153.07(1)
(1) The board shall advise the department with regard to the collection, analysis and dissemination of health care information required by this chapter.
153.07(3)
(3) The board shall approve all rules which are proposed by the department for promulgation to implement this chapter.
153.07(4)
(4) The board and the department shall jointly do all of the following:
153.07(4)(b)
(b) Provide oversight on the standard reports under this chapter, including the reports under
ss. 153.20 and
153.21.
153.07(4)(c)
(c) Develop the overall strategy and direction for implementation of this chapter.
153.07(4)(d)
(d) Provide information on their activities to the interagency coordinating council created under
s. 15.107 (7).
153.08
153.08
Hospital rate increases or charges in excess of rates. 153.08(1)(b)
(b) Notwithstanding
s. 153.01 (5), "hospital" has the meaning given in
s. 50.33 (2), except that "hospital" does not include a center for the developmentally disabled as defined in
s. 51.01 (3).
153.08(1)(c)
(c) "Rates" means individual charges of a hospital for the services that it provides.
153.08(2)
(2) No hospital may increase its rates or charge any payer an amount exceeding its rates that are in effect on May 12, 1992, unless the hospital first causes to be published a class 1 notice under
ch. 985 in a newspaper likely to give notice in the area where the hospital is located, no sooner than 45 days and no later than 30 days before the proposed rate change is to take effect. The notice shall describe the proposed rate change.
153.08(3)
(3) This section does not apply to a hospital that proposes to increase its rates during the course of the hospital's fiscal year by any amount or amounts that, in the aggregate, do not exceed the percentage amount that is the percentage difference between the consumer price index reported for the 12-month period ending on December 31 of the preceding year and the consumer price index reported for the 12-month period ending on December 31 of the year prior to the preceding year.
153.08(4)
(4) A hospital shall publish a class 1 notice under
ch. 985 at least 10 days prior to the institution by the hospital of a rate increase.
153.10
153.10
Health care data reports. The department shall prepare, and submit to the governor and the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2), standard reports that the department prepares and shall collect information necessary for preparation of those reports.
153.10 History
History: 1987 a. 399;
1997 a. 27,
231.
153.20
153.20
Uncompensated health care services report. 153.20(1)(1) The department shall prepare, and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2), an annual report setting forth the number of patients to whom uncompensated health care services were provided by each hospital and the total charges for the uncompensated health care services provided to the patients for the preceding year, together with the number of patients and the total charges that were projected by the hospital for that year in the plan filed under
sub. (2).
153.20(2)
(2) Every hospital shall file with the department an annual plan setting forth the projected number of patients to whom uncompensated health care services will be provided by the hospital and the projected total charges for the uncompensated health care services to be provided to the patients for the ensuing year.
153.21
153.21
Consumer guide. The department shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2) an annual guide to assist consumers in selecting health care providers and health care plans. The guide shall be written in language that is understandable to lay persons. The department shall widely publicize and distribute the guide to consumers.
153.21 History
History: 1997 a. 231.
153.45
153.45
Release of data. 153.45(1)(1) After completion of data verification, comment and review procedures specified by the department by rule, the department shall release data, together with comments, if any, in the following forms:
153.45(1)(b)
(b) Public use data files which do not permit the identification of specific patients, employers or health care providers, as defined by rules promulgated by the department. The identification of these groups shall be protected by all necessary means, including the deletion of patient identifiers and the use of calculated variables and aggregated variables.
153.45(1)(c)
(c) Custom-designed reports containing portions of the data under
par. (b).
153.45(1m)
(1m) After completion of data verification and review procedures specified by the department by rule, the department may, but is not required to, release special data compilations.
153.45(2)
(2) The department shall provide to other entities the data necessary to fulfill their statutory mandates for epidemiological purposes or to minimize the duplicate collection of similar data elements.
153.45(3)
(3) The department may, but is not required to, release health care provider-specific and employer-specific data, except in public use data files as specified under
sub. (1) (b), in a manner that is specified in rules promulgated by the department.
153.45(4)
(4) The department shall prohibit purchasers of data from rereleasing individual data elements of health care data files.
153.45(5)
(5) The department may not release any health care information that is subject to rules promulgated under
s. 153.75 (1) (b) until the verification, comment and review procedures required under those rules have been complied with. Nothing in this subsection prohibits release of health care provider-specific information to the health care provider to whom the information relates.
153.50
153.50
Protection of patient confidentiality. 153.50(1)(a)
(a) "Data element" means an item of information from a uniform patient billing form.
153.50(1)(b)
(b) "Patient-identifiable data" means all of the following data elements:
153.50(1)(c)
(c) "Small number" means a number that is insufficiently large to be statistically significant, as determined by the department.
153.50(2)
(2) Prohibition on release. Patient-identifiable data obtained under this chapter is not subject to inspection, copying or receipt under
s. 19.35 (1) and may not be released by the department except as provided in
sub. (4).
153.50(3)
(3) Departmental measures to ensure protection of patient identity. To ensure that the identity of patients is protected when information obtained by the department is disseminated, the department shall do all of the following:
153.50(3)(a)
(a) Aggregate any data element category containing small numbers, using procedures that are developed by the department and approved by the board and that follow commonly accepted statistical methodology.
153.50(3)(b)
(b) Remove and destroy all of the following data elements on the uniform patient billing forms that are received by the department under the requirements of this chapter:
153.50(3)(b)3.
3. Any other insured's name, employer name and date of birth.
153.50(3)(b)4.
4. The signature of the patient or other authorized signature.
153.50(3)(b)5.
5. The signature of the insured or other authorized signature.
153.50(4)
(4) Release of patient-identifiable data. Under the procedures specified in
sub. (5), release of patient-identifiable data may be made to any of the following:
153.50(4)(a)
(a) The patient or a person granted permission in writing by the patient for release of the patient's patient-identifiable data.
153.50(4)(b)
(b) An agent of the department who is responsible for the patient-identifiable data in the department, in order to store the data and ensure the accuracy of the information in the data base of the department.
153.50(4)(c)
(c) A health care provider or the agent of a health care provider, to ensure the accuracy of the information in the data base of the department.
153.50(4)(d)
(d) The department, for purposes of epidemiological investigation or to eliminate the need for duplicative data bases.
153.50(4)(e)
(e) An entity that is required by federal or state statute to obtain patient-identifiable data for purposes of epidemiological investigation or to eliminate the need for duplicative data bases.
153.50(5)
(5) Procedures for release of patient-identifiable data. 153.50(5)(a)(a) The department may not release or provide access to patient-identifiable data to a person authorized under
sub. (4) (a),
(c),
(d) or
(e) unless the authorized person requests the department, in writing, to release the patient-identifiable data. The request shall include all of the following:
153.50(5)(a)3.
3. For a person who is authorized under
sub. (4) (a),
(c) or
(d) to receive or have access to patient-identifiable data, evidence, in writing, that indicates that authorization.
153.50(5)(a)4.
4. For an entity that is authorized under
sub. (4) (e) to receive or have access to patient-identifiable data, evidence, in writing, of all of the following:
153.50(5)(a)4.a.
a. The federal or state statutory requirement to obtain the patient-identifiable data.
153.50(5)(a)4.b.
b. Any federal or state statutory requirement to uphold the patient confidentiality provisions of this chapter or patient confidentiality provisions that are more restrictive than those of this chapter; or, if the latter evidence is inapplicable, an agreement, in writing, to uphold the patient confidentiality provisions of this chapter.
153.50(5)(b)
(b) Upon receipt of a request under
par. (a), the department shall, as soon as practicable, comply with the request or notify the requester, in writing, of all of the following:
153.50(5)(b)1.
1. That the department is denying the request in whole or in part.
153.50(5)(b)3.
3. For a person who believes that he or she is authorized under
sub. (4), the action provided under
s. 19.37.
153.50(6)
(6) Information submitted. The department may not require a health care provider submitting health care information under this chapter to include the patient's name, street address or social security number.
153.55
153.55
Protection of health care provider confidentiality. Health care provider-identifiable data obtained under this chapter is not subject to inspection, copying or receipt under
s. 19.35 (1).
153.55 History
History: 1997 a. 231.
153.60
153.60
Assessments to fund operations of department and board. 153.60(1)(1) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures under this chapter for the department and the board for that fiscal year for data collection, data base development and maintenance, generation of data files and standard reports, orientation and training provided under
s. 153.05 (9) and maintaining the board. The department shall assess the estimated total amount for that fiscal year less the estimated total amount to be received for purposes of administration of this chapter under
s. 20.435 (1) (hi) during the fiscal year, the unencumbered balance of the amount received for purposes of administration of this chapter under
s. 20.435 (1) (hi) from the prior fiscal year and the amount in the appropriation account under
s. 20.435 (1) (dg) for the fiscal year, to health care providers who are in a class of health care providers from whom the department collects data under this chapter in a manner specified by the department by rule. The department shall obtain approval from the board for the amounts of assessments for health care providers other than hospitals and ambulatory surgery centers. The department shall work together with the department of regulation and licensing to develop a mechanism for collecting assessments from health care providers other than hospitals and ambulatory surgery centers. No health care provider that is not a facility may be assessed under this subsection an amount that exceeds $75 per fiscal year. Each hospital shall pay the assessment on or before December 1. All payments of assessments shall be deposited in the appropriation under
s. 20.435 (1) (hg).
153.60(3)
(3) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures required for the collection, database development and maintenance and generation of public data files and standard reports for health care plans that voluntarily agree to supply health care data under
s. 153.05 (6r). The department shall assess the estimated total amount for that fiscal year to health care plans in a manner specified by the department by rule and may enter into an agreement with the office of the commissioner of insurance for collection of the assessments. Each health plan that voluntarily agrees to supply this information shall pay the assessments on or before December 1. All payments of assessments shall be deposited in the appropriation under
s. 20.435 (1) (hg) and may be used solely for the purposes of
s. 153.05 (6r).
