See also ch. Med 14
, Wis. adm. code.
Fee splitting; separate billing required, partnerships and corporations; contract exceptions. 448.08(1)(1)
As used in this section:
“Hospital" means an institution providing 24-hour continuous service to patients confined therein which is primarily engaged in providing facilities for diagnostic and therapeutic services for the surgical and medical diagnosis, treatment and care, of injured or sick persons, by or under the supervision of a professional staff of physicians and surgeons, and which is not primarily a place of rest for the aged, drug addicts or alcoholics, or a nursing home. Such hospitals may charge patients directly for the services of their employee nurses, nonphysician anesthetists, physical therapists and medical assistants other than physicians or dentists, and may engage on a salary basis interns and residents who are participating in an accredited training program under the supervision of the medical staff, and persons with a resident educational license issued under s. 448.04 (1) (bm)
“Medical education and research organization" means a medical education and medical research organization operating on a nonprofit basis.
(1m) Fee splitting.
Except as otherwise provided in this section, no person licensed or certified under this subchapter may give or receive, directly or indirectly, to or from any person, firm or corporation any fee, commission, rebate or other form of compensation or anything of value for sending, referring or otherwise inducing a person to communicate with a licensee in a professional capacity, or for any professional services not actually rendered personally or at his or her direction.
(2) Separate billing required.
Any person licensed under this subchapter who renders any medical or surgical service or assistance whatever, or gives any medical, surgical or any similar advice or assistance whatever to any patient, physician or corporation, or to any other institution or organization of any kind, including a hospital, for which a charge is made to such patient receiving such service, advice or assistance, shall, except as authorized by Title 18 or Title 19 of the federal social security act, render an individual statement or account of the charges therefor directly to such patient, distinct and separate from any statement or account by any physician or other person, who has rendered or who may render any medical, surgical or any similar service whatever, or who has given or may give any medical, surgical or similar advice or assistance to such patient, physician, corporation, or to any other institution or organization of any kind, including a hospital.
(3) Billing for tests performed by the state laboratory of hygiene.
A person other than a state or local government agency who charges a patient, other person or 3rd-party payer for services performed by the state laboratory of hygiene shall identify the actual amount charged by the state laboratory of hygiene and shall restrict charges for those services to that amount.
(4) Professional partnerships and corporations permitted.
Notwithstanding any other provision in this section, it is lawful for 2 or more physicians, who have entered into a bona fide partnership for the practice of medicine, to render a single bill for such services in the name of such partnership, and it also is lawful for a service corporation to render a single bill for services in the name of the corporation, provided that each individual licensed, registered or certified under this chapter or ch. 446
that renders billed services is individually identified as having rendered such services.
(5) Contract exceptions; terms.
Notwithstanding any other provision in this section, when a hospital and its medical staff or a medical education and research organization and its medical staff consider that it is in the public interest, a physician may contract with the hospital or organization as an employee or to provide consultation services for attending physicians as provided in this subsection.
Require the physician to be a member of or acceptable to and subject to the approval of the medical staff of the hospital or medical education and research organization.
Permit the physician to exercise professional judgment without supervision or interference by the hospital or medical education and research organization.
If agreeable to the contracting parties, the hospital or medical education and research organization may charge the patient for services rendered by the physician, but the statement to the patient shall indicate that the services of the physician, who shall be designated by name, are included in the departmental charges.
No hospital or medical education and research organization may limit staff membership to physicians employed under this subsection.
The responsibility of physician to patient, particularly with respect to professional liability, shall not be altered by any employment contract under this subsection.
A medical professional service corporation may bill patients for services by both a physician and a physical therapist if billing states an accurate figure for the respective services. 71 Atty. Gen. 108
Penalties; appeal. 448.09(1)
A person who violates s. 448.08 (3)
may be fined not more than $250. Except as provided in sub. (1m)
, a person who violates any other provision of this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both.
A physician who violates any provision of this subchapter, except s. 448.08 (3)
, or any rule promulgated under this subchapter may be fined not more than $25,000 or imprisoned not more than 9 months or both.
Any person aggrieved by any action taken under this subchapter by the board, its officers or its agents may apply for judicial review as provided in ch. 227
, and shall file notice of such appeal with the secretary of the board within 30 days. No court of this state may enter an ex parte stay of any action taken by the board under this subchapter.
Notwithstanding s. 448.05 (2)
, a person who, on April 1, 2015, possessed a valid license to practice medicine and surgery under s. 448.05 (2)
, 2011 stats., may retain, practice under, and continue to renew that license, subject to any other provisions in this subchapter or any rules promulgated by the board governing a license to practice medicine and surgery.
If it appears upon complaint to the board by any person or if it is known to the board that any person is violating this subchapter, or rules adopted by the board under this subchapter, the board or the attorney general may investigate and may, in addition to any other remedies, bring action in the name and on behalf of the state against any such person to enjoin such person from such violation. The attorney general shall represent the board in all proceedings.
History: 1975 c. 383
; 1997 a. 175
A physician who has reason to believe any of the following about another physician shall promptly submit a written report to the board that shall include facts relating to the conduct of the other physician:
The other physician is engaging or has engaged in acts that constitute a pattern of unprofessional conduct.
The other physician is engaging or has engaged in an act that creates an immediate or continuing danger to one or more patients or to the public.
The other physician is or may be medically incompetent.
The other physician is or may be mentally or physically unable safely to engage in the practice of medicine or surgery.
No physician who reports to the board under sub. (1)
may be held civilly or criminally liable or be found guilty of unprofessional conduct for reporting in good faith.
History: 2009 a. 382
Anyone practicing medicine, surgery, osteopathy, or any other form or system of treating the sick without having a license or a certificate of registration shall be liable to the penalties and liabilities for malpractice; and ignorance shall not lessen such liability for failing to perform or for negligently or unskillfully performing or attempting to perform any duty assumed, and which is ordinarily performed by authorized practitioners.
History: 1975 c. 383
Biennial training requirement. 448.13(1)(a)(a)
Except as provided in par. (b)
, each physician shall, in each 2nd year at the time of application for a certificate of registration under s. 448.07
, submit proof of attendance at and completion of all of the following:
Continuing education programs or courses of study approved for at least 30 hours of credit by the board within the 2 calendar years preceding the calendar year for which the registration is effective.
Professional development and maintenance of certification or performance improvement or continuing medical education programs or courses of study required by the board by rule under s. 448.40 (1)
and completed within the 2 calendar years preceding the calendar year for which the registration is effective.
The board may waive any of the requirements under par. (a)
if it finds that exceptional circumstances such as prolonged illness, disability or other similar circumstances have prevented a physician from meeting the requirements.
The board shall, on a random basis, verify the accuracy of proof submitted by physicians under sub. (1) (a)
and may, at any time during the 2 calendar years specified in sub. (1) (a)
, require a physician to submit proof of any continuing education, professional development, and maintenance of certification or performance improvement or continuing medical education programs or courses of study that he or she has attended and completed at that time during the 2 calendar years.
Each person licensed as a perfusionist shall, in each 2nd year at the time of application for a certificate of registration under s. 448.07
, submit proof of completion of continuing education requirements promulgated by rule by the board.
Each person licensed as an anesthesiologist assistant shall, in each 2nd year at the time of application for a certificate of registration under s. 448.07
, submit proof of meeting the criteria for recertification by the National Commission on Certification of Anesthesiologist Assistants or by a successor entity, including any continuing education requirements.
See also Med
, Wis. adm. code.
Annually, no later than March 1, the board shall submit to the chief clerk of each house of the legislature for distribution to the appropriate standing committees under s. 13.172 (3)
a report that identifies the average length of time to process a disciplinary case against a physician during the preceding year and the number of disciplinary cases involving physicians pending before the board on December 31 of the preceding year.
History: 1997 a. 311
Council on physician assistants; duties. 448.20(1)
Recommend licensing and practice standards.
The council on physician assistants shall develop and recommend to the examining board licensing and practice standards for physician assistants practicing under physicians and shall develop and recommend to the podiatry affiliated credentialing board practice standards for physician assistants practicing under podiatrists. In developing the standards, the council shall consider the following factors: an individual's training, wherever given; experience, however acquired, including experience obtained in a hospital, a physician's or podiatrist's office, the armed services or the federal health service of the United States, or their equivalent as found by the examining board; and education, including that offered by a medical school and the technical college system board.
(2) Advise board of regents.
The council shall advise and cooperate with the board of regents of the University of Wisconsin System in establishing an educational program for physician assistants on the undergraduate level. The council shall suggest criteria for admission requirements, program goals and objectives, curriculum requirements, and criteria for credit for past educational experience or training in health fields.
(3) Advise board.
The council shall advise the board on:
Revising physician assistant licensing and practice standards and on matters pertaining to the education, training and licensing of physician assistants.
Developing criteria for physician assistant training program approval, giving consideration to and encouraging utilization of equivalency and proficiency testing and other mechanisms whereby full credit is given to trainees for past education and experience in health fields.
(3m) Advise podiatry affiliated credentialing board.
The council shall advise the podiatry affiliated credentialing board on revising practice standards for physician assistants practicing podiatry.
(4) Adhere to program objectives.
In formulating standards under this section, the council shall recognize that an objective of this program is to increase the existing pool of health personnel.
Physician assistants. 448.21(1)
No physician assistant may provide medical care, except routine screening, in:
The practice of dentistry or dental hygiene within the meaning of ch. 447
The practice of chiropractic within the meaning of ch. 446
The practice of podiatry, except when the physician assistant is acting under the supervision and direction of a podiatrist, subject to sub. (4)
and the rules promulgated under s. 448.695 (4)
The practice of acupuncture within the meaning of ch. 451
(2) Employee status.
No physician assistant may be self-employed. The employer of a physician assistant shall assume legal responsibility for any medical care, including the practice of podiatry, provided by the physician assistant during the employment. The employer of a physician assistant, if other than a licensed physician or podiatrist, shall provide for and not interfere with supervision of the physician assistant by a licensed physician or podiatrist.
(3) Prescriptive authority.
A physician assistant may issue a prescription order for a drug or device in accordance with guidelines established by a supervising physician or podiatrist and the physician assistant and with rules promulgated by the board. If any conflict exists between the guidelines and the rules, the rules shall control.
(4) Practice of podiatry.
A physician assistant who is acting under the supervision and direction of a podiatrist shall be limited to providing nonsurgical patient services.
Anesthesiologist assistants. 448.22(1)
In this section, “supervision" means the use of the powers of direction and decision to coordinate, direct, and inspect the accomplishments of another, and to oversee the implementation of the anesthesiologist's intentions.
An anesthesiologist assistant may assist an anesthesiologist in the delivery of medical care only under the supervision of an anesthesiologist and only as described in a supervision agreement between the anesthesiologist assistant and an anesthesiologist who represents the anesthesiologist assistant's employer. The supervising anesthesiologist shall be immediately available in the same physical location or facility in which the anesthesiologist assistant assists in the delivery of medical care such that the supervising anesthesiologist is able to intervene if needed.
A supervision agreement under sub. (2)
shall do all of the following:
Define the practice of the anesthesiologist assistant consistent with subs. (2)
, and (5)
An anesthesiologist assistant's practice may not exceed his or her education and training, the scope of practice of the supervising anesthesiologist, and the practice outlined in the anesthesiologist assistant supervision agreement. A medical care task assigned by the supervising anesthesiologist to the anesthesiologist assistant may not be delegated by the anesthesiologist assistant to another person.
An anesthesiologist assistant may assist only the supervising anesthesiologist in the delivery of medical care and may perform only the following medical care tasks as assigned by the supervising anesthesiologist:
Developing and implementing an anesthesia care plan for a patient.
Obtaining a comprehensive patient history and performing relevant elements of a physical exam.
Pretesting and calibrating anesthesia delivery systems and obtaining and interpreting information from the systems and from monitors.
Implementing medically accepted monitoring techniques.
Establishing basic and advanced airway interventions, including intubation of the trachea and performing ventilatory support.
Administering intermittent vasoactive drugs and starting and adjusting vasoactive infusions.
Administering anesthetic drugs, adjuvant drugs, and accessory drugs.
Implementing spinal, epidural, and regional anesthetic procedures.
Administering blood, blood products, and supportive fluids.