See also ch. DHS 127
, Wis. adm. code.
Licensing procedure and requirements. 50.52(1)(1)
No person may be required to obtain licensure as a rural medical center, except that no person may conduct, maintain, operate or permit to be conducted, maintained or operated health care services as a rural medical center unless the rural medical center is licensed by the department.
The department shall issue a provisional license or a regular license as a rural medical center to an applicant if all of the following are first done:
The applicant pays the appropriate license fee, as established under s. 50.51 (2) (c)
. Fees collected under this paragraph shall be credited to the appropriation under s. 20.435 (6) (jm)
for licensing and inspection activities.
Except as provided in par. (c)
, the department inspects the health care services provided by the applying rural medical center and finds that the applicant is fit and qualified and meets the requirements and standards of this subchapter and the rules promulgated under this subchapter.
In lieu of conducting the inspection under par. (b)
, the department accepts evidence that an applicant meets one of the following requirements:
Has applicable current, valid state licensure or approval as a hospital, a nursing home, a hospice or a home health agency.
Has an applicable, current agreement to participate as an eligible provider in medicare.
Satisfies qualifications that are specified by the department by rule.
Each license shall bear the name of the owner of the rural medical center, the name and address of the rural medical center and the health care services that the department licenses the rural medical center to provide.
A regular license issued to a rural medical center is valid until it is suspended or revoked. A provisional license issued to a rural medical center is valid for 6 months from the date of issuance.
Each license shall be issued only for the rural medical center and owner that are named in the license application and may not be transferred or assigned.
History: 1995 a. 98
; 1997 a. 27
Inspections and investigations. 50.53(1)(1)
The department may conduct unannounced inspections or investigations of a rural medical center as the department considers necessary.
A rural medical center that is inspected or investigated under this section shall provide the department with access to patient health care records, regardless of the source of patient health care payment, to fulfill the purpose of any inspections or investigations that the department conducts.
History: 1995 a. 98 50.535
Every 24 months, on a schedule determined by the department, a licensed rural medical center shall submit a biennial report in the form and containing the information that the department requires, including payment of the fee required under s. 50.51 (2) (c)
. If a complete annual report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
History: 1997 a. 27
An entity that is not licensed as a rural medical center under this subchapter may not designate itself as a “rural medical center" or use the phrase “rural medical center" to represent or tend to represent the entity as a rural medical center or services provided by the entity as health care services provided by a rural medical center.
No person may do any of the following:
Intentionally prevent, interfere with or impede an investigation by the department of an alleged violation or enforcement by the department of a requirement of this subchapter or the rules promulgated under this subchapter.
Intentionally retaliate or discriminate against a patient or rural medical center employee for doing any of the following:
Initiating, participating in or testifying in an action to enforce any provision of this subchapter or rules promulgated under this subchapter.
Intentionally destroy or modify the original report of an inspection that the department conducts under this subchapter or the rules promulgated under this subchapter.
History: 1995 a. 98 50.55
Penalties and remedies. 50.55(1)(a)(a)
Any person who violates this subchapter or any rule promulgated under this subchapter, except s. 50.54 (2)
, may be required to forfeit not less than $100 nor more than $500 for each offense. Each day of continued violation constitutes a separate offense.
In determining whether a forfeiture is to be imposed and in fixing the amount of the forfeiture to be imposed, if any, for a violation, the department shall consider all of the following factors:
Any previous violations committed by the licensee.
The financial benefit to the rural medical center of committing or continuing to commit the violation.
The department may directly assess forfeitures provided for under par. (a)
. If the department determines that a forfeiture should be assessed for a particular violation or for failure to correct it, the department shall send a notice of assessment to the rural medical center. The notice shall specify the amount of the forfeiture assessed, the violation, and the statute or rule alleged to have been violated, and shall inform the licensee of the right to a hearing under par. (d)
A rural medical center may contest an assessment of forfeiture by sending, within 10 days after receipt of notice under par. (c)
, a written request for hearing under s. 227.44
to the division of hearings and appeals under s. 15.103 (1)
. The division shall commence the hearing within 30 days after receipt of the request for hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings before the division are governed by ch. 227
All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under par. (d)
, within 10 days after receipt of the final decision, unless the final decision is appealed and the decision is in favor of the appellant. The department shall remit all forfeitures paid to the secretary of administration for deposit in the school fund.
(2) Other penalty.
Whoever violates s. 50.54 (2)
may be fined not more than $1,000 or imprisoned for not more than 6 months or both.
The department may, upon the advice of the attorney general, who shall represent the department in all proceedings under this subsection, institute an action in the name of the state in the circuit court for Dane County for injunctive relief or other process against any licensee, owner, operator, administrator or representative of any owner of a rural medical center for the violation of any of the provisions of this subchapter or rules promulgated under this subchapter if the department determines that the violation seriously affects the care, treatment, health, safety, rights, welfare or comfort of patients.
History: 1995 a. 98
; 2003 a. 33
Any of the following facilities or entities is not required to obtain licensure or a certificate of approval under the following statutes or to pay license fees under the following statutes if all of the services of the facility or entity are provided as a part of a rural medical center that holds a valid license under this subchapter:
may not be construed to apply to limit the authority of the department to develop, establish or enforce any statutes and rules for the care, treatment, health, safety, rights, welfare and comfort of patients or residents of facilities or entities that are specified in sub. (1) (a)
and for the construction, general hygiene, maintenance or operation of those facilities or entities.
Notwithstanding sub. (2)
, insofar as a conflict exists between this subchapter, or the rules promulgated under this subchapter, and subch. I
, or the rules promulgated under subch. I
, the provisions of this subchapter and the rules promulgated under this subchapter control.
This subchapter may not be construed to limit a health care service that is included in a rural medical center from any tax-exempt financing or reimbursement, insurance, payment for services or other advantage for which a health care service that is not included in a rural medical center is eligible.
Fees permitted for a workshop or seminar.
If the department develops and provides a workshop or seminar relating to the provision of services by rural medical centers under this subchapter, the department may establish a fee for each workshop or seminar and impose the fee on registrants for the workshop or seminar. A fee so established and imposed shall be in an amount sufficient to reimburse the department for the costs directly associated with developing and providing the workshop or seminar.
History: 1997 a. 27
In this subchapter:
“Interventional pain medicine" means the branch of medicine and surgery devoted to the diagnosis and treatment of pain syndromes through the use of invasive techniques.
“Pain clinic" means any of the following:
A privately owned facility where a majority of the health care providers, practicing within the scope of their licenses, devotes a majority of their practices to the treatment of pain syndromes through the practice of pain medicine or interventional pain medicine.
A privately owned facility that advertises or otherwise holds itself out as providing pain medicine or interventional pain medicine services and that has one or more employees or contractors who prescribe opioids or opiates, benzodiazepines, barbiturates, or carisoprodol as chronic therapy for pain syndromes.
“Pain medicine" means the branch of medicine devoted to the diagnosis and treatment of pain syndromes through treatments, including prescription of a monitored prescription drug, as defined in s. 961.385 (1) (ag)
“Pain syndrome" means any of the following:
Pain that is reasonably anticipated to persist, or has persisted, beyond the time frame for normal healing.
Pain that is reasonably anticipated to persist, or has persisted, for more than 3 months.
History: 2015 a. 265
Pain clinics. 50.65(1)(a)(a)
Except as provided under par. (g)
, no pain clinic may operate unless it holds a certificate to operate issued by the department.
A pain clinic shall submit to the department an application, on a form prescribed by the department, for a certificate. A business entity that owns more than one pain clinic may apply for a single certificate for all pain clinics it owns, but the business entity assuming responsibility for the pain clinics shall submit with the application a listing of each pain clinic site, the number of days each week each pain clinic site operates, and the health care providers who are working on each day of operation at each site. The department may charge an applicant a fee for applying for a certificate.
A certified pain clinic that undergoes a change of majority ownership shall submit a new application for a certificate.
A pain clinic shall have a medical director who is a physician that practices in this state. In the event that the medical director no longer meets the requirements of holding the position of medical director, the pain clinic shall notify the department within 10 business days of the identity of a physician who meets the requirements of medical director and who acts as medical director at that pain clinic. Failure to notify the department of an acting medical director within 10 days of the departure of the previous medical director may be a basis for the department to suspend the pain clinic's certification.
The department shall issue a certificate of operation to a pain clinic if the department finds that the pain clinic meets the requirements of this section, has paid any application fee required by the department, and meets any requirements established by the department. The department may not issue a certificate of operation to a pain clinic if the owner has been convicted of a felony or found guilty of a misdemeanor related to the distribution of an illegal prescription drug or controlled substance.
Subject to sub. (2)
, a certificate issued under this subsection is valid for 3 years and may be renewed.
A pain clinic at which health care providers do not regularly prescribe monitored prescription drugs, as defined in s. 961.385 (1) (ag)
, to a patient for more than 90 days in a 12-month period is not required to obtain a certificate to operate under this subsection.
If the department finds that a pain clinic which was issued a certificate under this section no longer meets any requirement of this section or rules promulgated under this section or of requirements established by the department, the department may do any of the following:
Suspend the certificate of the pain clinic until the department determines that the pain clinic demonstrates compliance.
Impose a forfeiture of up to $1,000 per day for each day of continued violation.
A pain clinic subject to a penalty under par. (a)
is entitled to an appeal and a hearing under ch. 227
In this subsection, “traceable" means capable of allowing a person to ascertain, retain, and verify personally identifiable information, including, at a minimum, the first and last name, home address, and date of birth, of a payer in connection with a payment.
A pain clinic may only accept payment by insurance coverage, credit, a credit card, a check, a draft, or another form of payment that is traceable to the individual seeking treatment at the pain clinic and shall retain records of payment. An individual seeking treatment for which a claim is submitted to an insurance company may pay to the pain clinic any insurance copayment, coinsurance, or deductible with cash or another payment method that is not traceable.
(4) Direct dispensing.
A pain clinic may not directly dispense, as defined in s. 450.01 (7)
, a monitored prescription drug, as defined in s. 961.385 (1) (ag)
, that is administered orally, unless any of the following are true: