SB315: Bill Text

LRB-3958/1

DAK:kaf:lp

1997 - 1998 LEGISLATURE

1997 Senate BILL 315

October 8, 1997 - Introduced by Joint Legislative Council. Referred to Committee on Health, Human Services, Aging, Corrections, Veterans and Military Affairs.

SB315,2,3 An Act to repeal 15.737, 20.145 (8) (title), 20.145 (8) (hj), (kx) and (mr), 153.01 (3), (4m), (6) and (9), 153.05 (1) (a) to (e), 153.05 (2), 153.05 (4), 153.05 (5) (a) and (bm), 153.05 (7), 153.05 (11), 153.07 (2), 153.08 (2) (b), 153.10 (1) (a) and (b) and (2), 153.15, 153.25, 153.30, 153.35, 153.40, 153.60 (2), 153.75 (1) (c), (d), (e), (i) and (j), 153.75 (2) (b), 230.08 (2) (ym) and 601.429; to renumber and amend 15.735 (2), 20.145 (8) (hg), 20.145 (8) (hi), 153.05 (1) (intro.) and 153.10 (1) (intro.); to consolidate, renumber and amend 153.05 (5) (intro.) and (b) and 153.08 (2) (intro.) and (a); to amend 15.01 (6), 15.02 (3) (c) 2., 15.107 (7) (b) to (d), 16.03 (1), 16.03 (3), 20.145 (1) (g), 40.03 (6) (j), 153.05 (3), 153.05 (6), 153.05 (6m), 153.05 (8), 153.05 (9), 153.05 (12), 153.07 (1), 153.07 (3), 153.20 (1) and (2), 153.45 (1) (intro.), (a), (b) and (c), (2) and (3), 153.50, 153.60 (title), 153.60 (1), 153.65, 153.75 (1) (intro.), (b), (f), (k) and (L), 153.75 (2) (intro.) and (c), 153.90 (1) and (2) and 153.90 (3); and to create 15.07 (1) (b) 21., 15.107 (7) (g), 15.194, 153.01 (4d), (4h), (4p) and (4t), 153.05 (6r), 153.07 (4), 153.21, 153.45 (4), 153.45 (5), 153.60 (3), 153.75 (1) (m), (n), (o), (p), (q), (r) and (s), 153.75 (2) (d) and 943.30 (5) of the statutes; relating to: eliminating the office of health care information and transferring functions related to collection, analysis and dissemination of health care information to the department of health and family services, confidentiality of patient health care records, granting rule-making authority, providing a penalty and making appropriations.

Analysis by the Legislative Reference Bureau

This bill is explained in the Notes provided by the joint legislative council in the bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

Prefatory note: This bill was prepared for the joint legislative council's special committee on health care information.

Current law creates an office of health care information (OHCI) in the office of the commissioner of insurance. OHCI is given specific powers and duties relating to the collection, analysis and dissemination of health care information under ch. 153 of the statutes. In addition, current law creates a board on health care information, which advises the director of OHCI and approves all rules that the commissioner of insurance promulgates with respect to OHCI and ch. 153. Current law also creates an interagency coordinating council with members representing several state agencies that are involved in collection, analysis and dissemination of health care information.

This bill eliminates OHCI and transfers many of its powers and duties to the department of health and family services (DHFS). These functions would be undertaken by a bureau of health care information in the division with primary responsibility for health issues in DHFS. The bill requires the bureau to coordinate its activities with persons in that division with responsibility for medical assistance administration and collection and analysis of health statistics.

The bill also transfers the board on health care information to DHFS and adds a requirement that appointees to the board are subject to confirmation by the senate. To reflect the transfer of functions, the membership of the interagency coordinating council is changed to add a representative from DHFS. In addition, the bill requires the interagency coordinating council to establish methods and criteria for analyzing and comparing complaints filed against health care plans and grievances filed with health maintenance organizations.

The bill deletes from the statutes the specific sources of health care information collected for purposes of ch. 153 and the specific reports OHCI is required to prepare periodically, except the annual report on uncompensated health care services provided by hospitals. These provisions are replaced by provisions requiring DHFS to specify by rule the standard reports that it will issue and the uniform data set of health care information to be collected and other details relating to collecting, using and disseminating data. As with other rules under ch. 153, these rules would have to be approved by the board on health care information.

In addition to the report on uncompensated health care services, which is retained from current law, the bill requires DHFS to prepare an annual consumer guide to assist consumers in selecting health care providers and health care plans. The bill also requires DHFS to prepare a report on the feasibility of requiring annual reports and plans on uncompensated health care services (i.e., charity care and bad debt services) from major health care providers other than hospitals, which are already required to prepare these reports and plans.

The bill also requires DHFS to study a voluntary system of health plan reporting and allows DHFS, based on the results of the study, to develop and implement such a system.

The bill modifies the current law on assessments on hospitals and ambulatory surgery centers to fund activities under ch. 153 by instead allowing assessments on health care providers who are in a class of health providers from whom DHFS collects claims data and other health care data under ch. 153. The classes of health care providers from whom claims data and other health care data is collected and the methods and criteria for assessing those health care providers would be specified by DHFS by rule.

The bill repeals the required approval of the board on health care information for contracts under ch. 153. In addition, the bill requires the board and DHFS to jointly: (1) develop rules under ch. 153; (2) provide oversight on standard reports; (3) develop the overall strategy and direction for implementation of ch. 153; and (4) provide information on their activities to the interagency coordinating council.

In preparing this bill in final form, the legislative reference bureau deleted a statement of legislative purpose and incorporated it, in large part, into a provision that cross-references the statement. The statement adopted by the special committee was as follows:

153.03 Legislative purpose. The availability of health care information is critical in a competitive health care market. Consumers and purchasers need information to make informed decisions in selecting health care plans and health care providers. Health care providers need information to provide health care that is both effective and economically efficient. The purpose of this chapter is to grant the department the authority and responsibility of collecting and disseminating health care information in a manner to meet those needs.

Current law requires that before a hospital increases its rates by more than the increase in the consumer price index, it must publish a notice and hold a public hearing. The bill eliminates the requirement that a public hearing be held. In addition, the bill requires that the notice be published in the area where the hospital is located and eliminates the alternative of publishing the notice in the official state newspaper.

The bill prohibits DHFS from releasing any health care information that is subject to the department's rules on review and verification until those rules have been complied with. Whoever intentionally violates this prohibition may be fined not more than $10,000, imprisoned for not more than 9 months, or both.

The bill creates a new crime in the criminal extortion statute, relating to using or threatening to use patient health care records for purposes of extortion or to compel a person to do an act against his or her will. A violator is subject to a Class D felony, punishable by a fine not to exceed $10,000, imprisonment not to exceed 5 years, or both.

SB315, s. 1 Section 1. 15.01 (6) of the statutes is amended to read:

SB315,4,5 15.01 (6) "Division," "bureau," "section" and "unit" means mean the subunits of a department or an independent agency, whether specifically created by law or created by the head of the department or the independent agency for the more economic and efficient administration and operation of the programs assigned to the department or independent agency. The office of justice assistance in the department of administration and the office of credit unions in the department of financial institutions have the meaning of "division" under this subsection. The office of health care information in the office of the commissioner of insurance, the office of the long-term care ombudsman under the board on aging and long-term care and the office of educational accountability in the department of education have the meaning of "bureau" under this subsection.

SB315, s. 2 Section 2. 15.02 (3) (c) 2. of the statutes is amended to read:

SB315,4,12 15.02 (3) (c) 2. The principal subunit of the division is the "bureau". Each bureau shall be headed by a "director". The office of health care information in the office of the commissioner of insurance, the office of the long-term care ombudsman under the board on aging and long-term care and the office of educational accountability in the department of education have the meaning of "bureau" under this subdivision.

SB315, s. 3 Section 3. 15.07 (1) (b) 21. of the statutes is created to read:

SB315,4,14 15.07 (1) (b) 21. Board on health care information.

SB315, s. 4 Section 4. 15.107 (7) (b) to (d) of the statutes are amended to read:

SB315,4,17 15.107 (7) (b) A representative of the unit in the department of health and social family services that deals with health statistics.

SB315,4,19 (c) A representative of the unit in the department of health and social family services that deals with the medical assistance program.

SB315,4,21 (d) A representative of the unit in the office of the commissioner of insurance that deals with health care information.

SB315, s. 5 Section 5. 15.107 (7) (g) of the statutes is created to read:

SB315,4,24 15.107 (7) (g) A representative of the bureau of health care information in the department of health and family services.

SB315, s. 6 Section 6. 15.194 of the statutes is created to read:

SB315,5,3 15.194 Same; specified bureaus. (1) There is created in the division within the department of health and family services that has primary responsibility for health issues a bureau of health care information.

SB315, s. 7 Section 7. 15.735 (2) of the statutes is renumbered 15.195 (6) and amended to read:

SB315,5,10 15.195 (6) Board on health care information. There is created a board on health care information which is attached to the office of the commissioner of insurance department of health and family services under s. 15.03. The board shall consist of 9 members, a majority of whom may neither be nor represent health care providers, appointed for 4-year terms.

SB315, s. 8 Section 8. 15.737 of the statutes is repealed.

SB315, s. 9 Section 9. 16.03 (1) of the statutes is amended to read:

SB315,6,2 16.03 (1) General functions. The interagency coordinating council shall serve as a means of increasing the efficiency and utility and facilitating the effective functioning of state agencies in activities related to health care data collection. The interagency coordinating council shall advise and assist state agencies in the coordination of health care data collection programs and the exchange of information related to health care data collection and dissemination, including agency budgets for health care data collection programs, health care data monitoring and management, public information and education, health care data analysis and facilities, research activities and the appropriation and allocation of state funds for health care data collection. The interagency coordinating council shall establish methods and criteria for analyzing and comparing complaints filed against health care plans, as defined under s. 628.36 (2) (a) 1., and grievances filed with health maintenance organizations, as defined under s. 609.01 (2), without requiring the collection of information in addition to the information already collected by state agencies.

SB315, s. 10 Section 10. 16.03 (3) of the statutes is amended to read:

SB315,6,7 16.03 (3) Report. The interagency coordinating council shall report at least twice annually to the board on health care information in the office of the commissioner of insurance department of health and family services, concerning the council's activities under this section.

SB315, s. 11 Section 11. 20.145 (1) (g) of the statutes is amended to read:

SB315,6,13 20.145 (1) (g) General program operations. The amounts in the schedule for general program operations and for funding the activities of the office of health care information under s. 153.05 (8) the commissioner of insurance. Ninety percent of all moneys received under ss. 601.31, 601.32, 601.45 and 601.47 shall be credited to this appropriation.

SB315, s. 12 Section 12. 20.145 (8) (title) of the statutes is repealed.

SB315, s. 13 Section 13. 20.145 (8) (hg) of the statutes is renumbered 20.435 (1) (hg) and amended to read:

SB315,6,21 20.435 (1) (hg) (title) General program operations; office of health care information. The amounts in the schedule to fund the activities of the office of health care information department of health and family services and the board on health care information under ch. 153. The contract fees paid under s. 153.05 (6m) and assessments paid under s. 153.60 shall be credited to this appropriation account.

SB315, s. 14 Section 14. 20.145 (8) (hi) of the statutes is renumbered 20.435 (1) (hi), and 20.435 (1) (hi) (title), as renumbered, is amended to read:

SB315,6,25 20.435 (1) (hi) (title) Compilations and special reports; office of health care information.

SB315, s. 15 Section 15. 20.145 (8) (hj), (kx) and (mr) of the statutes are repealed.

SB315, s. 16 Section 16. 40.03 (6) (j) of the statutes is amended to read:

SB315,7,7 40.03 (6) (j) May contract with the office of health care information in the office of the commissioner of insurance department of health and family services and may contract with other public or private entities for data collection and analysis services related to health maintenance organizations and insurance companies that provide health insurance to state employes.

SB315, s. 17 Section 17. 153.01 (3), (4m), (6) and (9) of the statutes are repealed.

SB315, s. 18 Section 18. 153.01 (4d), (4h), (4p) and (4t) of the statutes are created to read:

SB315,7,10 153.01 (4d) "Department" means the department of health and family services.