Iowa: Iowa's administrative code governing conduct has no specific language requiring education prior to the use of a new therapy; however, there are requirements for chiropractors to be competent in their practice. Excerpts from their administrative code are as follows:
45.2 (2) Professional incompetence. Professional incompetence includes, but is not limited to:
a. A substantial lack of knowledge or ability to discharge professional obligations within the scope of practice.
b. A substantial deviation from the standards of learning or skill ordinarily possessed and applied by other chiropractic physicians in the state of Iowa acting in the same or similar circumstances.
c. A failure to exercise the degree of care which is ordinarily exercised by the average chiropractic physician acting in the same or similar circumstances.
d. Failure to conform to the minimal standard of acceptable and prevailing practice of a chiropractic physician in this state.
Michigan: Michigan's administrative code relating to rules governing the practice of chiropractic has no specific rules regulating professional conduct. The rules relating to actions against a Michigan chiropractic license holder are covered under Michigan Statutes: Chapter 333.16221 – 16226. More may be found at:
http://www.legislature.mi.gov/mileg.asp?page=executesearch
Minnesota: Minnesota's statutes governing conduct has no specific language requiring education prior to the use of a new therapy; however, there are requirements for chiropractors to be competent in their practice. Excerpts from their administrative code are as follows:
From Minnesota statutes: 148.10 Licenses Revoked; New Licenses.
(11), unprofessional conduct means any unethical, deceptive or deleterious conduct or practice harmful to the public, any departure from or the failure to conform to the minimal standards of acceptable chiropractic practice, or a willful or careless disregard for the health, welfare or safety of patients, in any of which cases proof of actual injury need not be established. Unprofessional conduct shall include, but not be limited to, the following acts of a chiropractor:
(1) gross ignorance of, or incompetence in, the practice of chiropractic
Summary of factual data and analytical methodologies: No study resulting in the collection of factual data was used in reference to this rule-making effort. The primary methodology for revising the rule is the board's ongoing analysis and determination that a rules change is necessary.
Analysis and supporting documents used to determine effect on small business or in preparation of economic impact report: The Department of Regulation and Licensing has a small business review advisory committee (SBRAC) consisting of representatives of a variety of small business and geographic locations. This proposed rule was reviewed by the SBRAC and found that the rule would not have a significant economic impact on small business.
This conclusion is supported by an analysis by department staff. Licensed chiropractors are required to follow the Standards of Conduct Rules under ch.
Chir 6 of the Wisconsin administrative code. The existing rules prevent licensed chiropractors from performing professional services inconsistent with their training, education or experience. Given the current pace of technological advancement, and the resulting marketing effort targeting practitioners, the existing rules governing professional conduct is amended by the board to clarify education and training requirements of chiropractors prior to application and/or incorporation of new technology-based therapies and treatments into their practice.
The incorporation and use of modern technology has always been and will be a part of patient care; however, the rules governing conduct should keep up with those applications, especially where they relate to existing rules of conduct for the protection of the public.
This proposed rule does not mandate any additional education or training with regards to new technology or treatments, unless chiropractors wish to incorporate those new treatments into their practice.
Anticipated costs incurred by private sector/fiscal estimate: The department finds that this rule has no significant fiscal effect on the private sector.
Fiscal estimate
The proposed rule will have no impact on the department's funds.
Effect on small business: These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1), Stats. The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@drl.state.wi.us, or by calling (608) 266-8608.
Agency contact person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708-8935. Telephone: (608) 266-0495. Email:
pamela.haack@drl.state.wi.us.
TEXT OF RULE
SECTION 1. Chir 6.02 (6) is amended to read:
Chir 6.02 (6) Performing professional services inconsistent with training, education or experience.
Prior to application to patients of new therapies or treatment modalities, a chiropractor shall obtain adequate and appropriate training and education. Such training and education may be obtained from coursework at an accredited college of chiropractic, or from a board-approved continuing education program or from a program sponsored by an organization listed in s. Chir 5.02 (1) (a).
Notice of Hearing
Insurance
Notice is hereby given that pursuant to the authority granted under s.
601.41 (3), Stats., and the procedures set forth in under s.
227.18, Stats., OCI will hold a public hearing to consider the adoption of the attached proposed rulemaking order affecting Section
Ins 17.28, Wis. Adm. Code, relating to Fund fees for fiscal year 2007.
Hearing Information
Date: February 13, 2006
Time: 10:00 a.m., or as soon thereafter as the matter may be reached
Place: OCI, Room 223, 125 South Webster St
2nd Floor
Madison, WI
Written comments or comments submitted through the Wisconsin Administrative Rule website at:
http://adminrules.wisconsin.gov on the proposed rule will be considered. The deadline for submitting comments is 4:30 p.m. on the 8
th day after the date for the hearing stated in this Notice of Hearing.
Written comments should be sent to:
Theresa Wedekind
OCI Rule Comment for Rule Ins 1728
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Initial Regulatory Flexibility Analysis
Notice is hereby further given that pursuant to s.
227.114, Stats., the proposed rule may have an effect on small businesses. The initial regulatory flexibility analysis is as follows:
a. Types of small businesses affected: Entities organized and operated in this state for the primary purpose of providing the services of physicians or certified registered nurse anesthetists.
b. Description of reporting and bookkeeping procedures required: None beyond those currently required.
c. Description of professional skills required: None beyond those currently required.
The office of the commissioner of insurance and the board of governors of the injured patients and families compensation fund propose an order to amend s.
Ins 17.01 (3), and s.
Ins 17.28 (3) (c) 1. and
2., and to repeal and recreate s.
Ins 17.28 (6), relating to annual patients compensation fund and mediation fund fees for the fiscal year beginning July 1, 2006 and may have an effect on small businesses.
Analysis Prepared by the Office of the Commissioner of Insurance (OCI)
3. Explanation of the OCI's authority to promulgate the proposed rule under these statutes: The commissioner of insurance, with the approval of the board of governors (board) of the injured patients and families compensation fund (fund), is required to establish by administrative rule the annual fees which participating health care providers must pay to the fund.
4. Related Statutes or rules: None.
5. The plain language analysis and summary of the proposed rule: This rule establishes the fees which participating health care providers must pay to the fund for the fiscal year beginning July 1, 2006. These fees represent a 25 % increase compared with fees paid for the 2005-06 fiscal year. The board approved these fees at its meeting on December 14, 2005, based on the recommendation of the board's actuarial and underwriting committee and reports of the fund's actuaries.
This rule includes fees for two new categories of health care providers:
1.
A new part-time classification for physicians as approved by the fund's board for those physicians working 1040 hours or less per fiscal year, and
2.
A new classification for organizations or enterprises not specified as a partnership or corporation, such as a limited liability company (LLC), that are organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists pursuant to
2005 Wisconsin Act 36.
This rule includes additions to the Insurance Services Office (ISO) code listing to address new classification specialties. ISO codes are the numerical designation for a health care provider's specialty and are used to classify the provider for assessment purposes.
The board is also required to promulgate by rule the annual fees for the operation of the injured patients and families compensation mediation system, based on the recommendation of the director of state courts. This rule implements the funding level recommendation of the board's actuarial and underwriting committee by establishing mediation panel fees for the next fiscal year at $25.00 for physicians and $2.00 per occupied bed for hospitals, representing a decrease from 2005-06 fiscal year mediation panel fees.
6. Summary of and preliminary comparison with any existing or proposed federal regulation that is intended to address the activities to be regulated by the proposed rule: To the fund board's and OCI's knowledge there is no existing or proposed federal regulation that is intended to address patient compensation fund rates, administration or activities.
7. Comparison of similar rules in adjacent states as found by OCI: To the fund board's and OCI's knowledge there are no similar rules in the adjacent states to compare this rule to as none of these states have a patients compensation fund created by statute where rates are directed to be established yearly by rule as is true in Wisconsin.
8. A summary of the factual data and analytical methodologies that OCI used in support of the proposed rule and how any related findings support the regulatory approach chosen for the proposed rule: None. This rule establishes annual fund fees pursuant to the requirements of the above-noted Wisconsin statutes.
9. Any analysis and supporting documentation that OCI used in support of OCI's determination of the rule's effect on small businesses under s.
227.114: This increase in fund fees will have an effect on some small businesses in Wisconsin. However, the vast majority of Fund participants that meet the definition of a small business are single shareholder corporations owned by a physician. These entities do not pay an additional fee separate from the fund fee physician's pay for their individual Fund coverage and therefore, will not be effected by the proposed rule. The fund identified a few small businesses which meet the definition of small business and that may pay an additional fee separate from the physician fee. However, even for these few entities, although there is an effect it is not significant nor should it negatively effect the small business's ability to compete with other providers not subject to potential additional fee.
10. If these changes may have a significant fiscal effect on the private sector, the anticipated costs that will be incurred by private sector in complying with the rule: The increase in fees promulgated by this rule does not result in a significant fiscal effect on the private sector. The cost of Fund coverage is a very small portion of the expenses incurred by health care providers. This increase is the first such increase after several years of decreases. Fund fees prior to this increase are 55% less then they were 5 years ago and after this increase will still be 43% less then 5 years ago. Although a health care provider may pass this increase on to it patients, there will not be a significant fiscal effect on the private sector as a result of this proposed rule.
11. A description of the Effect on Small Business: This rule will have little or no effect on small businesses. The increase contained in the proposed rule will require providers to pay an increased assessment which will increase the operational expenses for the providers. However, as stated in response to #10, above, while this proposed rule increases fund fees, the fees that will be assessed are still 43% lower than fees paid 5 years ago and the fee is proportional to all size businesses. As such, small businesses will not be disproportionately effected and the proposed rule will have no effect to the provider's competitive abilities.
12. Agency contact person: A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the WEB sites at:
http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, OCI Services Section, at:
Phone: (608) 264-8110
Address: 125 South Webster St – 2nd Floor Madison WI 53702
Mail: PO Box 7873, Madison WI 53707-7873
13. Place where comments are to be submitted and deadline for submission:
The deadline for submitting comments is 4:30p.m. on February 21, 2006.
Mailing address:
Theresa Wedekind
OCI Rule Comment for Rule Ins 17287 PCF fee rule
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Street address:
Theresa Wedekind
OCI Rule Comment for Rule Ins 17287 PCF fee rule
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53702
OCI Small Business Regulatory Coordinator
The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266- 7843 or at email address
Eileen.Mallow@oci.state.wi.us
