(1) REGULATIONS. To make and enforce such regulations, not inconsistent with law, as it may deem necessary for the exercise and discharge of all the powers and duties of the department, and to adopt such measures and make such regulations as are necessary and proper for the enforcement by the state of chs. 93 to 100, which regulations shall have the force of law.
Section 100.20 (2) (a).
The department, after public hearing, may issue general orders forbidding methods of competition in business or trade practices in business which are determined by the department to be unfair. The department, after public hearing, may issue general orders prescribing methods of competition in business or trade practices in business which are determined by the department to be fair.
4. Estimate of the Amount of Time that State Employees will Spend to Develop the Rule and of Other Resources Necessary to Develop the Rule
DATCP estimates that it will use approximately 0.15 FTE staff to develop this rule. That includes time required for investigation and analysis, rule drafting, preparing related documents, coordinating advisory committee meetings, holding public hearings and communicating with affected persons and groups. DATCP will use existing staff to develop this rule.
5. Description of all Entities that may be Impacted by the Rule
DATCP's initial analysis shows that the existing rule is obsolete. Therefore, the proposed repeal of the rule will have no impact on any entities.
6. Summary and Preliminary Comparison of any Existing or Proposed Federal Regulation that is Intended to Address the Activities to be Regulated by the Rule
There are a number of federal regulations that relate, generally, to the tobacco industry. For example, the IRS enforces regulations that control the manufacture and distribution of tobacco products. Further, the 2010 Family Smoking Prevention and Tobacco Control Act grants FDA authority to write rules that may require growers and brokers to disclose certain information to manufactures about the type of tobacco, levels of certain chemicals, and curing methods used. However, our search does not reveal any federal law or regulation that regulates the transaction between tobacco growers and buyers comparable to ch. ATCP 104.
7. Anticipated Economic Impact
DATCP expects the proposed rule to have no economic impact locally or statewide.
Contact Person
Kevin LeRoy, Program and Policy Analyst, DATCP; Phone (608) 224-4928.
Health Services
Community Services, Chs. 30
Medical Assistance, Chs. 101
This statement of scope was approved by the governor on December 30, 2013.
Rule No.
Relating to
Medical Assistance coverage for outpatient mental health services.
Rule Type
Permanent
1. Finding/Nature of Emergency
Not applicable.
2. Detailed Description of the Objective of the Proposed Rule
The objective of the rulemaking is to update rules to reflect current policy and to conform rules to statute concerning MA reimbursement for outpatient mental health services.
3. Description of the Existing Policies Relevant to the Rule, New Policies Proposed to be Included in the Rule, and an Analysis of Policy Alternatives
Section DHS 35.16 (4) (b) requires as a condition for MA reimbursement a physician's prescription for psychotherapy services. Similarly, ss. DHS 107.02 (2m) (a) 7. and 107.13 (2) (a) (intro.) and 2. and (b) 4. b., require a physician's prescription for mental health services, alcohol and other drug abuse services, and psychotherapy services as a condition for MA reimbursement. Pursuant to ss. 49.45 (30f) and 49.46 (2) (b) 6. f., fm., k., and Lr., Stats., the department is prohibited from requiring a prescription from a physician or other health care provider for psychotherapy services, medical day treatment services, or mental health and alcohol and other drug abuse services as a condition for MA reimbursement. Thus, the department proposes to conform ss. DHS 35.16 (4) (b), 107.02 (2m) (a) 7., and 107.13 (2) (a) (intro.) and 2. and (b) 4. b. to existing state law.
2013 Wisconsin Act 20 included funding to expand MA outpatient mental health coverage to in-home psychotherapy services for children. See, LFB Budget Summary. To effectuate this, the department proposes to revise s. DHS 107.13 (2) (a) 4. and (d) 3. to authorize in-home psychotherapy services as a covered service for children.
3.b. Alternatives
The policy alternative to rulemaking to authorize outpatient in-home psychotherapy for children as a covered service is to explicitly authorize the services by statute or do nothing. There is no alternative to conforming ss. DHS 35.16 (4) (b), 107.02 (2m) (a) 7., and 107.13 (2) (a) (intro.) and 2. and (b) 4. b. to state law.
4. Detailed Explanation of Statutory Authority for the Rule (Including the Statutory Citation and Language)
The department's authority to revise the referenced rules is as follows:
Section 49.45 (10), Stats., reads: Rule-making powers and duties. The department is authorized to promulgate such rules as are consistent with its duties in administering medical assistance.
Section 227.11 (2) (a) 1. to 3., Stats. reads: Rule-making authority is expressly conferred as follows:
(a) Each agency may promulgate rules interpreting the provisions of any statute enforced or administered by the agency, if the agency considers it necessary to effectuate the purpose of the statute, but a rule is not valid if the rule exceeds the bounds of correct interpretation. All of the following apply to the promulgation of a rule interpreting the provisions of a statute enforced or administered by an agency:
1. A statutory or nonstatutory provision containing a statement or declaration of legislative intent, purpose, findings, or policy does not confer rule-making authority on the agency or augment the agency's rule-making authority beyond the rule-making authority that is explicitly conferred on the agency by the legislature.
2. A statutory provision describing the agency's general powers or duties does not confer rule-making authority on the agency or augment the agency's rule-making authority beyond the rule-making authority that is explicitly conferred on the agency by the legislature.
3. A statutory provision containing a specific standard, requirement, or threshold does not confer on the agency the authority to promulgate, enforce, or administer a rule that contains a standard, requirement, or threshold that is more restrictive than the standard, requirement, or threshold contained in the statutory provision.
5. Estimate of Amount of Time that State Employees Will Spend Developing the Rule and of Other Resources Necessary to Develop the Rule
The department estimates it will take 22 hours to develop the rule. No other resources will be necessary.
6. List with Description of all Entities that may be Affected by the Proposed Rule
Children receiving MA that need psychotherapy services in the home and psychotherapy providers individually certified under s. DHS 105.22 and who work in an outpatient mental health clinic that is certified under s. DHS 105.22 may be affected by the proposed changes to s. DHS 107.13 (2) (a) 4. and (d) 3. The proposed changes to conform ss. DHS 35.16 (4) (b), 107.02 (2m) (a) 7., and 107.13 (2) (a) (intro.) and 2. and (b) 4. b. to state law will have no effect on the public.
7. Summary and Preliminary Comparison with any Existing or Proposed Federal Regulation that is Intended to Address the Activities to be Regulated by the Proposed Rule
There appears to be no existing or proposed federal regulations that address the activities to be regulated by the rules.
8. Anticipated Economic Impact of Implementing the Rule (Note if the Rule is Likely to Have a Significant Economic Impact on Small Businesses)
The department anticipates that the proposed rules would have little to no economic impact.
Contact Person
Dan Zimmerman, 608-266-7072, Daniel.Zimmerman@wisconsin.gov
Al Matano, 608-267-6848, Alfred.Matano@wisconsin.gov
Dave Stepien, 608-267-9314, david.stepien@wisconsin.gov
Jami Crespo, 608-267-9697, jami.crespo@wisconsin.gov
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