Establishing procedures under which health care providers who are not hospitals or ambulatory surgery centers are permitted to review, verify and comment on information and include the comments with the information.
Establishing criteria for the publication and contents of notices under s. 153.08
Defining the term “major purchaser, payer or provider of health care services" for the purposes of s. 153.05 (6)
Establishing methods and criteria for assessing health care providers under s. 153.60 (1)
NOTE: 2015 Wis. Act 55
consolidated s. 153.60 (1) with s. 153.60 (intro.) and the consolidated provision was renumbered to be s. 153.60 and amended. The provision for the assessment of health care providers in the former s. 153.60 (1) was deleted from the consolidated s. 153.60 by the Act 55 amendment, rendering par. (k) without effect. Corrective legislation is pending.
Specifying the classes of health care providers, other than hospitals and ambulatory surgery centers, from whom claims data and other health care information will be collected.
Specifying the uniform data set of health care information, as adjusted for case mix and severity, to be collected from health care providers other than hospitals and ambulatory surgery centers.
Specifying the means by which the information in par. (b)
will be collected, including the procedures for submission of data by electronic means.
Specifying the methods for using and disseminating health care data in order for health care providers other than hospitals and ambulatory surgery centers to provide health care that is effective and economically efficient and for consumers and purchasers to make informed decisions in selecting health care plans and health care providers.
Specifying the information to be provided by the department in the consumer guide under s. 153.21 (1)
Specifying the standard reports that will be issued by the department in addition to those required in s. 153.21 (1)
Specifying the methods for adjusting health care information obtained from health care providers other than hospitals and ambulatory surgery centers for case mix and severity.
Exempting certain classes of health care providers that are not hospitals or ambulatory surgery centers from providing all or portions of the data required under this subchapter.
Providing for the efficient collection, analysis and dissemination of health care information which the department may require under this subchapter.
See also ch. DHS 120
, Wis. adm. code.
Except as provided in s. 153.77
, any person violating s. 153.50
or rules promulgated under s. 153.75 (1) (a)
is liable to the patient for actual damages and costs, plus exemplary damages of up to $1,000 for a negligent violation and up to $5,000 for an intentional violation.
1987 s. 399; 1999 a. 9
; 2009 a. 274
; Stats. 2009 s. 153.76.
Immunity from liability. 153.77(1)
A health care provider that submits information to the department under this subchapter is immune from civil liability for all of the following:
Any act or omission of an employee, official or agent of the health care provider that results in the release of a prohibited data element while submitting data to the department.
Any act or omission of the department that results in the release of data.
The immunity provided under this section does not apply to intentional, willful or reckless acts or omissions by health care providers.
History: 1999 a. 9
; 2009 a. 274
; Stats. 2009 s. 153.77.
Whoever intentionally violates s. 153.45 (5)
or rules promulgated under s. 153.75 (1) (a)
may be fined not more than $15,000 or imprisoned for not more than one year in the county jail or both.
Any person who violates this subchapter or any rule promulgated under the authority of this subchapter, except ss. 153.45 (5)
and 153.75 (1) (a)
, as provided in s. 153.76
and sub. (1)
, shall forfeit not more than $100 for each violation. Each day of violation constitutes a separate offense, except that no day in the period between the date on which a request for a hearing is filed under s. 227.44
and the date of the conclusion of all administrative and judicial proceedings arising out of a decision under this section constitutes a violation.
The department may directly assess forfeitures under sub. (2)
. If the department determines that a forfeiture should be assessed for a particular violation or for failure to correct the violation, the department shall send a notice of assessment to the alleged violator. The notice shall specify the alleged violation of the statute or rule and the amount of the forfeiture assessed and shall inform the alleged violator of the right to contest the assessment under s. 227.44
ELECTRONIC HEALTH INFORMATION EXCHANGE
In this subchapter:
“Department" means the department of health services.
“Health care provider" has the meaning given in s. 146.81 (1)
and includes an ambulatory surgery center, which has the meaning given for “ambulatory surgical center" under 42 CFR 416.2
“Secretary" means the secretary of health services.
“State-designated entity" means a nonprofit corporation designated by the state as eligible to apply for and receive grants under 42 USC 300jj-33
from the secretary of the U.S. department of health and human services.
History: 2009 a. 274
Requirements for designation and funding. 153.81(1)(1)
The state may designate a nonprofit corporation that is incorporated under ch. 181
as the state-designated entity only if the secretary determines that all of the following conditions are satisfied:
The articles of incorporation or bylaws of the corporation state that a purpose of the corporation is to use information technology to improve health care quality and efficiency through the authorized and secure electronic exchange and use of health information.
The corporation annually evaluates, analyzes, and reports to the secretary on the progress toward implementing statewide health information exchange and how the health information exchange efforts are enabling meaningful use of certified electronic health record technology, as defined in 42 USC 300jj
and by the U.S. department of health and human services by regulation, by health care providers.
The governing structure and bylaws of the corporation allow it to consult and consider recommendations from all of the persons specified under 42 USC 300jj-33
(g) (1) to (10) in carrying out statewide health information exchange.
The board of directors of the corporation includes all of the following persons:
The person who is appointed by the secretary to be the director of the Medical Assistance program, or his or her designee.
One person who is specified by the governor, or his or her designee.
One or more persons who represent each of the following such that the representation of the public and private health sector is balanced in the board's representation:
The corporation agrees to fulfill all of the following purposes:
Building substantial health information exchange capacity statewide to support all of the following:
Health care providers' meaningful use of electronic health records.
Developing policies and recommending legislation that advance efficient statewide and interstate health information exchange and that protect consumer privacy.
Developing or facilitating the creation of a statewide technical infrastructure that supports statewide health information exchange and enables interoperability among users of health information.
Coordinating between the Medical Assistance and public health programs to enable information exchange and promote meaningful use of electronic health records.
Providing oversight and accountability for health information exchange to protect the public interest.
Increasing public awareness of and support for statewide health information exchange and fostering agreement among health care providers and other users of health care information on an approach to statewide health information exchange.
Adopting standards for health information exchange in accordance with national standards, implementation protocols, and reporting requirements.
Prioritizing among health information exchange services according to the needs of the residents of this state.
Managing and sustaining funding necessary to develop and sustain statewide health information infrastructure and services.
Conducting or overseeing health information exchange business and technical operations, including providing technical assistance to health information organizations and other health information exchanges.
Developing or facilitating the creation and use of shared directories and technical services, as applicable to statewide health information exchange.
Creating a model, uniform statewide patient consent and authorization process to allow electronic access to, review of, or disclosure of a patient's identifiable health care information.
Certifying regional health information exchange networks, if any, and confirming that any regional health information exchange network meets the criteria to participate in and connect to the statewide health information exchange network.
Monitoring health information technology and health information exchange efforts nationally and facilitating alignment of statewide, interstate, and national health information exchange strategies.
Developing programs and initiatives to promote and advance health information exchange to improve the safety, quality, and efficiency of health care and to reduce waste due to redundancy and administrative costs.
The department may make payments to a nonprofit corporation that is incorporated under ch. 181
to support health information exchange if the secretary determines that the conditions under sub. (1)
History: 2009 a. 274
Creation of corporation. 153.82(1)
The secretary may organize and assist in maintaining a nonstock, nonprofit corporation under ch. 181
for all of the purposes specified under s. 153.81 (1) (f)
If the secretary organizes a corporation under sub. (1)
, the secretary shall appoint all of the individuals specified under s. 153.81 (1) (e) 1.
as initial directors of the board of the corporation.
The assets and liabilities of the corporation under sub. (1)
shall be separate from all other assets and liabilities of the state, of all political subdivisions of the state, and of the department. The state, any political subdivision of the state, and the department do not guarantee any obligation of or have any obligation to the corporation. The state, any political subdivision of the state, and the department are not liable for any debt or liability of the corporation.
History: 2009 a. 274