Feed for /2005/related/proposals/ab907 PDF
2005 - 2006 LEGISLATURE
December 29, 2005 - Introduced by Representatives Underheim, Vos, Petrowski,
Owens, Nelson
and Hines, cosponsored by Senators Darling, Roessler,
Robson
and Olsen. Referred to Committee on Health.
AB907,2,5 1An Act to repeal 15.07 (2) (b), 15.07 (3) (bm) 1., 15.107 (7), 15.195 (6), 15.195 (9),
216.03, 153.01 (2), 153.05 (6r), 153.07, 153.45 (6), 153.60 (3), 153.67, 153.75 (2)
3(d), 153.76 and 253.12 (4) (b); to renumber 153.01 (1) and 153.22 (1); to amend
420.435 (1) (hg), 20.435 (1) (hg), 20.435 (1) (hi), 20.515 (1) (r), 153.01 (5m), 153.05
5(1) (a), 153.05 (3) (a), 153.05 (5) (a), 153.05 (8) (a), 153.05 (9) (a), 153.05 (12) (a),
6153.10 (1), 153.45 (1) (b) 9., 153.45 (1) (b) 11., 153.45 (1) (c) (intro.), 153.50 (1)
7(b) 2. (intro.), 153.50 (3) (intro.), 153.50 (3) (a), 153.50 (3) (b) (intro.), 153.50 (3)
8(d), 153.50 (3m), 153.50 (4) (a) (intro.), 153.50 (4) (a) 1. a., 153.50 (4) (a) 1. b.,
9153.50 (4) (a) 2., 153.50 (4) (a) 3., 153.50 (5) (a) (intro.), 153.50 (5) (b) (intro.),
10153.50 (5) (b) 1., 153.60 (title), 153.60 (1), 153.60 (1), 153.65 (1), 153.75 (1)
11(intro.), 153.75 (1) (intro.), 153.75 (2) (intro.) and 153.75 (2) (intro.); and to
12create
153.01 (1d), 153.01 (2g), 153.01 (3g), 153.01 (8m), 153.05 (1) (c), 153.05
13(2r), 153.05 (3) (c), 153.05 (5) (c), 153.05 (8) (c), 153.05 (9) (c), 153.05 (12) (c),
14153.45 (intro.), 153.455, 153.50 (intro.), 153.50 (1) (b) 1m., 153.50 (4) (a) 1. c.,

1153.50 (4) (c) and 153.60 (intro.) of the statutes; relating to: requiring a
2contract with a data organization for the collection, analysis, and dissemination
3of health care claims information; eliminating the Board on Health Care
4Information, the Interagency Coordinating Council, and the Independent
5Review Board; and making appropriations.
Analysis by the Legislative Reference Bureau
Under current law, the Department of Health and Family Services (DHFS)
must collect, analyze, and disseminate health care information from health care
providers other than hospitals and ambulatory surgery centers; in addition, the
Department of Administration (DOA) must contract with an entity to collect,
analyze, and disseminate health care information from hospitals and ambulatory
surgery centers. Both DHFS and the entity under contract with DOA must, from the
data collected, prepare certain reports that do not permit the identification of a
patient, an employer, or a health care provider. The Independent Review Board
(Review Board) attached to DHFS must first review and approve release or sale by
DHFS of certain health care information, including that which contains the name of
a health care provider, includes a patient's month and year of birth, or contains data
elements other than those available for public use data files.
Currently, the nine-member Interagency Coordinating Council (the Council),
created in DOA, has numerous duties including advising and assisting state
agencies in the coordination and exchange of information concerning programs that
collect, analyze, and disseminate health care data. The Council must report twice
annually to the Board on Health Care Information (the Board), and, in turn, DHFS
and the Board must provide information on their activities to the Council. The
11-member Board, attached to DHFS, must advise DHFS on the collection, analysis,
and dissemination of health care information; provide oversight on the reports
issued by DHFS and the entity under contract with DOA; develop overall strategy
and direction for health care information collection activities; and review and
approve any rules that the Review Board proposes to promulgate. Activities of the
Board and DHFS are funded from fees for performance of certain work under
contract and from assessments that are annually levied on health care providers
other than hospitals and ambulatory surgery centers. For health care providers that
are not facilities, the assessments may not exceed $75 per fiscal year.
This bill authorizes the Department of Employee Trust Funds (DETF) and
DHFS jointly to contract with a data organization to collect, analyze, and publicly
report certain health care claims information from insurers and administrators, to
develop and maintain a centralized data repository, and to provide to DHFS, without
charge, health care claims information and reports requested by DHFS. ("Data
organization," "administrator," and "insurer" are all defined in the bill.) As a

condition of the contract, the data organization must include as voting members of
its board of directors the secretaries of health and family services and employee trust
funds, or their designees, and must provide certain matching funds. Beginning on
the date that is 60 days after the contract takes effect, DHFS must cease collecting
health care information for any calendar quarter after that date, and
implementation of DHFS' rules for the collection of this health care information is
suspended. However, the secretaries may modify or terminate the contract with the
data organization if the secretaries determine that the data organization is not in
compliance with the contract or determine that there is insufficient statewide
participation under the requirements of the contract; if the secretaries terminate the
contract, they must recommend to the Department of Administration (DOA) that
DOA use a request-for-proposals process to solicit offers from other organizations
for performance of services required of the data organization. If no organization
responds to the request for proposals or if a successor contract cannot be achieved,
DHFS shall collect, analyze, and disseminate health care information from health
care providers other than hospitals and ambulatory surgery centers, and DHFS'
rules for doing so apply. Also, if the contract is terminated, DHFS may collect,
analyze, and disseminate health care claims information voluntarily provided by
insurers and administrators, or contract for the collection, analysis, and
dissemination.
The assessments that currently fund activities of DHFS and the Board would,
under the bill, fund the contract with the data organization or, if the contract is
terminated, health care information collection, analysis, and dissemination
activities of DHFS. The bill eliminates the prohibition on assessing health care
providers that are not facilities more than $75 per fiscal year and, instead, requires
that DHFS, if it proposes to increase the assessment for health care providers that
are not facilities to an amount that exceeds $70 per fiscal year, obtain approval of the
joint committee on finance of the legislature under a passive review process.
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.
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