Notice is hereby given that pursuant to ss. 153.75 (1) and 227.11 (2) (a), Stats., the Department of Health and Family Services will hold public hearings to consider the proposed repeal and recreation of ch. HFS 120, relating to the collection, analysis and dissemination of health care information.
Hearing Information
June 16, 2000 Lower Level Meeting Room
Friday Brown County Library
Beginning at 9 a.m. 515 Pine Street
GREEN BAY, WI
June 19, 2000 Bascom Room
Monday Best Western-Inntowner
Beginning at 9 a.m. 2424 University Avenue
MADISON, WI
June 22, 2000 Room 120
Thursday State Office Building
Beginning at 9 a.m. 141 NW Barstow Street
WAUKESHA, WI
June 23, 2000 City Council Chambers
Friday La Crosse City Hall
Beginning at 9 a.m. 400 La Crosse Street
LA CROSSE, WI
The hearing sites are accessible to people with disabilities.
Analysis Prepared by the Department of Health & Family Services
The Department of Health and Family Services is responsible for collecting, analyzing and disseminating a variety of health care data pursuant to ch. 153, Stats. 1997 Wis. Act 231 and 1999 Wis. Act 9 substantially modified ch. 153, Stats. Consequently, the Department is proposing to revise ch. HFS 120 to those recent statutory changes.
Chapter HFS 120, as it currently exists, primarily addresses the collection and analysis of data from hospitals and ambulatory surgery centers. 1997 Wis. Act 231 directed the Department to collect claims data and other health care information from health care providers besides hospitals and freestanding ambulatory surgery centers, including from physicians in their offices and clinics. In response to the statutory changes, the proposed rules specify the other providers from whom data will be collected, the data elements to be collected and the manner in which data will be disseminated, and extend to these other providers instructions for data verification and review and comment that apply now only to hospitals and freestanding ambulatory service centers. The rules also provide for assessing a fee from the other providers from whom data are collected for the costs of collection, database development and maintenance, generation of data files and standard reports, orientation and training and the expenses of the Board of Health Care Information.
Other changes that are being proposed for ch. HFS 120 to implement the Act 231 changes to ch. 153, Stats., include the following:
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A waiver process and standards by which a health care provider could, upon request, obtain an exemption from data submission requirements that are burdensome.
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A manner of assessing a fee on health care plans that voluntarily supply health care data to the Department is specified. The assessment fee covers the costs of collection, database development and maintenance and generation of public use data files and standard reports for the health care plans.
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Rules have been added to govern the release of all health care provider-specific and employer-specific information collected. The current rules have only a procedure for releasing physician-specific data.
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Methods have been specified for adjusting health care information for case mix and severity.
Several provisions have been repealed, including definitions of uniform patient billing form, charge element and uncompensated health care services; the requirement that hospitals and freestanding ambulatory surgery centers use uniform patient billing forms; the requirement that hospitals submit financial data; Board responsibility to determine whether to contract for provision of data processing services for the Department; the requirement that a hospital hold a public hearing before raising its rates; the production by the Department of quarterly and annual reports for the public; certain procedures for data review and verification; and assessment language specific to free standing ambulatory surgery centers.
1999 Wis. Act 9, the biennial Budget Bill, further modified ch. 153, Stats., insofar as it:
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Established additional constraints on the type of physician data that can be released in public use data files.
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Established additional required means of masking the identification of specific patients, employers and health care providers.
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Established the requirement that compilation and release of custom-designed reports with nonaggregated age, zip code or physician identifiers based on physician data be subject to the review and approval of the independent review board.
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Prohibited the Department's sale or distribution of physician data that can be linked with public use data files without the approval of the independent review board.
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Established a separate set of data elements collected from physicians that constitutes “patient-identifiable data."
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Requires the Department to develop and use a data use agreement.
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Requires that purchasers of data sign and have notarized Department data use agreements.
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Prohibits employers from requesting the release of or access to patient-identifiable data.
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Prohibits the Department from requiring physicians to submit uniform patient billing forms.
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Prohibits physicians from submitting a variety of data to the Department.
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Establishes immunity from civil liability for health care providers that mistakenly submit data to the Department in a manner that results in the release of prohibited data elements.
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Increases by 30-50% the penalties for violation of selected statutory provisions related to confidential data.
The rule-making order that is the subject of these public hearings proposes to revise ch. HFS 120 to respond to these major changes to ch. 153, Stats., made by 1997 Wis. Act 231 and 1999 Wis. Act 9.
Contact Person
To find out more about the hearing or to request a copy of the rules, write or phone:
Gary L. Radloff
Bureau of Health Information
Division of Health Care Financing
P.O. Box 7984
Madison, Wisconsin 53707-7984
(608) 267-0245 or,
if you are hearing impaired,
(608) 261-7798 (TDD)
If you are hearing or visually impaired, do not speak English, or have circumstances which might make communication at a hearing difficult and if you, therefore, require an interpreter or a non-English, large print or taped version of the hearing document, contact the person at the address or phone number shown above. A person requesting a non-English or sign language interpreter should contact the person at the address or phone number given above at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments on the proposed rules received at the above address no later than June 30, 2000 will be given the same consideration as testimony presented at the hearing.
Fiscal Estimate
The Department is responsible for collecting, analyzing and disseminating a variety of health care data pursuant to ch. 153, Stats. Chapter HFS 120 is being modified to implement the statutory changes included in 1997 Wis. Act 231, which grants the Department authority to assess physicians and collect data for reports, and 1999 Wis. Act 9 which provided the Department with 8.0 FTE PRO positions and $870,000 PRO in annual expenditure authority. These changes detail the requirements for collecting health care information from physicians in their offices and clinics. The rules provide for assessing health care providers from whom data are collected for the costs of collection, database development and maintenance, generation of data files and standard reports, orientation and training and the expenses of the Board of Health Care Information. In addition, changes required under 1999 Wis. Act 9 relative to the release of physician data include the creation of an independent review board. The board will review custom-designed reports based on physician data and other data materials.
Under the revised rules, BHI increases operating costs by $500,000 for 3.5 positions and information technology related to the outpatient data collection. For other patient encounter data collection costs increase by $70,000 for 1 position and information technology. A physician survey will be completed at a cost of $63,000. The staff support and meeting costs for the independent review board will be $37,000. Initial costs for collection of the physician assessment will be $37,000. This is based on the assumption of 14,000 physicians receiving the assessment. In future years, the Department of Regulation and Licensing may collect the assessment as a part of the physician licensure. Revenue projections use the assumption that 14,000 physicians will receive and pay the assessment of $65. Total operational costs over the biennial budget period of $1,064,000 are built into the one-year physician assessment. Future assessments may vary in costs as other revenues increase from the sale of data.
The annualized fiscal impact of the administrative rules is estimated at $707,000. There are no local government costs. A copy of the full fiscal estimate may be obtained from Gary Radloff who may be contacted via the contact information provided in this notice.
Initial Regulatory Flexibility Analysis
The proposed rules affect hospitals, freestanding ambulatory surgery centers, physicians and other health care professionals. Six hospitals meet the s. 227.114 (1), Stats., definition of a “small business." In addition, the Department estimates that approximately 2,400 to 2,800 physician practices that would be required to submit data under these proposed rules have fewer than 25 employes. The Department does not have data from ambulatory surgery centers that allow an estimate of which centers may be characterized as “small businesses." Many centers are located at a medical clinic or hospital.
To accommodate entities that can meet the s. 227.114 (1), Stats., definition of a “small business," the rules propose applying a less stringent standard for a physician who does not currently submit electronic claims. In addition, the rule proposes that the Department may grant an exception to the data submission requirements for a physician who submits an affidavit of financial hardship and supporting evidence demonstrating financial inability to comply with the requirements of the rules.
Notice of Hearing
Natural Resources
(Fish, Game, etc., Chs. NR 1-)
Notice is hereby given that pursuant to ss. 29.014, 29.197, 227.11(2)(a) and 227.24, Stats., interpreting ss. 29.014, 29.177, 19.197 and 29.181, Stats., the Department of Natural Resources will hold a public hearing on Natural Resources Board Emergency Order No. WM-15-00(E) pertaining to deer hunting in deer management units 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 17, 18, 19, 20, 24, 28, 29A, 29B, 30, 31, 34, 35, 36, 37, 38, 44, 49B, 50, 52, 52A, 53, 55, 56, and 78. This emergency order was published on May 15, 2000 and will take effect on August 4, 2000. The emergency rule includes a 9-day either-sex gun hunt, two 4-day antlerless-only gun hunts on October 26-29 and December 7-10, free antlerless tags, and 4 additional archery season days. State parks included in the 38 deer management units will not participate in the October or December hunts.
Hearing Information
June 12, 2000 Room 027, GEF #2, ,
Monday 101 South Webster Street
at 1:00 p.m. Madison, WI
Notice is hereby further given that pursuant to the Americans with Disabilities Act, reasonable accommodations, including the provision of informational material in an alternative format, will be provided for qualified individuals with disabilities upon request, Please call Larry Konopacki at (608) 261-7589 with specific information on your request at least 10 days before the date of the scheduled hearing.
Written comments on the emergency rule may be submitted to M. Larry Konopacki, Bureau of Wildlife Management, P.O. Box 7921, Madison, WI 53707 no later than June 16, 2000. Written comments will have the same weight and effect as oral statements presented at the hearing. A copy of the emergency rule [WM-15-00(E)] may be obtained from Mr. Konopacki.
Fiscal Estimate
Fiscal Impact - Forest Zone T Units
Revenue Reduction:
One expected financial impact o f this order is the loss of revenue from the $3.00 application fee for hunter's choice and bonus permits, which will not be collected for Zone T deer management units. The reduction in revenue from permit application fees is estimated to b e $280,230 (93,410 applications submitted for these units in 1999 at $3 each = $280,230).
Another expected financial impact will be the loss of revenue from bonus sales in these units. The reduction in revenue from lost bonus permit sales is estimated to be $1,691,152 (8,456 non-resident bonus permits at $20 each = $169, 120, and 126,836 resident permits at $12 each = $1,522,032). These fees will not be collected because of the issuance of special free anterless permits or these units. Bonus anterless permits will be available for sale in the Zone T units aftera hunter has received his/her allotted number of free permits. We expect this option to be used very rarely, and so have estimated the loss of revenue to include all bonus sales in Zone T units in 1999.
Revenue Increase:
Over the last decade, there has been a pattern of increased license sales in years with high antlerless permit availability. In years when antlerless permits increased substantially over the previous year, there were increases in deer-related license sales of between 4% and 5% (1998-1999 and 1989-1990). The proposed Zone T permit issuance procedure will include a marked increase over 1999 in the total number of antlerless permits available to hunters. A 4% increase in license sales would result in the sale of 37,700 more licenses than in 1999. At a minimum of $20 per license, these extra 37.700 total licenses would bring in at least $754,000 statewide. 38% of the proposed 2000 Zone T units are in the forest region of the state. The portion of this estimated increase in revenue in the Zone T forest units, equal to 38% of the above total, is $286,520.
