AB552-ASA1,2,3
1An Act to repeal 153.01 (3) and (9), 153.05 (1) (a) to (e), 153.05 (2), 153.05 (4),
2153.05 (5) (a) and (bm), 153.05 (7), 153.05 (11), 153.07 (2), 153.08 (2) (b), 153.10
3(1) (a) and (b), 153.10 (2), 153.15, 153.25, 153.30, 153.35, 153.40, 153.60 (2),
4153.75 (1) (c), (d), (e), (i) and (j) and 153.75 (2) (b);
to renumber and amend
5153.05 (1) (intro.) and 153.10 (1) (intro.);
to consolidate, renumber and
6amend 153.05 (5) (intro.) and (b) and 153.08 (2) (intro.) and (a);
to amend 16.03
7(1), 20.435 (1) (hg), 153.05 (3), 153.05 (6), 153.05 (6m), 153.05 (8), 153.05 (9),
8153.07 (1), 153.20, 153.45 (1) (intro.), 153.45 (1) (a), 153.45 (1) (b), 153.45 (1) (c),
9153.45 (3), 153.50, 153.60 (1), 153.65, 153.75 (1) (b), 153.75 (1) (f), (k) and (L),
10153.75 (2) (intro.) and 153.90 (1) and (2); and
to create 15.07 (1) (b) 21., 15.107
11(7) (g), 15.194, 153.01 (4d), (4h), (4p) and (4t), 153.05 (6r), 153.07 (4), 153.21,
12153.45 (4), 153.45 (5), 153.60 (3), 153.75 (1) (m), (n), (o), (p), (q), (r) and (s),
13153.75 (2) (d) and 943.30 (5) of the statutes;
relating to: collection, analysis and
1dissemination of health care information by the department of health and
2family services, confidentiality of patient health care records, granting
3rule-making authority, providing a penalty and making an appropriation.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB552-ASA1, s. 1
4Section
1. 15.07 (1) (b) 21. of the statutes is created to read:
AB552-ASA1,2,55
15.07
(1) (b) 21. Board on health care information.
AB552-ASA1,2,77
15.107
(7) (g) A representative of the office of the commissioner of insurance.
AB552-ASA1,2,11
915.194 Same; specified bureaus. (1)
Bureau of health care information. 10There is created in the division within the department of health and family services
11that has primary responsibility for health issues a bureau of health care information.
AB552-ASA1,3,413
16.03
(1) General functions. The interagency coordinating council shall serve
14as a means of increasing the efficiency and utility and facilitating the effective
15functioning of state agencies in activities related to health care data collection. The
16interagency coordinating council shall advise and assist state agencies in the
17coordination of health care data collection programs and the exchange of information
18related to health care data collection and dissemination, including agency budgets
19for health care data collection programs, health care data monitoring and
20management, public information and education, health care data analysis and
21facilities, research activities and the appropriation and allocation of state funds for
22health care data collection.
The interagency coordinating council shall establish
23methods and criteria for analyzing and comparing complaints filed against health
1care plans, as defined under s. 628.36 (2) (a) 1., and grievances filed with health
2maintenance organizations, as defined under s. 609.01 (2), without requiring the
3collection of information in addition to the information already collected by state
4agencies.
AB552-ASA1,3,117
20.435
(1) (hg)
General program operations; health care information. The
8amounts in the schedule to fund the activities of the department of health and family
9services and the board on health care information under ch. 153. The
contract fees
10paid under s. 153.05 (6m) and assessments paid under s. 153.60 shall be credited to
11this appropriation account.
AB552-ASA1, s. 7
13Section
7. 153.01 (4d), (4h), (4p) and (4t) of the statutes are created to read:
AB552-ASA1,3,1414
153.01
(4d) "Department" means the department of health and family services.
AB552-ASA1,3,16
15(4h) "Employer coalition" means an organization of employers formed for the
16purpose of purchasing health care coverage or services as a group.
AB552-ASA1,3,18
17(4p) "Health care plan" means an insured or self-insured plan providing
18coverage of health care expenses or an employer coalition.
AB552-ASA1,3,20
19(4t) "Health care provider" has the meaning given in s. 146.81 (1) and includes
20an ambulatory surgery center.
AB552-ASA1, s. 8
21Section
8. 153.05 (1) (intro.) of the statutes is renumbered 153.05 (1) and
22amended to read:
AB552-ASA1,4,823
153.05
(1) In order to provide to hospitals, health care providers, insurers,
24consumers, governmental agencies and others information concerning
hospital
25service utilization, charges, revenues, expenditures, mortality and morbidity rates
1health care providers and uncompensated health care services, and in order to
2provide information to assist in peer review for the purpose of quality assurance, the
3office department shall collect, analyze and disseminate
health care information, in
4language that is understandable to lay persons
, health care information obtained
5from the following data sources:. This chapter shall be administered by a bureau of
6health care information. The bureau of health care information shall coordinate its
7activities with persons with responsibility for medical assistance administration and
8collection and analysis of health statistics.
AB552-ASA1,4,1715
153.05
(3) Upon request of the department, state agencies shall provide health
16care information to the department for use in preparing reports under
ss. 153.10 to
17153.35 this chapter.
AB552-ASA1,5,222
153.05
(5) The department
: (b) May
may require
hospitals health care
23providers to submit to the department information
from sources identified under
24sub. (1) (a) to (e) that the department deems necessary for the preparation of reports,
1plans and recommendations
under ss. 153.10 to 153.35 and any other reports
2required of the department in the form specified by the department
by rule.
AB552-ASA1,5,117
153.05
(6) If the requirements of s. 153.07 (2) are first met, the The department
8may contract with a public or private entity that is not a major purchaser, payer or
9provider of health care services in this state for the provision of data processing
10services for the collection, analysis and dissemination of health care information
11under sub. (1)
or the department shall provide the services under s. 153.07 (2).
AB552-ASA1,5,2014
153.05
(6m) If the requirements of s. 153.07 (2) are first met, the The 15department may contract with the group insurance board for the provision of data
16collection and analysis services related to health maintenance organizations and
17insurance companies that provide health insurance for state employes
or the
18department shall provide the services under s. 153.07 (2). The department shall
19establish contract fees for the provision of the services. All moneys collected under
20this subsection shall be credited to the appropriation under s. 20.435 (1)
(kx) (hg).
AB552-ASA1,6,822
153.05
(6r) The department shall study and, based on the results of the study,
23may develop and implement a voluntary system of health care plan reporting that
24enables purchasers and consumers to assess the performance of health care plans
25and the health care providers that are employed or reimbursed by the health care
1plans. The department shall undertake the study and any development and
2implementation in cooperation with private health care purchasers, the board, the
3department of employe trust funds, the office of the commissioner of insurance, the
4interagency coordinating council created under s. 15.107 (7), major associations of
5health care providers, health care plans and consumers. If implemented, the
6department shall operate the system in a manner so as to enable purchasers,
7consumers, the public, the governor and legislators to assess the performance of
8health care plans and health care providers.
AB552-ASA1, s. 18
9Section
18. 153.05 (7) of the statutes, as affected by 1997 Wisconsin Act, is
10repealed.
AB552-ASA1,6,2313
153.05
(8) Beginning April 1, 1992, the The department shall collect, analyze
14and disseminate, in language that is understandable to lay persons,
health care
15claims information
and other health care information under the provisions of this
16chapter, as determined by rules promulgated by the department, from health care
17providers
, as defined specified by rules promulgated by the department
, other than
18hospitals and ambulatory surgery centers. Data from
physicians shall health care
19providers may be obtained through sampling techniques in lieu of collection of data
20on all patient encounters and data collection procedures shall minimize unnecessary
21duplication and administrative burdens.
If the department collects health care
22provider-specific data from health care plans, the department shall attempt to avoid
23collecting the same data from health care providers.
AB552-ASA1,7,4
1153.05
(9) The department shall provide orientation and training to
2physicians, hospital personnel and other health care providers
who submit data
3under this chapter to explain the process of data collection and analysis and the
4procedures for data verification, interpretation and release.
AB552-ASA1,7,119
153.07
(1) The board shall advise the
director of the department with regard
10to the collection, analysis and dissemination of health care information required by
11this chapter.
AB552-ASA1,7,1515
153.07
(4) The board and the department shall jointly do all of the following:
AB552-ASA1,7,1616
(a) Develop the rules that are required or authorized under this chapter.
AB552-ASA1,7,1817
(b) Provide oversight on the standard reports under this chapter, including the
18reports under ss. 153.20 and 153.21.
AB552-ASA1,7,2019
(c) Develop the overall strategy and direction for implementation of this
20chapter.
AB552-ASA1,7,2221
(d) Provide information on their activities to the interagency coordinating
22council created under s. 15.107 (7).
AB552-ASA1, s. 25
23Section
25. 153.08 (2) (intro.) and (a) of the statutes are consolidated,
24renumbered 153.08 (2) and amended to read:
AB552-ASA1,8,8
1153.08
(2) No hospital may increase its rates or charge any payer an amount
2exceeding its rates that are in effect on May 12, 1992, unless the hospital first
does
3all of the following: (a) Causes causes to be published a class 1 notice under ch. 985
4in the official newspaper designated under s. 985.04 or 985.05 or in a newspaper
5likely to give notice in the area where the hospital is located, no sooner than 45 days
6and no later than 30 days before the proposed rate change is to take effect. The notice
7shall describe the proposed rate change
and the time and place for the public hearing
8required under sub. (2).
AB552-ASA1,8,19
13153.10 Health care data reports. Beginning in 1990 and quarterly
14thereafter, the The department shall prepare
, and submit to the governor and the
15chief clerk of each house of the legislature for distribution to the legislature under
16s. 13.172 (2),
in a manner that permits comparisons among hospitals, a report setting
17forth all of the following for every hospital for the preceding quarter: standard
18reports that the department prepares and shall collect information necessary for
19preparation of those reports.
AB552-ASA1,9,11
3153.20 Uncompensated health care services report. (1) Beginning in
41990 and annually thereafter, the The department shall prepare
, and submit to the
5governor and to the chief clerk of each house of the legislature for distribution to the
6legislature under s. 13.172 (2)
a, an annual report setting forth the number of
7patients to whom uncompensated health care services were provided by each
8hospital and the total charges for the uncompensated health care services provided
9to the patients for the preceding year, together with the number of patients and the
10total charges that were projected by the hospital for that year in the plan filed under
11sub. (2).
AB552-ASA1,9,16
12(2) Beginning in 1990 and annually thereafter, every Every hospital shall file
13with the department
a an annual plan setting forth the projected number of patients
14to whom uncompensated health care services will be provided by the hospital and the
15projected total charges for the uncompensated health care services to be provided to
16the patients for the ensuing year.
AB552-ASA1,9,23
18153.21 Consumer guide. The department shall prepare and submit to the
19governor and to the chief clerk of each house of the legislature for distribution to the
20legislature under s. 13.172 (2) an annual guide to assist consumers in selecting
21health care providers and health care plans. The guide shall be written in language
22that is understandable to lay persons. The department shall widely publicize and
23distribute the guide to consumers.
AB552-ASA1,10,119
153.45
(1) (intro.) After completion of data verification and review procedures
10under s. 153.40 specified by the department by rule, the department shall release
11data in the following forms:
AB552-ASA1,10,1313
153.45
(1) (a) Standard reports
in accordance with ss. 153.10 to 153.35.
AB552-ASA1,10,2016
153.45
(1) (b) Public use
tapes data files which do not permit the identification
17of specific patients,
physicians, employers or
other health care providers
, as defined
18by rules promulgated by the department. The identification of these groups shall be
19protected by all necessary means, including the deletion of patient identifiers and the
20use of calculated variables and aggregated variables.
AB552-ASA1,10,2422
153.45
(1) (c) Custom-designed
subfile tapes, other electronic media, special
23data compilations or reports containing portions of the
public use tape data under
24par. (b).
AB552-ASA1,11,63
153.45
(3) The department shall release
physician-specific health care
4provider-specific and employer-specific data, except in public use
tapes data files as
5specified under sub. (1) (b), in a manner that is specified in rules promulgated by the
6department.
AB552-ASA1,11,98
153.45
(4) The department shall prohibit purchasers of data from rereleasing
9individual data elements of health care data files.
AB552-ASA1,11,1511
153.45
(5) The department may not release any health care information that
12is subject to rules promulgated under s. 153.75 (1) (b) until the verification and
13review procedures required under those rules have been complied with. Nothing in
14this subsection prohibits release of health care provider-specific information to the
15health care provider to whom the information relates.
AB552-ASA1,11,25
18153.50 Protection of patient confidentiality. Patient-identifiable data
19obtained under this chapter
and contained in the discharge data base of the
20department is not subject to inspection, copying or receipt under s. 19.35 (1) and may
21not be released
by the department, except to the patient or to a person granted
22permission for release by the patient and except that a
hospital, a physician health
23care provider or the agent of a
hospital or physician health care provider may have
24access to patient-identifiable data to ensure the accuracy of the information in the
25discharge data base.
AB552-ASA1,12,183
153.60
(1) The department shall, by the first October 1 after the
4commencement of each fiscal year, estimate the total amount of expenditures under
5this chapter for the department and the board for that fiscal year
for data collection,
6data base development and maintenance, generation of data files and standard
7reports, orientation and training provided under s. 153.05 (9) and maintaining the
8board. The department shall assess the estimated total amount for that fiscal year
9less the estimated total amount to be received
for purposes of administration of this
10chapter under s. 20.435 (1) (hi) during the fiscal year and the unencumbered balance
11of the amount received
for purposes of administration of this chapter under s. 20.435
12(1) (hi) from the prior fiscal year, to
hospitals in proportion to each hospital's
13respective gross private-pay patient revenues during the hospital's most recently
14concluded entire fiscal year health care providers who are in a class of health care
15providers from whom the department collects data under this chapter in a manner
16specified by the department by rule. Each
hospital health care provider shall pay the
17assessment on or before December 1. All payments of assessments shall be deposited
18in the appropriation under s. 20.435 (1) (hg).
AB552-ASA1,13,722
153.60
(3) The department shall, by the first October 1 after the
23commencement of each fiscal year, estimate the total amount of expenditures
24required for the collection, database development and maintenance and generation
25of public data files and standard reports for health care plans that voluntarily agree
1to supply health care data under s. 153.05 (6r). The department shall assess the
2estimated total amount for that fiscal year to health care plans in a manner specified
3by the department by rule and may enter into an agreement with the office of the
4commissioner of insurance for collection of the assessments. Each health plan that
5voluntarily agrees to supply this information shall pay the assessments on or before
6December 1. All payments of assessments shall be deposited in the appropriation
7under s. 20.435 (1) (hg) and may be used solely for the purposes of s. 153.05 (6r).