Feed for /2005/related/proposals/ab907 PDF
The bill eliminates the Board, the Review Board, and the Council on July 1,
2006.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB907, s. 1 1Section 1. 15.07 (2) (b) of the statutes is repealed.
AB907, s. 2 2Section 2. 15.07 (3) (bm) 1. of the statutes is repealed.
AB907, s. 3 3Section 3. 15.107 (7) of the statutes is repealed.
AB907, s. 4 4Section 4. 15.195 (6) of the statutes is repealed.
AB907, s. 5 5Section 5. 15.195 (9) of the statutes is repealed.
AB907, s. 6
1Section 6. 16.03 of the statutes is repealed.
AB907, s. 7 2Section 7. 20.435 (1) (hg) of the statutes, as affected by 2005 Wisconsin Act 25,
3is amended to read:
AB907,4,94 20.435 (1) (hg) General program operations; health care information. The
5amounts in the schedule to fund the activities of the department of health and family
6services and the board on health care information under ch. 153 and to contract with
7the data organization under s. 153.05 (2r)
. The contract fees paid under s. 153.05
8(6m) and assessments paid under s. 153.60 shall be credited to this appropriation
9account.
AB907, s. 8 10Section 8 . 20.435 (1) (hg) of the statutes, as affected by 2005 Wisconsin Act ....
11(this act), is amended to read:
AB907,4,1712 20.435 (1) (hg) General program operations; health care information. The
13amounts in the schedule to fund the activities of the department of health and family
14services and the board on health care information under ch. 153 and to contract with
15the data organization under s. 153.05 (2r). The contract fees paid under s. 153.05
16(6m) and assessments paid under s. 153.60 shall be credited to this appropriation
17account.
AB907, s. 9 18Section 9. 20.435 (1) (hi) of the statutes, as affected by 2005 Wisconsin Act 25,
19is amended to read:
AB907,4,2420 20.435 (1) (hi) Compilations and special reports; health care information. All
21moneys received from user fees imposed under s. 153.65 (1) for the purpose of
22financing the costs of the department of health and family services of producing
23special data compilations or special reports under s. 153.65 and to contract with the
24data organization under s. 153.05 (2r)
.
AB907, s. 10 25Section 10. 20.515 (1) (r) of the statutes is amended to read:
AB907,5,7
120.515 (1) (r) Benefit and coverage payments; data collection, analysis, and
2reporting
. All moneys credited to the public employee trust fund for payment from
3the appropriate accounts and reserves of the fund of the benefits, contributions,
4insurance premiums and refunds authorized by ch. 40 for the respective benefit
5plans and for the costs of contracting for data collection, analysis, and reporting
6under s. 153.05 (2r)
. Estimated disbursements under this paragraph shall not be
7included in the schedule under s. 20.005.
AB907, s. 11 8Section 11. 153.01 (1) of the statutes is renumbered 153.01 (1g).
AB907, s. 12 9Section 12. 153.01 (1d) of the statutes is created to read:
AB907,5,1010 153.01 (1d) "Administrator" has the meaning given in s. 633.01 (1).
AB907, s. 13 11Section 13. 153.01 (2) of the statutes is repealed.
AB907, s. 14 12Section 14. 153.01 (2g) of the statutes is created to read:
AB907,5,1413 153.01 (2g) "Calculated variable" means a data element that is computed or
14derived from an original data item or derived using another data source.
AB907, s. 15 15Section 15. 153.01 (3g) of the statutes is created to read:
AB907,5,1916 153.01 (3g) "Data organization" means a nonstock corporation organized
17under ch. 181 that is described in section 501 (c) (3) of the Internal Revenue Code,
18is exempt from federal income tax under section 501 (a) of the Internal Revenue
19Code, and, in its capacity as a public health authority, does all of the following:
AB907,5,2120 (a) Represents health care consumers, insurers, administrators, and health
21care providers.
AB907,5,2222 (b) Is formed specifically to do all of the following:
AB907,5,2523 1. Create a centralized claims repository for this state with credible and useful
24data elements for the purposes of quality improvement, health care provider
25performance comparisons, ready understandability, and consumer decision making.
AB907,6,2
12. Use the information it collects to develop and disseminate unified public
2reports on health care quality, safety, and efficiency.
AB907, s. 16 3Section 16. 153.01 (5m) of the statutes is amended to read:
AB907,6,44 153.01 (5m) "Insurer" has the meaning given under s. 600.03 (27) 632.745 (15).
AB907, s. 17 5Section 17. 153.01 (8m) of the statutes is created to read:
AB907,6,86 153.01 (8m) "Public health authority" means the department or a person
7acting under this chapter under a grant of authority from or contract with the
8department.
AB907, s. 18 9Section 18. 153.05 (1) (a) of the statutes is amended to read:
AB907,6,1310 153.05 (1) (a) The Subject to s. 153.455, the department shall collect from
11health care providers other than hospitals and ambulatory surgery centers, analyze,
12and disseminate health care information, as adjusted for case mix and severity, in
13language that is understandable to laypersons.
AB907, s. 19 14Section 19. 153.05 (1) (c) of the statutes is created to read:
AB907,7,215 153.05 (1) (c) Subject to s. 153.455 (1) to (3), the data organization under
16contract under sub. (2r) may request health care claims information from insurers
17and administrators. The data organization shall analyze and publicly report the
18health care claims information with respect to the cost, quality, and effectiveness of
19health care, in language that is understandable by lay persons, and shall develop and
20maintain a centralized data repository. The data organization shall provide to the
21department, without charge, health care claims information collected by and reports
22produced by the data organization that the department requests. If s. 153.455 (4)
23applies, the department may request health care claims information, which may be
24voluntarily provided by insurers and administrators, and may perform or contract

1for the performance of the other duties specified for the data organization under this
2paragraph.
AB907, s. 20 3Section 20. 153.05 (2r) of the statutes is created to read:
AB907,7,124 153.05 (2r) Notwithstanding s. 16.75 (1), (2), and (3m), from the appropriation
5account under s. 20.515 (1) (r) the department of employee trust funds may expend
6up to $150,000, and from the appropriation accounts under s. 20.435 (1) (hg) and (hi)
7the department of health and family services, in its capacity as a public health
8authority, may expend moneys, to contract jointly with a data organization to
9perform services under this chapter that are specified for the data organization
10under sub. (1) (c) or, if s. 153.455 (4) applies, for the department of health and family
11services to perform or contract for the performance of these services. As condition
12of the contract under this subsection, all of the following apply:
AB907,7,1613 (a) At least during the period of the contract, the data organization shall
14include as voting members of the board of directors of the data organization the
15secretary of health and family services and the secretary of employee trust funds, or
16their designees.
AB907,7,1817 (b) The data organization shall provide matching funds, which may include
18in-kind contributions, as specified in the contract.
AB907,7,2119 (c) Termination of funding and of services of the data organization under the
20contract or modification of the contract is subject to a determination made under s.
21153.455 (3).
AB907, s. 21 22Section 21. 153.05 (3) (a) of the statutes is amended to read:
AB907,8,223 153.05 (3) (a) Upon request of the department for health care information
24relating to health care providers other than hospitals and ambulatory surgery
25centers and, if s. 153.455 (4) applies, for health care claims information as specified

1in sub. (1) (c)
, state agencies shall provide that health care information to the
2department for use in preparing reports under this chapter.
AB907, s. 22 3Section 22. 153.05 (3) (c) of the statutes is created to read:
AB907,8,94 153.05 (3) (c) Upon request of the data organization under contract under sub.
5(2r) for health care claims information, insurers and administrators may provide the
6health care claims information to the data organization for use in preparing reports
7and developing and maintaining a central data repository under this chapter, and,
8if s. 153.455 (4) applies, insurers and administrators may provide the health care
9claims information as requested by the department.
AB907, s. 23 10Section 23. 153.05 (5) (a) of the statutes is amended to read:
AB907,8,1511 153.05 (5) (a) Unless sub. (13) applies, subject to s. 153.455, the department
12may require health care providers other than hospitals and ambulatory surgery
13centers to submit to the department health care information specified by rule under
14s. 153.75 (1) (n) for the preparation of reports, plans, and recommendations in the
15form specified by the department by rule.
AB907, s. 24 16Section 24. 153.05 (5) (c) of the statutes is created to read:
AB907,8,2417 153.05 (5) (c) Subject to s. 153.455 (1) to (3), the data organization under
18contract under sub. (2r) may request insurers and administrators to submit to the
19data organization health care claims information for the preparation of reports,
20plans, and recommendations in the form specified by the data organization,
21including in standard electronic format. If s. 153.455 (4) applies, the department
22may request submission of the health care claims information from insurers and
23administrators in the form specified by the department, including in standard
24electronic format.
AB907, s. 25 25Section 25. 153.05 (6r) of the statutes is repealed.
AB907, s. 26
1Section 26. 153.05 (8) (a) of the statutes is amended to read:
AB907,9,132 153.05 (8) (a) Unless sub. (13) applies, subject to s. 153.455, the department
3shall collect, analyze and disseminate, in language that is understandable to
4laypersons, claims information and other health care information, as adjusted for
5case mix and severity, under the provisions of this chapter, as determined by rules
6promulgated by the department, from health care providers, other than hospitals
7and ambulatory surgery centers, specified by rules promulgated by the department.
8Data from those health care providers may be obtained through sampling techniques
9in lieu of collection of data on all patient encounters and data collection procedures
10shall minimize unnecessary duplication and administrative burdens. If the
11department collects from health care plans data that is specific to health care
12providers other than hospitals and ambulatory surgery centers, the department
13shall attempt to avoid collecting the same data from those health care providers.
AB907, s. 27 14Section 27. 153.05 (8) (c) of the statutes is created to read:
AB907,9,2415 153.05 (8) (c) Subject to s. 153.455 (1) to (3), the data organization under
16contract under sub. (2r) may request, analyze, and publicly report, in language that
17is understandable to laypersons, health care claims information, as adjusted for case
18mix and severity, from insurers and administrators. Data from these sources may
19be obtained through sampling techniques in lieu of collection of data on all insureds,
20and data collection procedures shall minimize unnecessary duplication and
21administrative burdens. If s. 153.455 (4) applies, the department may request health
22care claims information, which may be voluntarily provided by insurers and
23administrators, and may perform or contract for the performance of the other duties
24specified for the data organization under this paragraph.
AB907, s. 28 25Section 28. 153.05 (9) (a) of the statutes is amended to read:
AB907,10,5
1153.05 (9) (a) The Subject to s. 153.455, the department shall provide
2orientation and training to health care providers, other than hospitals and
3ambulatory surgery centers, who submit data under this chapter, to explain the
4process of data collection and analysis and the procedures for data verification,
5comment, interpretation, and release.
AB907, s. 29 6Section 29. 153.05 (9) (c) of the statutes is created to read:
AB907,10,137 153.05 (9) (c) Subject to s. 153.455 (1) to (3), the data organization under
8contract under sub. (2r) shall provide orientation and training to insurers and
9administrators that submit data under this chapter, to explain the process of data
10collection and analysis and the procedures for data verification, comment,
11interpretation, and release. If s. 153.455 (4) applies, the department may perform
12or contract for the performance of the duties specified for the data organization under
13this paragraph.
AB907, s. 30 14Section 30. 153.05 (12) (a) of the statutes is amended to read:
AB907,10,1715 153.05 (12) (a) The Subject to s. 153.455, the department shall, to the extent
16possible and upon request, assist members of the public in interpreting data in
17health care information disseminated by the department.
AB907, s. 31 18Section 31. 153.05 (12) (c) of the statutes is created to read:
AB907,10,2419 153.05 (12) (c) The data organization under contract under sub. (2r) shall,
20subject to s. 153.455 (1) to (3), to the extent possible and upon request, assist
21members of the public in interpreting data in health care information disseminated
22by the data organization. If s. 153.455 (4) applies, the department may perform or
23contract for the performance of the duties specified for the data organization under
24this paragraph.
AB907, s. 32 25Section 32. 153.07 of the statutes is repealed.
AB907, s. 33
1Section 33. 153.10 (1) of the statutes is amended to read:
AB907,11,92 153.10 (1) The Subject to s. 153.455, the department shall prepare, and submit
3to the governor and the chief clerk of each house of the legislature for distribution
4to the legislature under s. 13.172 (2), standard reports concerning health care
5providers other than hospitals and ambulatory surgery centers that the department
6prepares and shall collect information necessary for preparation of those reports. If
7s. 153.455 (4) applies, the department shall include in the reports under this
8subsection reports concerning any health care claims information the department
9collects or contracts to collect under s. 153.05.
AB907, s. 34 10Section 34. 153.22 (1) of the statutes is renumbered 153.22.
AB907, s. 35 11Section 35. 153.45 (intro.) of the statutes is created to read:
AB907,11,1212 153.45 (intro.) Subject to s. 153.455:
AB907, s. 36 13Section 36 . 153.45 (1) (b) 9. of the statutes is amended to read:
AB907,11,1814 153.45 (1) (b) 9. Information that contains the name of a health care provider
15that is not a hospital or ambulatory surgery center, if the independent review board
16department first reviews and approves the release or if the department promulgates
17rules that specify circumstances under which the independent review board need not
18review and approve the release
.
AB907, s. 37 19Section 37. 153.45 (1) (b) 11. of the statutes is amended to read:
AB907,11,2120 153.45 (1) (b) 11. Information other than patient-identifiable data, as defined
21in s. 153.50 (1) (b), as approved by the independent review board department.
AB907, s. 38 22Section 38. 153.45 (1) (c) (intro.) of the statutes is amended to read:
AB907,12,923 153.45 (1) (c) (intro.) Custom-designed reports containing portions of the data
24under par. (b). Of information submitted by health care providers that are not
25hospitals or ambulatory surgery centers, requests under this paragraph for data

1elements other than those available for public use data files under par. (b), including
2the patient's month and year of birth, require review and approval by the
3independent review board before the data elements may be released.
Information
4that contains the name of a health care provider that is not a hospital or ambulatory
5surgery center may be released only if the independent review board department
6first reviews and approves the release or if the department promulgates rules that
7specify circumstances under which the independent review board need not review
8and approve the release
. Reports under this paragraph may include the patient's zip
9code only if at least one of the following applies:
AB907, s. 39 10Section 39. 153.45 (6) of the statutes is repealed.
AB907, s. 40 11Section 40. 153.455 of the statutes is created to read:
AB907,12,17 12153.455 Data organization; contract contingency. (1) Except as provided
13in subs. (2), (3), and (4), beginning on the date, if any, that is 60 days after the contract
14under s. 153.05 (2r) takes effect, the department shall cease collecting, for calendar
15quarters that occur after that date, health care information as specified under s. HFS
16120.14 (1), 2005 Wis. Adm. Code, in effect on the effective date of this subsection ....
17[revisor inserts date].
AB907,12,18 18(2) Subsection (1) does not apply to ss. 153.21 (1) and 153.60 (1).
AB907,13,6 19(3) Beginning on the date, if any, that the secretary of health and family
20services and the secretary of employee trust funds determine that the data
21organization is not in compliance with the contract under s. 153.05 (2r) with respect
22to the performance of the collection and public reporting of information regarding the
23cost, quality, and effectiveness of health care, including the development and
24maintenance of a centralized data repository, or determine that there is insufficient
25statewide participation under the requirements of the contract, the secretaries may

1modify or terminate the contract. If the secretaries terminate the contract, they shall
2recommend to the department of administration that that department use a
3competitive request-for-proposal process to solicit offers from other organizations
4for performance of the services required of the data organization under the
5terminated contract. If no organization responds to the request for proposals or if a
6successor contract cannot be achieved, sub. (4) applies.
AB907,13,16 7(4) If the contract with the data organization is terminated under sub. (3) and
8no organization responds to the request for proposals or a successor contract cannot
9be achieved, the department, in its capacity as a public health authority, shall collect
10health care information, including as specified under s. HFS 120.14 (1), Wis. Adm.
11Code, in effect on the effective date of this subsection .... [revisors inserts date], and
12may request health care claims information, which may be voluntarily provided by
13insurers or administrators, under this chapter; shall analyze and disseminate, or
14contract for the performance of analysis and dissemination of, the health care
15information; and may analyze and disseminate, or may contract for the performance
16of analysis and dissemination of, the health care claims information.
AB907, s. 41 17Section 41. 153.50 (intro.) of the statutes is created to read:
AB907,13,1818 153.50 (intro.) Subject to s. 153.455:
AB907, s. 42 19Section 42. 153.50 (1) (b) 1m. of the statutes is created to read:
AB907,13,2220 153.50 (1) (b) 1m. "Patient-identifiable data" does not include calculated
21variables that are derived from patient-identifiable data and the dissemination of
22which does not permit patient identification.
AB907, s. 43 23Section 43. 153.50 (1) (b) 2. (intro.) of the statutes is amended to read:
AB907,14,3
1153.50 (1) (b) 2. (intro.) "Patient-identifiable data", for information submitted
2by health care providers who are not hospitals or ambulatory surgery centers and by
3insurers and administrators
, means all of the following data elements:
AB907, s. 44 4Section 44. 153.50 (3) (intro.) of the statutes is amended to read:
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