Statutes interpreted: s.
448.956, Stats.
A new provision is being added to modify s.
AT 4.02 to clarify the duties of a licensee in the clinical context and when working on behalf of a primary employer in the instance of receiving a referral of a patient for treatment. Currently, the mandatory protocol requirements for the treatment of an athletic injury do not explicitly provide guidelines delineating the consultation duty and protocol disclosure duty of a licensee who receives a referral of a patient from a person who is not the licensee's consulting physician. Modifying s.
AT 4.02 will assist licensees by clarifying the type of disclosures and professional consultations that must be made with consulting physicians and health care providers in the instance of the evaluation and treatment of referred patients.
SECTION 1 creates a new provision to clarify the five conditions under which a licensee may accept the referral of a patient from a health care provider who is not the licensee's consulting physician.
This proposed rule-making order was reviewed and approved by the Medical Examining Board.
Federal Regulations: There is no existing federal regulation regarding referrals.
State Regulations:
Michigan -- No regulation.
Illinois -- No rules regarding referrals.
Indiana -- (Referral by physician, osteopath, podiatrist, chiropractor)
IC25-5.1-1-4 Athletic training
Sec. 4. “Athletic training" means the practice of prevention, recognition, assessment, management, treatment, disposition, and reconditioning of athletic injuries under the direction of a licensed physician, osteopath, podiatrist, or chiropractor. However, in a clinic accessible to the general public, the term means practicing athletic training only upon the referral and order of a licensed physician, osteopath, podiatrist, or chiropractor.
Minnesota -- (Referral – license to practice – medicine, chiropractic, podiatry, dentistry. In corporate setting, the AT may also work under the direct supervision of a physical therapist, which is similar to a referral.) Minn. Stats. Section
148.7806 Athletic training.
Athletic training by a registered athletic trainer under section 148.7808 includes the activities described in paragraphs (c) to (e).
(c) At the primary employment site, except in a corporate setting, an athletic trainer may evaluate and treat an athlete for an athletic injury not previously diagnosed for not more than 30 days, or a period of time as designated by the primary physician on the protocol form, from the date of the initial evaluation and treatment. Preventative care after resolution of the injury is not considered treatment. This paragraph does not apply to a person who is referred for treatment by a person licensed in this state to practice medicine as defined in section 147.081, to practice chiropractic as defined in section 148.01, to practice podiatry as defined in section 153.01, or to practice dentistry as defined in section 150A.05 and whose license is in good standing.
(d) An athletic trainer may:
(e) In a clinical, corporate, and physical therapy setting, when the service provided is, or is represented as being, physical therapy, an athletic trainer may work only under the direct supervision of a physical therapist as defined in section 148.65.
Iowa -- (Referral – doctor, dentist)
IAC-645-351.6(1) Standards for athletic training-direct service. c. Standard 3-documentation. The athletic trainer shall accept responsibility for recording details of the athlete's health status. Documentation shall include:
(2) Referral source (doctor, dentist).
Fiscal Estimate
The Department of Regulation and Licensing will incur $500 in costs to print and distribute this rule change.
Private Sector Fiscal Effect
The Department of Regulation and Licensing has determined that this rule has no significant fiscal effect on the private sector.
Final Regulatory Flexibility Analysis
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1) (a), Stats.
Copies of Rule and Contact Person
Copies of this proposed rule are available without cost upon request to: Pamela Haack, Department of Regulation and Licensing, Office of Administrative Rules, 1400 East Washington Avenue, Room 171, P.O. Box 8935, Madison, Wisconsin 53708 (608) 266-0495
Notice of Hearing
Dentistry Examining Board
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Dentistry Examining Board in ss.
15.08 (5) (b) and
227.11 (2), Stats., and interpreting s.
447.04 (1) (a) 3., Stats., the Dentistry Examining Board will hold a public hearing at the time and place indicated below to consider an order to create DE 1.02 (4m), relating to the definition of “dental school."
Hearing Date, Time and Location
Date: November 3, 2004
Time: 9:00 a.m.
Location: 1400 East Washington Avenue
Room 179A
Madison, Wisconsin
Appearances at the Hearing
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Department of Regulation and Licensing, Office of Administrative Rules, P.O. Box 8935, Madison, Wisconsin 53708. Written comments must be received by November 15, 2004, to be included in the record of rule-making proceedings. Analysis prepared by the Department of Regulation and Licensing.
Analysis
In Section 1, the Dentistry Examining Board proposes to define dental school to specify that the school or college must be approved by the board; be a 4 year program or equivalent; and result in the degree of doctor of dental surgery or doctor of dental medicine.
Regulation in adjoining states:
Illinois:
Does not define the term “dental school" in its administrative rules.
Indiana:
Does not define the term “dental school" in its administrative rules.
Iowa:
The term “accredited school" is defined as a dental, dental hygiene, or dental assisting education program accredited by the American Dental Association Commission on Dental Accreditation.
Michigan:
Does not include the term “dental school" in its administrative rules.
Minnesota:
Does not define the term “dental school" in its administrative rules. However, the term “Commission on Accreditation" is defined as the Commission on Dental Accreditation of the American Dental Association.
There is no existing federal regulation that defines dental schools.
TEXT OF RULE
SECTION 1. DE 1.02 (4m) is created to read:
DE 1.02 (4m) “Dental school" means a school or college approved by the board that offers at least 4 academic years of instruction or its equivalent in all dental disciplines and that leads to the degree of doctor of dental surgery or doctor of dental medicine.
Fiscal Estimate
The Department of Regulation and Licensing will incur $500 in costs for staff to print and distribute the rule change.
Private Sector Fiscal Effect
The Department of Regulation and Licensing has determined that this rule has no significant fiscal effect on the private sector.
Final Regulatory Flexibility Analysis
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1) (a), Stats.
Copies of Rule and Contact Person
Copies of this proposed rule are available without cost upon request to: Pamela Haack, Department of Regulation and Licensing, Office of Administrative Rules, 1400 East Washington Avenue, Room 171, P.O. Box 8935, Madison, Wisconsin 53708 (608) 266-0495.
Notice of Hearing
Employee Trust Funds
The Wisconsin Department of Employee Trust Funds (DETF) will hold a public hearing to review this proposed rule, which amends Wis. Admin. Code ss.
ETF 10.30 (8),
10.75 (2) (a) and
10.82 (1), repeals and recreates s.
ETF 10.82 (2) and creates s.
ETF 10.82 (1) (am) regarding the receipt of facsimile and electronic mail communications by the department. The public hearing will be held on
October 28, 2004, at 1:30 PM in the downstairs Conference Room GB at the offices of the Department of Employee Trust Funds, 801 West Badger Road, Madison, Wisconsin.
The public record on this proposed rule making will be held open until 4:30 p.m. on Friday, November 12, 2004, to permit persons who are unable to attend the public hearing in person to submit written comments on the proposed rule. Any such written comments should be addressed to Robert Weber, Department of Employee Trust Funds, 801 W. Badger Road, P.O. Box 7931, Madison, WI 53707-7931.
Statutory authority:
This proposed rule will be promulgated under the authority granted to the Secretary of the Department of Employee Trust Funds under Wis. Stat. s.
40.03 (2) (i).
Explanation of agency authority:
The Secretary of the Department of Employee Trust Funds is expressly authorized to promulgate rules required for the efficient administration of the Public Employee Trust Fund or the benefit plans administered by the Department. Rules required for the administration of group health, long-term care, income continuation or life insurance plans under subchs.
IV to
VI of ch. 40, Stats., must also be approved by the Group Insurance Board. Approval by the Deferred Compensation Board is necessary for all rules required for the administration of deferred compensation plans established under subch.
VII of ch. 40. Those programs aside, rule-making under Wis. Stat. s.
40.03 (2) (i) requires the approval of the Employee Trust Funds Board and rules relating to teachers must be approved by the Teachers Retirement Board while rules relating to participants other than teachers must be approved by the Wisconsin Retirement Board.
Related statute or rule:
Wis. Stat. ss.
137.11,
137.16,
137.17, and
137.23, all being part of subchapter II ("Electronic Transactions and Records; Electronic Notarization and Acknowledgement") of ch.
137 as affected by
2003 Wis. Act 294, effective May 5, 2004. Act 294 is intended to enact the Uniform Electronic Transactions Act in Wisconsin. As described by the National Conference of Commissioners on Uniform State Laws, the UETA is designed to support the use of electronic commerce. The primary objective of the UETA to establish the legal equivalence of electronic records and signatures with paper writings and manually signed signatures, removing barriers to electronic commerce.
Plain language analysis:
The rule is loosely modeled on provisions of ss.
137.11,
137.16,
137.17, and
137.23, Stats. The proposed rule codifies a general department policy that receipt of a document via facsimile ("fax") or electronic mail ("e-mail") is functionally identical to receipt of that document by other available means, such as mail delivery or delivery by hand, for purposes of administering benefits under ch.
40 of the Wisconsin Statutes. An electronic copy may be treated as the original.
The rule does provide a different treatment of electronic documents concerning time of receipt. Facsimiles and e-mails may be received even when the Department's offices are closed, unlike other forms of communication.
Beginning in 1997, the DETF has optically imaged participant files to computer instead of retaining paper copies of documents. Since then, for DETF record keeping purposes at least, a facsimile is functionally identical to the original document.
The rule repeals and recreates Wis. Admin. Code s.
ETF 10.82 (2). That provision was originally promulgated in 1995 for the purpose of allowing for documents to be filed via facsimile transmission, in order to preserve the earliest possible date of receipt, and included several additional requirements, including that the original of the document be provided to the DETF within 14 days, so that it could be added to the participant's file for future reference. The rule expressly applied only to forms listed in the rule. The purpose of that 1995 rule-making was to allow a person to “lock in" an earlier date of receipt by DETF than might be possible if the applicant relied only on mail, or other delivery methods that are less immediate than electronic transmission.
The proposed rule is permissive. It does not require the department to accept documents transmitted electronically as originals when there may be doubts about the completeness or authenticity of the document. The department may make inquiries and require additional authentication. The department also retains its strong preference for receipt of certain documents in the original (or by certified copy), such as court orders. However, when authenticity is satisfactorily established, the rule provides the department may even accept court orders by fax or e-mail.
Since the department promulgated its first fax rule in 1995, an occasional question has arisen about whether the rule prohibited receiving documents by facsimile if the document was not specifically listed in the rule, or whether DETF had technically “received" a document at all if it arrived by fax but the sender then deliberately failed to send the original within 14 days. This proposed rule resolves those questions, in large part, by removing the list of permitted documents and minimizing the criteria for deeming a fax or e-mail document as “received" by the department.
Some administrative rules written since 1995 have included specific authorization to receive a particular document by “fax." This proposed rule codifies a general policy, rather than a piecemeal approach, by amending those provisions to fit under the proposed rule.
Summary of, and comparison with, existing or proposed federal regulation:
Public Law 106-229 (June 30, 2000), the federal Electronic Signatures in Global and National Commerce Act, codified at 15 U.S. Code ss. 7001 to 7006, 7021 and 7031, provides that in all transactions in or affecting interstate or foreign commerce, a contract or other record relating to the transaction shall not be denied legal effect merely because it is in electronic form. The federal law generally preempts state laws that require contracts or other records be written, signed, or in non-electronic form and, to at least some extent, requires governmental agencies to use and accept electronic records and electronic signatures with respect to records other than contracts to which the agency is a party. However, the federal law also allows states to instead adopt the Uniform Electronic Transactions Act as approved and recommended for enactment in all the States by the National Conference of Commissioners on Uniform State Laws.
Comparison with rules in adjacent states:
There are numerous administrative code provisions in adjacent states that use the terms “facsimile," “fax," “e-mail" or “electronic mail." A search on one legal database located 880 documents containing such references. For example, the Illinois Secretary of State accepts filings by electronic or facsimile transmission and the date the transmission is received is the receipt date, if the document is acknowledged and accepted. See 2 Illinois Administrative Code s.
570.40. Similar provisions for honoring the time of receipt of a fax can be found in 44 Ill. Adm. Code ss.
1.2005,
500.300,
526.2005, 1100.2005, 1120.2005, 1300.2005, 1400.2505, 1500.2005, 1600.2005 and 2000.2005. Some other Illinois code provisions require a separate acknowledgement of receipt in order to establish the fax was received.
