Date of enactment: December 1, 1995
1995 Assembly Bill 520 Date of publication*: December 15, 1995
1995 WISCONSIN ACT 98
An Act to repeal 50.02 (6); to amend 20.435 (1) (gm); and to create subchapter III of chapter 50 [precedes 50.50], 146.81 (1) (p) and 146.82 (2) (a) 17. of the statutes; relating to: regulating rural medical centers, granting rule-making authority, making an appropriation and providing penalties.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
98, s. 1
20.435 (1) (gm) of the statutes is amended to read:
20.435 (1) (gm) Licensing, review and certifying activities. The amounts in the schedule for the purposes specified in ss. 50.135, 50.49 (2) (b), 50.52 (2) (a), 146.50 (8), 250.05 (6), 252.22 (7), 254.176, 254.178, 254.20 (5) and (8), 254.31 to 254.39, 254.47, 254.61 to 254.89 and 255.08 (2), subch. IV of ch. 50 and ch. 150. All moneys received under ss. 50.135, 50.49 (2) (b), 50.52 (2) (a), 50.93 (1) (c), 146.50 (8) (d), 150.13, 250.05 (6), 252.22 (7), 254.176, 254.178, 254.20 (5) and (8), 254.31 to 254.39, 254.47, 254.61 to 254.89 and 255.08 (2) (b), less the amounts appropriated under s. 20.488 (1) (g), shall be credited to this appropriation.
98, s. 2
50.02 (6) of the statutes is repealed.
98, s. 3
Subchapter III of chapter 50 [precedes 50.50] of the statutes is created to read:
rural medical centers
50.50 Definitions. In this subchapter:
(1) "Ambulatory surgery center" has the meaning given in s. 49.45 (6r) (a) 1.
(2) "End-stage renal disease services" has the meaning given under 42 CFR 405.2102.
(3) "Health care services" means any of the following:
(a) Care that is provided in or by any of the following:
1. A hospital.
2. A nursing home.
3. A hospice.
4. A rural health clinic.
5. An ambulatory surgery center.
6. A rural primary care hospital.
(b) Home health services.
(c) Outpatient physical therapy services.
(cm) Outpatient occupational therapy services.
(d) End-stage renal disease services.
(e) Services that are specified in rules that the department promulgates.
(4) "Home health services" has the meaning given in s. 50.49 (1) (b).
(5) "Hospice" has the meaning given in s. 50.90 (1).
(6) "Hospital" has the meaning given in s. 50.33 (2) (a) or (b), except that "hospital" does not include a rural primary care hospital.
(7) "Medicare" has the meaning given in s. 49.45 (3) (L) 1. b.
(7m) "Occupational therapy" has the meaning given in s. 448.01 (2m).
"Outpatient physical therapy services" has the meaning given under 42 USC 1395x
(9) "Patient" means an individual who receives services from a rural medical center.
"Rural health clinic" has the meaning given under 42 USC 1395x
(11) "Rural medical center" means an arrangement of facilities, equipment, services and personnel that is all of the following:
(a) Organized under a single governing and corporate structure.
(b) Capable of providing or assuring health care services, including appropriate referral, treatment and follow-up services, at one or more locations in a county, city, town or village that has a population of less than 15,000 and that is in an area that is not an urbanized area, as defined by the federal bureau of the census.
(c) A provider of at least 2 health care services under the arrangement or through a related corporate entity.
"Rural primary care hospital" means a facility that is currently designated by the federal health care financing administration as meeting the applicable requirements of 42 USC 1395i-4
(i) (2) and of 42 CFR 485, Subpart F.
50.51 Departmental powers. The department shall do all of the following:
(1) Provide uniform, statewide licensing, inspection and regulation of rural medical centers as specified in this subchapter.
(2) Promulgate rules that establish all of the following:
(a) For the operation of licensed rural medical centers, standards that are designed to protect and promote the health, safety, rights and welfare of patients who receive health care services in rural medical centers.
(b) Minimum requirements for issuance of a provisional license, a regular initial license or a license renewal to rural medical centers.
(c) Fees for rural medical center provisional licensure and regular initial licensure and licensure renewal. The amounts of the fees shall be based on the health care services provided by the rural medical center.
(d) A procedure and criteria for waiver of or variance from standards under par. (a) or minimum requirements under par. (b).
50.52 Licensing procedure and requirements. (1) No person may be required to obtain licensure as a rural medical center, except that no person may conduct, maintain, operate or permit to be conducted, maintained or operated health care services as a rural medical center unless the rural medical center is licensed by the department.
(2) The department shall issue a provisional license, a regular initial license or a license renewal as a rural medical center to an applicant if all of the following are first done:
(a) The applicant pays the appropriate license fee, as established under s. 50.51 (2) (c). Fees collected under this paragraph shall be credited to the appropriation under s. 20.435 (1) (gm) for licensing and inspection activities.
(b) Except as provided in par. (c), the department inspects the health care services provided by the applying rural medical center and finds that the applicant is fit and qualified and meets the requirements and standards of this subchapter and the rules promulgated under this subchapter.
(c) In lieu of conducting the inspection under par. (b), the department accepts evidence that an applicant meets one of the following requirements:
1. Has applicable current, valid state licensure or approval as a hospital, a nursing home, a hospice or a home health agency.
2. Has an applicable, current agreement to participate as an eligible provider in medicare.
3. Is a rural primary care hospital.
4. Satisfies qualifications that are specified by the department by rule.
(3) Each license shall bear the name of the owner of the rural medical center, the name and address of the rural medical center and the health care services that the department licenses the rural medical center to provide.
(4) Unless sooner revoked or suspended, a regular initial license or a license renewal issued to a rural medical center is valid for 24 months from the date of issuance and a provisional license issued to a rural medical center is valid for 6 months from the date of issuance.
(5) Each license shall be issued only for the rural medical center and owner that are named in the license application and may not be transferred or assigned.
50.53 Inspections and investigations. (1) The department may conduct unannounced inspections or investigations of a rural medical center as the department considers necessary.
(2) A rural medical center that is inspected or investigated under this section shall provide the department with access to patient health care records, regardless of the source of patient health care payment, to fulfill the purpose of any inspections or investigations that the department conducts.