person [potentially] authorized by 
the patient" is "request[ing] copies of a patient's health care 
records," § 146.83(3f)(a), the definition of "person authorized 
by the patient" in that portion of the statutes, in the court's 
view, is "person authorized by the patient to obtain the 
patient's 
healthcare 
records" 
(as 
long 
as, 
pursuant 
to 
§ 146.81(5), that authorization is written authorization).  But 
any person who obtains records this way would need written 
authorization.  
¶57 In other words, the court simply concludes that 
because Moya's attorney was "authorized in writing" to receive 
copies of Moya's health care records, he is a "[p]erson 
authorized by the patient" as defined in Wis. Stat. § 146.81(5), 
which definition applies to the fee portion of the statutory 
scheme, Wis. Stat. § 146.83(3f)(b).  See § 146.81.  That 
interpretation possesses the benefit of being uncomplicated, but 
that does not mean it is correct.  The court's reading fails to 
account for a number of important considerations——namely, 
significant clues provided by investigation of the statutory 
                                                 
2 Typically, the "[p]resumption of consistent usage" canon 
would instruct that "[a] word or phrase is presumed to bear the 
same meaning throughout a text."  Antonin Scalia & Bryan A. 
Garner, Reading Law: The Interpretation of Legal Texts 170 
(2012).  In the court's defense, however, it may not be 
necessarily in violation of that canon because the nature of the 
authority, while changing, changes to attend to the purpose of 
the specific statute.  
No.  2014AP2236.akz 
 
12 
 
context and the application of canons of construction——which 
counsel a different reading of the statute.   
¶58 More specifically, the court's conclusion falls prey 
to a criticism directed at Moya by Healthport: 
Although [Moya] repeatedly urges this Court to follow 
the "plain language" or "plain meaning" of the 
statutory words, she fails to provide a reason why her 
proposed interpretation follows from those words.  
Instead, [Moya] simply assumes that the legislature 
meant to say "any person authorized in writing by the 
patient to obtain that patient's health care records."  
A plain language argument that simply assumes the 
addition of a critical clause is not a plain language 
argument at all. 
¶59 The truth of the matter is that the statutory phrase 
"any person authorized in writing by the patient," viewed alone, 
simply does not provide enough information for the court to 
reach a conclusion in this case.  But statutory interpretation 
requires more than simply looking at a set of words in total 
isolation.  The court must look to something more——the context 
of the phrase and applicable canons of constructions——to reach 
the correct answer.    
¶60 Before discussing how these tools help establish the 
plain meaning of this phrase in this statute, I explain how 
these tools immediately demonstrate a number of significant 
deficits in the court's approach.  First, the phrase "person 
authorized by the patient" must require more in the context of 
Wis. Stat. § 146.83(3f) than the court says it does because, 
with a few exceptions, "a person request[ing] copies of a 
patient's health care records" under that provision must 
additionally "provide[] informed consent" in order to obtain the 
No.  2014AP2236.akz 
 
13 
 
records.  § 146.83(3f)(a).  Informed consent under the statute 
"means written consent to the disclosure of information from 
patient health care records to an individual, agency, or 
organization that includes" specified pieces of information such 
as the patient's name and the signature of the patient or the 
person authorized by the patient.  Wis. Stat. § 146.81(2).  
Therefore, under the court's interpretation, nearly every person 
who obtains health care records under § 146.83(3f) will, by 
nature of the informed consent they must provide, automatically 
be a "person authorized by the patient" and thus, virtually no 
one will ever pay certification or retrieval fees as called for 
by the statute.   
¶61 If the court were correct and all one needed to become 
a "person authorized by the patient" was informed consent, then 
there would be no need for a statutory definition of "person 
authorized by the patient."  A person possessing informed 
consent and a "person authorized by the patient" must therefore 
be very different individuals possessing different degrees of 
authority.  See, e.g., Pawlowski v. Am. Family Mut. Ins. Co., 
2009 WI 105, ¶22, 322 Wis. 2d 21, 777 N.W.2d 67 ("As a basic 
rule of statutory construction, we endeavor to give each 
statutory word independent meaning so that no word is redundant 
or superfluous.  When the legislature chooses to use two 
different words, we generally consider each separately and 
presume that different words have different meanings.").  The 
reason that both informed consent and separate authorization are 
required in this statutory scheme is because the individuals 
No.  2014AP2236.akz 
 
14 
 
exempted from the statutory fees at issue are either patients or 
those who are essentially the equivalents of patients.  The 
legislature defined "person authorized by the patient" to mean 
individuals that could actually step in and make decisions for 
the patient.  In contrast, lawyers are advocates but they do not 
step in and become the decision-maker; in fact, it is unethical 
for them to do so.  
¶62 The legislature does not enact a fee statute to 
collect no fees.  While this seems obvious, I need not look to 
legislative history or some unknown possible intent; I need only 
look at the words of the statute.  And this is where context and 
canons of construction provide guidance.  It is a "well-
established canon[] of statutory construction" that "[s]tatutory 
interpretations that render provisions meaningless should be 
avoided."  Belding v. Demoulin, 2014 WI 8, ¶17, 352 Wis. 2d 359, 
843 N.W.2d 373; see also, e.g., United States v. Tohono O'Odham 
Nation, 563 U.S. 307, 315 (2011) ("Courts should not render 
statutes nugatory through construction."); Louisville Water Co. 
v. Clark, 143 U.S. 1, 12 (1892) ("Any other interpretation of 
the act . . . would render it inoperative for the purposes for 
which, manifestly, it was enacted."); Kalal, 271 Wis. 2d 633, 
¶46 ("Statutory language is read where possible to give 
reasonable 
effect 
to 
every 
word, 
in 
order 
to 
avoid 
surplusage."). 
 
The 
court's 
approach 
virtually 
guts 
the 
No.  2014AP2236.akz 
 
15 
 
possibility of collecting fees and certainly contravenes fairly 
basic canons of construction.3   
¶63 Another flaw in the court's reading of the relevant 
statutes is that the language of Wis. Stat. § 146.81(5) does not 
mention lawyers at all but lawyers are exempted in other 
sections.  "Under the doctrine of expressio unius est exclusio 
alterius, 'the express mention of one matter excludes other 
similar matters [that are] not mentioned.'"  FAS, LLC v. Town of 
Bass Lake, 2007 WI 73, ¶27, 301 Wis. 2d 321, 733 N.W.2d 287 
(alteration in original) (quoting Perra v. Menomonee Mut. Ins. 
Co., 2000 WI App 215, ¶12, 239 Wis. 2d 26, 619 N.W.2d 123).  The 
legislature 
was 
fully 
capable 
of 
adding 
lawyers 
to 
the 
                                                 
3 It is true that Wis. Stat. § 146.82(2) contains a list of 
entities that may obtain health care records without informed 
consent 
under 
certain 
circumstances, 
such 
as 
(generally 
speaking) emergency medical services personnel assisting a 
patient, district attorneys prosecuting alleged child abuse, and 
courts conducting termination of parental rights proceedings.  
See § 146.82(2)(a)2., 11.-11m.  I do not find compelling the 
argument that the certification and retrieval fees in Wis. Stat. 
§ 146.83(3f)(b)4.-5. are reserved for this specialized subset of 
requesters.  If the legislature had intended such a result, it 
could have provided for it much more clearly.   
Further, it may well be that these entities share common 
characteristics of which the court is not, at this time, fully 
aware.  For instance, many of the entities listed in this group 
seem to possess a public interest component, such that a fee for 
health care records would ultimately be transferred to the 
taxpayer.  Other entities in this group would seemingly include 
health care providers themselves using health care records for 
internal matters.  See, e.g., Wis. Stat. § 146.82(2)(a)3. 
(exception provided "[t]o the extent that the records are needed 
for billing, collection or payment of claims."). 
No.  2014AP2236.akz 
 
16 
 
definition of "person authorized by the patient," but it did not 
do so.  
¶64 A third problem with the court's interpretation stems 
from the language of the legislature's 2014 enactment of 2013 
Wisconsin 
Act 
342, 
which 
in 
turn 
created 
Wis. 
Stat. 
§ 146.83(1b).  Importantly, this statute further defined those 
who are exempt from payment.  Section § 146.83(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 [a section in the chapter pertaining to the 
State Public Defender] if that attorney has written 
informed consent from the patient to view and obtain 
copies of the records. 
§ 146.83(1b) (emphasis added).  "Notwithstanding" the definition 
of "person authorized by the patient" means "in spite of" the 
definition 
of 
"person 
authorized 
by 
the 
patient." 
Notwithstanding, Black's Law Dictionary 1231 (10th ed. 2014) 
(emphasis added).  It would be strange indeed for the 
legislature to have used the word "notwithstanding" if, as is 
suggested by the court's opinion, these attorneys already met 
the definition of "person authorized by the patient" in Wis. 
Stat. § 146.81(5) prior to the enactment of § 146.83(1b).  Put 
differently, 
the 
legislature's 
recent 
amendment 
strongly 
indicates that individuals like Moya's attorney are not included 
in the definition of "person authorized by the patient."  If 
lawyers who received authorization in writing were included in 
§ 146.81(5), § 146.83(1b) would be surplusage and completely 
unnecessary.   
No.  2014AP2236.akz 
 
17 
 
¶65 The amendment in Wis. Stat. § 146.83(1b) provides 
similar guidance when viewed in light of any of a number of 
canons of construction.  One such canon has already been 
referenced: "Statutory language is read where possible to give 
reasonable effect to every word, in order to avoid surplusage."  
Kalal, 271 Wis. 2d 633, ¶46.  As Healthport points out, "[i]f 
the definition of 'person authorized by the patient' already 
included attorneys with an informed consent, the new section 
146.83(1b) would be wholly superfluous."  Indeed it would.   
¶66 Again, "[u]nder the doctrine of expressio unius est 
exclusio alterius, 'the express mention of one matter excludes 
other similar matters [that are] not mentioned.'"  FAS, LLC, 301 
Wis. 2d 321, ¶27 (alteration in original) (quoting Perra, 239 
Wis. 2d 26, ¶12).  That is, the legislature obviously could have 
expanded the reach of Wis. Stat. § 146.83(1b) to include 
personal injury attorneys, but it did not do so.  Similarly, 
"[n]othing is to be added to what the text states or reasonably 
implies (casus omissus pro omisso habendus est).  That is, a 
matter not covered is to be treated as not covered."  Scalia & 
Garner, supra, at 93 (describing this as the "Omitted-Case 
Canon").  Under this principle, a judge should not, among other 
things "elaborate unprovided-for exceptions to a text."  Id.; 
see also id. ("[I]f the Congress [had] intended to provide 
additional exceptions, it would have done so in clear language." 
(alterations in original) (quoting Petteys v. Butler, 367 F.2d 
528, 538 (8th Cir. 1966) (Blackmun, J., dissenting))).  This is 
exactly what the court may be read to do in concluding that 
No.  2014AP2236.akz 
 
18 
 
Moya's attorney is exempt from the fees at issue.  This court 
should not be acting where the legislature has declined to do 
so. 
¶67 Accordingly, the court's interpretation of Wis. Stat. 
§ 146.83(3f)(b) possesses substantial flaws, and I cannot agree 
with it.  Fortunately, it is not the only interpretation 
presented in this case.  Again, it is important to recognize 
that Wis. Stat. § 146.81(5) does not clearly define the nature 
of the "authori[ty]" provided by the patient to the person 
chosen by the patient; the statute instead lists categories of 
individuals.  In order to determine the nature of this 
authority, then, it is again beneficial to look to context and 
to apply recognized canons of construction. 
¶68 Two related canons of construction, noscitur a sociis 
and ejusdem generis, are particularly helpful here.  Pursuant to 
the noscitur a sociis canon of construction, "[a]n unclear 
statutory term should be understood in the same sense as the 
words immediately surrounding or coupled with it."  State v. 
Quintana, 2008 WI 33, ¶35, 308 Wis. 2d 615, 748 N.W.2d 447 
(quoting  Wis. Citizens Concerned for Cranes & Doves v. DNR, 
2004 WI 40, ¶40, 270 Wis. 2d 318, 677 N.W.2d 612).  That is, it 
is reasonable to ascertain the meaning of the phrase "person 
authorized by the patient" by analyzing the phrase in light of 
the surrounding categories enumerated in the definition.  See 
Moya, 366 Wis. 2d 541, ¶12; see also Kalal, 271 Wis. 2d 633, ¶46 
("Context is important to meaning.").  
No.  2014AP2236.akz 
 
19 
 
¶69 As explained, none of the enumerated categories in 
Wis. Stat. § 146.81(5) consists of attorneys.  Further, the 
phrase "any person authorized in writing by the patient" is 
placed in the middle of the list rather than at its end; 
therefore, it does not seem to be an expansion of the categories 
previously listed to new categories of people, nor does it seem 
to be an extension of the previously listed categories to 
include a host of new categories.  See, e.g., State v. Givens, 
28 Wis. 2d 109, 115, 135 N.W.2d 780 (1965) ("When the statute, 
after 
the 
specific 
enumerations, 
in 
a 
'catchall' 
clause 
proscribes 
'otherwise 
disorderly 
conduct' 
which 
tends 
to 
'provoke a disturbance,' this must mean conduct of a type not 
previously enumerated but similar thereto in having a tendency 
to disrupt good order and to provoke a disturbance."). 
¶70 In fact, if I consult the noscitur a sociis canon of 
construction, it depends upon whether the enumerated persons in 
Wis. Stat. § 146.81(5) possess a "similar meaning."  Quintana, 
308 Wis. 2d 615, ¶35.  If the various categories are unrelated, 
then one would presume that the individual categories should be 
interpreted broadly.  See id.  Conversely, if the various 
categories are related, then the "authori[ty]" provided by the 
patient to the person chosen by the patient in § 146.81(5) 
should be understood in light of the characteristics shared by 
each category.  See id.  As was previously discussed, the 
categories of individuals listed have in common the fact that 
they become decision-makers for the patient.  Thus, we further 
No.  2014AP2236.akz 
 
20 
 
conclude that the phrase "person authorized by the patient" is 
not to be construed as expansive. 
¶71 Additionally, a related canon of construction, ejusdem 
generis, "instructs that when general words follow specific 
words in the statutory text, the general words should be 
construed in light of the specific words listed" such that "the 
general word or phrase will encompass only things of the same 
type as those specific words listed."  Id., ¶27 (citing Adams 
Outdoor Advert., Ltd. v. City of Madison, 2006 WI 104, ¶62 n.15, 
294 Wis. 2d 441, 717 N.W.2d 803).  But if "[t]he specific terms 
listed in the statute have no common feature or class from which 
one could ascertain an intention to restrict the meaning of the 
general term," then "the general terms should be interpreted 
broadly to give effect to the legislature's intent."  Id., ¶¶26, 
28, 31-32; see also Scalia & Garner, supra, at 101 (under the 
"General-Terms Canon," "[g]eneral terms are to be given their 
general 
meaning 
(generalia 
verba 
sunt 
generaliter 
intelligenda)," so long as there is no "indication to the 
contrary").  So again, because the categories of individuals 
have in common the fact that they become decision-makers for the 
patient, the words are not expansive.   
¶72 Consequently, it is important to ascertain whether 
there are similarities between the categories of individuals 
listed in Wis. Stat. § 146.81(5).  If there are similarities, 
this 
would 
indicate 
that 
the 
"authori[ty]" 
granted 
in 
§ 146.81(5) should be interpreted more narrowly and more 
exclusively; 
if 
there 
are 
no 
similarities, 
then 
this 
No.  2014AP2236.akz 
 
21 
 
"authori[ty]" should be interpreted more broadly and less 
exclusively.  
¶73 Wisconsin 
Stat. 
§ 146.81(5) 
defines 
"[p]erson 
authorized by the patient" to include individuals acting on 
behalf of: (1) minor patients; (2) patients who have been 
adjudicated 
incompetent; 
(3) 
deceased 
patients; 
and 
(4) 
incapacitated patients.  § 146.81(5).  One might argue that the 
legislature 
envisioned 
a 
certain 
commonality 
among 
these 
categories of individuals.  And indeed, the court of appeals, 
comparing Moya and her personal injury attorney to these other 
pairs of individuals, interpreted "authorized" in the phrase 
"person authorized by the patient" to mean "having the power to 
consent to the release of the patient's records," rather than 
merely the power to receive those records.  
Moya, 366 
Wis. 2d 541, ¶16 (emphasis added); see also § 146.81(5) ("A 
court may appoint a temporary guardian for a patient believed 
incompetent to consent to the release of records under this 
section as the person authorized by the patient to decide upon 
the release of records, if no guardian has been appointed for 
the patient." (emphasis added)).  The court of appeals concluded 
that adoption of Moya's argument would violate the manifest 
purpose of the relevant statutes, expanding the definition of 
"person authorized by the patient" beyond the "very specific 
list of individuals" contemplated by the legislature.  See Moya, 
366 Wis. 2d 541, ¶12.   
¶74 The 
interpretation 
of 
the 
court 
of 
appeals 
is 
reasonable.  It better comports with the other enumerated 
No.  2014AP2236.akz 
 
22 
 
categories of persons in Wis. Stat. § 146.81(5).  It possesses 
none of the major defects of the court's interpretation which I 
identified above.  And it is supported by the statutory context 
and by canons of construction.  And this holds true whether "any 
person authorized in writing by the patient" is read as a 
standalone category or together with the following clause.  If 
read as a standalone category, "any person authorized in writing 
by the patient" would clearly not be intended as a broad, 
"catch-all" group, because it would not fall at the end of the 
list of enumerated categories; and if read together with the 
following clause ("or a health care agent designated by the 
patient as a principal under ch. 155 if the patient has been 
found to be incapacitated under s. 155.05(2)," § 146.81(5)), 
then "any person authorized in writing by the patient" would 
share the characteristics of the other enumerated categories and 
would not be intended to include attorneys.  These canons 
certainly point strongly in one direction: against the reading 
adopted by the court.  
¶75 The court does not adequately address the reading 
dictated by application of the interpretative methodology 
discussed above; as a result, its reasoning is unpersuasive.  It 
also does not explain why Wis. Stat. § 146.83(1b) would be 
necessary to exempt public defenders from the payment of these 
fees because public defenders, as virtually all others, would 
need written authorization to obtain the patient's records in 
the first instance.  The court adopts a more expansive 
interpretation, but seems to base its interpretation on language 
No.  2014AP2236.akz 
 
23 
 
that does not have support in common tools of construction.  In 
my view, little or nothing in the statutory text supports the 
court's expansive view. 
¶76 On balance, I must conclude that the interpretation 
adopted by the court today is unlikely to be the correct answer.  
If the statute at issue is really as broad as the court says it 
is, the challenged fee requirements are rendered largely 
meaningless.  I cannot accept that a plain meaning here was 
intended to exempt virtually all who obtain records from payment 
of the fees set forth. 
¶77 The 
clear 
purpose 
of 
the 
statute, 
as 
"gathered . . . from the text itself," is to charge certain 
individuals fees.  Scalia & Garner, supra, at 33.  Very simply 
stated, since nearly anyone who wishes to receive a patient's 
records 
needs 
that 
patient's 
authorization 
and 
no 
such 
authorized person would ever need to pay the applicable fee, 
virtually no fees would be paid under this statute.  It is not 
as though an attorney, appropriately authorized, could never fit 
the definition of "person authorized by the patient."  But every 
attorney does not fit that definition, and an examination of the 
text reveals that Moya's attorney does not fit that definition. 
¶78 Finally, 
given 
the 
competing 
interpretative 
possibilities 
here, 
a 
point 
about 
judicial 
restraint 
is 
appropriate.  Even if it intuitively makes sense that personal 
injury lawyers should not have to pay fees to receive their 
clients' medical records, if I am incorrect, the legislature 
could easily amend the statute as it did with Wis. Stat. 
No.  2014AP2236.akz 
 
24 
 
§ 146.83(1b) thereby excluding the public defenders.  The 
legislative "fix," if the court is incorrect, requires a virtual 
rewrite of these fee statutes.   
IV 
¶79 Interpretation of the statutory text leads me to 
conclude, like the court of appeals, that Moya's personal injury 
attorney is not a "person authorized by the patient" under Wis. 
Stat. § 146.83(3f)(b).  Regardless, it would be well worth the 
legislature's time for it to clarify these statutes so as to 
provide guidance to the public, to lawyers, and to the courts.  
In the absence of such guidance, however, I must respectfully 
dissent. 
¶80 For the foregoing reasons, I respectfully dissent. 
 
No.  2014AP2236.akz 
 
 
 
1