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(d) This subsection does not apply after December 30, 2000.
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23Section
3. 146.36 of the statutes is created to read:
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24146.36 Council on health care fraud and abuse. (1) In this section:
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(a) "Agency" has the meaning given in s. 13.62 (2).
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1(b) "Council" means the council on health care fraud and abuse.
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(c) "Health care provider" has the meaning given in s. 146.81 (1).
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(d) "Insurer" means an insurer, as defined in s. 600.03 (27), that is authorized
4to do business in this state in one or more lines of insurance that includes health in
5surance.
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6(2) The council may do all of the following:
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(a) Study all aspects of health care fraud and abuse, including the making of
8self-interested referrals and billing in excess of reasonable charges.
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(b) Develop strategies to combat health care fraud and abuse by health care
10consumers and health care providers.
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(c) Examine problems that relate to electronic claims for payment.
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(d) Survey efforts of other states to reduce health care fraud and abuse.
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(e) Collect information relevant to preparation of the report specified under
14sub. (3), from health care providers, insurers, employe benefit plan administrators,
15law enforcement agencies and other sources.
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(f) Conduct public hearings concerning health care fraud and abuse.
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(g) Engage in public information programs concerning health care fraud and
18abuse.
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(h) Receive, for deposit in the council's account under s. 20.505 (4) (gm), gifts,
20grants or bequests to fund its operating expenses.
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21(3) Annually, the council shall submit to the governor and, under s. 13.172 (2),
22to the legislature a report that does all of the following:
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(a) Identifies different types of fraud and abuse perpetrated by health care con
24sumers and health care providers, including different methods of billing in excess of
25reasonable charges by health care providers.
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1(b) Analyzes self-interested referrals that are made among health care provid
2ers.
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(c) Lists successful prosecutions of health care fraud and activities to combat
4health care abuse, including billing in excess of reasonable charges, as identified in
5par. (a), that have been conducted in courts in this state or as contested cases under
6subch. III of ch. 227.
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(d) Specifies activities conducted by the council to combat health care fraud and
8abuse, including billing in excess of reasonable charges, as identified in par. (a).
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(e) Recommends specific proposed changes to state statutes or administrative
10rules to define terms and to combat health care fraud and abuse, including self-inter
11ested referrals, as analyzed in par. (b), and billing in excess of reasonable charges,
12as identified in par. (a).
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13(4) A council member shall be immune from civil liability and criminal prosecu
14tion for any act or omission done in good faith within the scope of his or her powers
15and duties under this section.
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16(5) This section does not apply after December 30, 2000.
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17Section
4.
Nonstatutory provisions; administration.
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18(1)
Initial appointments of members of the council on health care fraud
19and abuse. Notwithstanding the length of terms specified in section 15.107 (6) (a)
20of the statutes, as created by this act, the initial members of the council on health care
21fraud and abuse shall be appointed for the following terms:
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22(a) Four members, for terms expiring on July 1, 1997.
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23(b) Four members, for terms expiring on July 1, 1998.
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24(c) Four members, for terms expiring on July 1, 1999.
