146.903(5)(e)
(e) The attorney general may bring an action in the name of the state to collect any forfeiture imposed under this subsection if the forfeiture has not been paid following the exhaustion of all administrative and judicial reviews. The only issue to be contested in any such action is whether the forfeiture has been paid.
146.903 History
History: 2009 a. 146.
146.905
146.905
Reduction in fees prohibited. 146.905(1)
(1) Except as provided in
sub. (2), a health care provider, as defined in
s. 146.81 (1) (a) to
(p), that provides a service or a product to an individual with coverage under a disability insurance policy, as defined in
s. 632.895 (1) (a), may not reduce or eliminate or offer to reduce or eliminate coinsurance or a deductible required under the terms of the disability insurance policy.
146.905(2)
(2) Subsection (1) does not apply if payment of the total fee would impose an undue financial hardship on the individual receiving the service or product.
146.91
146.91
Long-term care insurance. 146.91(1)
(1) In this section, "long-term care insurance" means insurance that provides coverage both for an extended stay in a nursing home and home health services for a person with a chronic condition. The insurance may also provide coverage for other services that assist the insured person in living outside a nursing home including but not limited to adult day care and continuing care retirement communities.
146.91(2)
(2) The department, with the advice of the council on long-term care insurance, the office of the commissioner of insurance, the board on aging and long-term care and the department of employee trust funds, shall design a program that includes the following:
146.91(2)(a)
(a) Subsidizing premiums for persons purchasing long-term care insurance, based on the purchasers' ability to pay.
146.91(2)(b)
(b) Reinsuring by the state of policies issued in this state by long-term care insurers.
146.91(3)
(3) The department shall collect any data on health care costs and utilization that the department determines to be necessary to design the program under
sub. (2).
146.91(6)
(6) The department, with the advice of the council on long-term care insurance, may examine use of tax incentives for the sale and purchase of long-term care insurance.
146.95
146.95
Patient visitation. 146.95(2)(a)(a) Any individual who is 18 years of age or older may identify to a health care provider at an inpatient health care facility at any time, either orally or in writing, those persons with whom the individual wishes to visit while the individual is a patient at the inpatient health care facility. Except as provided in
par. (b), no inpatient health care facility may deny visitation during the inpatient health care facility's regular visiting hours to any person identified by the individual.
146.95(2)(b)
(b) Subject to
s. 51.61 for a treatment facility, an inpatient health care facility may deny visitation with a patient to any person if any of the following applies:
146.95(2)(b)1.
1. The inpatient health care facility or a health care provider determines that the patient may not receive any visitors.
146.95(2)(b)2.
2. The inpatient health care facility or a health care provider determines that the presence of the person would endanger the health or safety of the patient.
146.95(2)(b)3.
3. The inpatient health care facility determines that the presence of the person would interfere with the primary operations of the inpatient health care facility.
146.95(2)(b)4.
4. The patient has subsequently expressed in writing to a health care provider at the inpatient health care facility that the patient no longer wishes to visit with the person. Unless
subd. 2. applies, an inpatient health care facility may not under this subdivision deny visitation to the person based on a claim by someone other than a health care provider that the patient has orally expressed that the patient no longer wishes to visit with that person.
146.95 History
History: 1997 a. 153.
146.96
146.96
Uniform claim processing form. Beginning no later than July 1, 2004, every health care provider, as defined in
s. 146.81 (1) (a) to
(p), shall use the uniform claim processing form developed by the commissioner of insurance under
s. 601.41 (9) (b) when submitting a claim to an insurer.
146.96 History
History: 2001 a. 109;
2009 a. 28.
146.98
146.98
Ambulatory surgical center assessment. 146.98(2)
(2) The department of revenue may impose an assessment on ambulatory surgical centers in this state that satisfies the requirements under
42 CFR 433.68 for collecting an assessment without incurring a reduction in federal financial participation under the federal Medicaid program. The department shall allocate any assessment imposed under this section among ambulatory surgical centers in proportion to their gross patient revenue.
146.98(3)
(3) The department of revenue may do all of the following:
146.98(3)(a)
(a) Subject to
sub. (2), determine the amount of assessment under this section.
146.98(3)(b)
(b) Collect assessments imposed under this section from ambulatory surgical centers.
146.98(3)(c)
(c) Require ambulatory surgical centers to provide the department of revenue any data that is required by the department of revenue to determine assessment amounts under this section.
146.98(3)(d)
(d) Establish deadlines by which ambulatory surgical centers shall pay assessments required under this section and provide data required under
par. (c).
146.98(3)(e)
(e) Impose penalties on ambulatory surgical centers that do not comply with requirements under this section or rules promulgated under
sub. (5).
146.98(4)
(4) The department of revenue shall transfer 99.5 percent of the moneys collected under this section to the Medical Assistance trust fund.
146.98(5)
(5) The department of revenue shall promulgate rules for the administration of the assessment under this section.
146.98(6)(a)(a) If the federal government does not provide federal financial participation under the federal Medicaid program for amounts collected under this section that are transferred under
sub. (4) and used to make payments from the Medical Assistance trust fund, the department shall, from the fund from which the payment or expenditure was made, refund ambulatory surgical centers the amount for which the federal government does not provide federal financial participation.
146.98(6)(b)
(b) If the department makes a refund under
par. (a) as result of failure to obtain federal financial participation under the federal Medicaid program for a payment from the Medical Assistance trust fund, the department shall recoup the part of the payment for which the federal government does not provide federal financial participation.
146.98(6)(c)
(c) Moneys recouped under
par. (b) for payments made from the Medical Assistance trust fund shall be deposited in the Medical Assistance trust fund.
146.98 History
History: 2009 a. 28;
2011 a. 191.
146.997
146.997
Health care worker protection. 146.997(1)(a)
(a) "Department" means the department of workforce development.
146.997(1)(c)
(c) "Health care facility" means a facility, as defined in
s. 647.01 (4), or any hospital, nursing home, community-based residential facility, county home, county infirmary, county hospital, county mental health complex or other place licensed or approved by the department of health services under
s. 49.70,
49.71,
49.72,
50.03,
50.35,
51.08 or
51.09 or a facility under
s. 45.50,
51.05,
51.06,
233.40,
233.41,
233.42 or
252.10.
146.997(1)(d)
(d) "Health care provider" means any of the following:
146.997(1)(d)4.
4. A physician, podiatrist, perfusionist, physical therapist, or physical therapist assistant licensed under
ch. 448.
146.997(1)(d)5.
5. An occupational therapist, occupational therapy assistant, physician assistant or respiratory care practitioner certified under
ch. 448.
146.997(1)(d)11.
11. A social worker, marriage and family therapist or professional counselor certified under
ch. 457.
146.997(1)(d)12.
12. A speech-language pathologist or audiologist licensed under
subch. II of ch. 459 or a speech and language pathologist licensed by the department of public instruction.
146.997(1)(d)16.
16. A corporation or limited liability company of any providers specified under
subds. 1. to
14. that provides health care services.
146.997(1)(d)17.
17. A cooperative health care association organized under
s. 185.981 that directly provides services through salaried employees in its own facility.
146.997(2)(a)(a) Any employee of a health care facility or of a health care provider who is aware of any information, the disclosure of which is not expressly prohibited by any state law or rule or any federal law or regulation, that would lead a reasonable person to believe any of the following may report that information to any agency, as defined in
s. 111.32 (6) (a), of the state; to any professionally recognized accrediting or standard-setting body that has accredited, certified or otherwise approved the health care facility or health care provider; to any officer or director of the health care facility or health care provider; or to any employee of the health care facility or health care provider who is in a supervisory capacity or in a position to take corrective action:
146.997(2)(a)1.
1. That the health care facility or health care provider or any employee of the health care facility or health care provider has violated any state law or rule or federal law or regulation.
146.997(2)(a)2.
2. That there exists any situation in which the quality of any health care service provided by the health care facility or health care provider or by any employee of the health care facility or health care provider violates any standard established by any state law or rule or federal law or regulation or any clinical or ethical standard established by a professionally recognized accrediting or standard-setting body and poses a potential risk to public health or safety.
146.997(2)(b)
(b) An agency or accrediting or standard-setting body that receives a report under
par. (a) shall, within 5 days after receiving the report, notify the health care facility or health provider that is the subject of the report, in writing, that a report alleging a violation specified in
par. (a) 1. or
2. has been received and provide the health care facility or health care provider with a written summary of the contents of the report, unless the agency, or accrediting or standard-setting body determines that providing that notification and summary would jeopardize an ongoing investigation of a violation alleged in the report. The notification and summary may not disclose the identity of the person who made the report.
146.997(2)(c)
(c) Any employee of a health care facility or health care provider may initiate, participate in or testify in any action or proceeding in which a violation specified in
par. (a) 1. or
2. is alleged.
146.997(2)(d)
(d) Any employee of a health care facility or health care provider may provide any information relating to an alleged violation specified in
par. (a) 1. or
2. to any legislator or legislative committee.
146.997(3)(a)(a) No health care facility or health care provider and no employee of a health care facility or health care provider may take disciplinary action against, or threaten to take disciplinary action against, any person because the person reported in good faith any information under
sub. (2) (a), in good faith initiated, participated in or testified in any action or proceeding under
sub. (2) (c) or provided in good faith any information under
sub. (2) (d) or because the health care facility, health care provider or employee believes that the person reported in good faith any information under
sub. (2) (a), in good faith initiated, participated in or testified in any action or proceeding under
sub. (2) (c) or provided in good faith any information under
sub. (2) (d).
146.997(3)(b)
(b) No health care facility or health care provider and no employee of a health care facility or health care provider may take disciplinary action against, or threaten to take disciplinary action against, any person on whose behalf another person reported in good faith any information under
sub. (2) (a), in good faith initiated, participated in or testified in any action or proceeding under
sub. (2) (c) or provided in good faith any information under
sub. (2) (d) or because the health care facility, health care provider or employee believes that another person reported in good faith any information under
sub. (2) (a), in good faith initiated, participated in or testified in any action or proceeding under
sub. (2) (c) or provided in good faith any information under
sub. (2) (d) on that person's behalf.
146.997(3)(c)
(c) For purposes of
pars. (a) and
(b), an employee is not acting in good faith if the employee reports any information under
sub. (2) (a) that the employee knows or should know is false or misleading, initiates, participates in or testifies in any action or proceeding under
sub. (2) (c) based on information that the employee knows or should know is false or misleading or provides any information under
sub. (2) (d) that the employee knows or should know is false or misleading.
146.997(4)(a)(a) Any employee of a health care facility or health care provider who is subjected to disciplinary action, or who is threatened with disciplinary action, in violation of
sub. (3) may file a complaint with the department under
s. 106.54 (6). If the department finds that a violation of
sub. (3) has been committed, the department may take such action under
s. 111.39 as will effectuate the purpose of this section.
146.997(5)
(5) Civil penalty. Any health care facility or health care provider and any employee of a health care facility or health care provider who takes disciplinary action against, or who threatens to take disciplinary action against, any person in violation of
sub. (3) may be required to forfeit not more than $1,000 for a first violation, not more than $5,000 for a violation committed within 12 months of a previous violation and not more than $10,000 for a violation committed within 12 months of 2 or more previous violations. The 12-month period shall be measured by using the dates of the violations that resulted in convictions.
146.997(6)
(6) Posting of notice. Each health care facility and health care provider shall post, in one or more conspicuous places where notices to employees are customarily posted, a notice in a form approved by the department setting forth employees' rights under this section. Any health care facility or health care provider that violates this subsection shall forfeit not more than $100 for each offense.
146.997 Annotation
This section applies only to employees, a category that does not include interns who do not receive compensation or tangible benefits. Because the plaintiff received no compensation or tangible benefits, she was not an employee of the defendant and was not entitled to anti-retaliation protection under sub. (3) (a). Masri v. State of Wisconsin Labor and Industry Review,
2014 WI 81, ___ Wis. 2d ___, ___ N.W.2d ___,
12-1047.
