2015 - 2016 LEGISLATURE
September 25, 2015 - Introduced by Representatives Nygren, Petryk, Novak,
Tauchen, Swearingen, Spiros, Jagler, A. Ott, Ripp, Kolste, Kerkman, Goyke,
Schraa, Horlacher, Murtha, Edming, VanderMeer, Allen, E. Brooks,
Kuglitsch, Mursau, Macco, Sanfelippo, Born, Skowronski, J. Ott, Ohnstad,
Sinicki, Loudenbeck, Genrich, Meyers, Spreitzer, Barca, Petersen, Subeck
and Billings, cosponsored by Senators Darling,
Gudex, Harsdorf, Marklein,
Olsen, Petrowski and Cowles. Referred to Committee on Health.
1An Act to repeal
subchapter IV (title) of chapter 50 [precedes 50.90]; to amend
20.435 (6) (jm), 50.56 (3), 146.40 (1) (bo), 146.81 (1) (L) and 146.997 (1) (d) 18.; 3
and to create
subchapter V (title) of chapter 50 [precedes 50.60], 50.60, 50.65 4
and subchapter VI (title) of chapter 50 [precedes 50.90] of the statutes; relating
5to: pain clinic certification and requirements, granting rule-making authority,
6and providing a penalty.
Analysis by the Legislative Reference Bureau
This bill requires certification of a pain clinic in order for it to operate. A pain
clinic must submit an application to the Department of Health Services (DHS),
which is required to issue the certificate of operation if the pain clinic meets the
requirements specified in the bill, has paid any required application fee, and meets
any requirements established by DHS. Each pain clinic location is certified
separately regardless of whether the clinic is operated under the same business
name, ownership, or management as another pain clinic. The bill requires a pain
clinic to have a medical director who is a physician that practices in Wisconsin and
requires a pain clinic to report annually to DHS certain information specified in the
bill. The bill also requires a physician or other health care provider at a pain clinic
authorized to prescribe pain medication to review for treatment purposes an
individual's records on the prescription drug monitoring database for use of other
For further information see the state 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:
20.435 (6) (jm) of the statutes is amended to read:
(jm) Licensing and support services.
The amounts in the schedule 3
for the purposes specified in ss. 48.685 (2) (am) and (b) 1., (3) (a), (am), (b), and (bm), 4
and (5) (a), 49.45 (47), 50.02 (2), 50.025, 50.065 (2) (am) and (b) 1., (3) (a) and (b), and 5
(5), 50.13, 50.135, 50.36 (2), 50.49 (2) (b), 50.495, 50.52 (2) (a), 50.57, 50.981, and 6
146.40 (4r) (b) and (er), and subch. IV VI
of ch. 50 and to conduct health facilities plan 7
and rule development activities, for accrediting nursing homes, convalescent homes, 8
and homes for the aged, to conduct capital construction and remodeling plan reviews 9
under ss. 50.02 (2) (b) and 50.36 (2), and for the costs of inspecting, licensing or 10
certifying, and approving facilities, issuing permits, and providing technical 11
assistance, that are not specified under any other paragraph in this subsection. All 12
moneys received under ss. 48.685 (8), 49.45 (42) (c), 49.45 (47) (c), 50.02 (2), 50.025, 13
50.065 (8), 50.13, 50.36 (2), 50.49 (2) (b), 50.495, 50.52 (2) (a), 50.57, 50.93 (1) (c), and 14
50.981, all moneys received from fees for the costs of inspecting, licensing or 15
certifying, and approving facilities, issuing permits, and providing technical 16
assistance, that are not specified under any other paragraph in this subsection, and 17
all moneys received under s. 50.135 (2) shall be credited to this appropriation 18
50.56 (3) of the statutes is amended to read:
Notwithstanding sub. (2), insofar as a conflict exists between this 21
subchapter, or the rules promulgated under this subchapter, and subch. I, II or IV
, or the rules promulgated under subch. I, II or IV VI
, the provisions of this 2
subchapter and the rules promulgated under this subchapter control.
Subchapter V (title) of chapter 50 [precedes 50.60] of the statutes 4
is created to read:
50.60 of the statutes is created to read:
950.60 Definitions; clinics.
In this subchapter: (1)
"Advanced practice nurse 10
prescriber" means an individual certified under s. 441.16 (2).
"Health care provider" has the meaning given in s. 146.81 (1) (a) to (hp).
"Pain clinic" means any of the following:
(a) A privately owned facility at which a physician, advanced practice nurse 14
prescriber, physician assistant, or other health care provider with prescribing 15
privileges, who prescribes controlled substances, provides pain management 16
services to patients, a majority of whom are prescribed opioids or opiates, 17
benzodiazepines, barbiturates, or carisoprodol, and provides prescriptions for more 18
than 90 days in a 12-month period.
(b) Any privately owned facility or office that advertises or otherwise holds 20
itself out as providing pain management services and that has one or more employees 21
or contractors who prescribe a controlled substance for pain management.
"Physician assistant" has the meaning given in s. 448.01 (6).
50.65 of the statutes is created to read:
2450.65 Pain clinics. (1)
(a) No pain clinic may 25
operate unless it holds a certificate to operate issued by the department.
(b) A pain clinic shall submit to the department an application, on a form 2
prescribed by the department, for a certificate. Each pain clinic location is certified 3
separately regardless of whether the clinic is operated under the same business 4
name, ownership, or management as another pain clinic. The department may 5
charge an applicant a fee for applying for a certificate.
(c) A certified pain clinic that undergoes a change of majority ownership shall 7
submit a new application for a certificate.
(d) A pain clinic shall have a medical director who is a physician that practices 9
in this state. In the event that the medical director no longer meets the requirements 10
of holding the position of medical director, the pain clinic shall notify the department 11
within 10 business days of the identity of a physician who meets the requirements 12
of medical director and who acts as medical director at that pain clinic. Failure to 13
notify the department of an acting medical director within 10 days of the departure 14
of the previous medical director may be a basis for the department to suspend the 15
pain clinic's certification.
(e) The department shall issue a certificate of operation to a pain clinic if the 17
department finds that the pain clinic meets the requirements of this section, has paid 18
any application fee required by the department, and meets any requirements 19
established by the department.
20(2) Penalty for violation.
(a) If the department finds that a pain clinic which 21
was issued a certificate under this section no longer meets any requirement of this 22
section or rules promulgated under this section or of requirements established by the 23
department, the department may do any of the following:
1. Suspend the certificate of the pain clinic until the department determines 25
that the pain clinic demonstrates compliance.
2. Revoke the certificate of the pain clinic.
3. Impose a forfeiture of up to $1,000 per day for each day of continued violation.
(b) A pain clinic subject to a penalty under par. (a) is entitled to an appeal and 4
a hearing under ch. 227.
(a) Annually, a pain clinic shall report to the department all 6
of the following:
1. The ratio of pain clinic staff to the number of individuals receiving pain 8
2. The number of individuals receiving pain treatment who are also receiving 10
behavioral health services.
3. The pain clinic staff's plan for tapering individuals off of pain medications, 12
4. The average mileage that individuals receiving pain treatment in the pain 14
clinic are traveling to receive treatment in that clinic.
(b) The pain clinic shall ensure that the information under par. (a) is provided 16
in a manner that does not permit the identification of an individual who is receiving 17
pain medication from the pain clinic.
18(4) Prescription monitoring.
Before prescribing a pain medication, a 19
physician or other health care provider at a pain clinic who is authorized to prescribe 20
pain medication shall review for treatment purposes an individual's records on the 21
prescription drug monitoring database for use of other pain medications.
This section does not apply to any of the following:
(a) A medical or dental school, nursing school, physician assistant training 24
program, or outpatient clinic associated with any of the schools or training programs 25
specified in this paragraph.
(b) A hospital, as defined in s. 50.33 (2).
(c) Hospice, as defined in s. 50.90 (1).
(d) A nursing home, as defined in s. 50.01 (3).