SB45-SSA1-SA1,289,23 23947. Page 1158, line 11: after that line insert:
SB45-SSA1-SA1,289,24 24" Section 2251r. 146.84 (3) of the statutes is amended to read:
SB45-SSA1-SA1,290,4
1146.84 (3) Discipline of employes. Any person employed by the state, or any
2political subdivision of the state who violates s. 146.82 or 146.83 , except a health care
3provider that negligently violates s. 153.50 (6) (c),
may be discharged or suspended
4without pay.".
SB45-SSA1-SA1,290,5 5948. Page 1158, line 11: after that line insert:
SB45-SSA1-SA1,290,6 6" Section 2252g. 146.83 (1) (b) of the statutes is amended to read:
SB45-SSA1-SA1,290,107 146.83 (1) (b) Receive a copy of the patient's health care records, whether
8certified or not,
upon payment of reasonable an approximation of actual costs. In this
9paragraph, "approximation of actual costs" means, at a maximum, the fees that are
10prescribed by the department by rule under s. 908.03 (6m) (d).
SB45-SSA1-SA1, s. 2252h 11Section 2252h. 146.83 (3m) of the statutes is created to read:
SB45-SSA1-SA1,290,1612 146.83 (3m) If a health care provider provides a copy of a patient health care
13record after 30 days after receipt of a statement of informed consent for the release
14of the copy, the health care provider, notwithstanding sub. (1) (b) and s. 908.03 (6m)
15(d), may collect as payment no more than 25% of the approximation of actual costs,
16as specified under sub. (1) (b).".
SB45-SSA1-SA1,290,18 17949. Page 1163, line 15: delete the material beginning with that line and
18ending with page 1165, line 8 and substitute:
SB45-SSA1-SA1,290,19 19" Section 2262e. 149.143 (1) (b) (intro.) of the statutes is repealed.
SB45-SSA1-SA1, s. 2262m 20Section 2262m. 149.143 (1) (b) 1. (intro.) of the statutes is repealed.
SB45-SSA1-SA1, s. 2262r 21Section 2262r. 149.143 (1) (b) 1. a. of the statutes is renumbered 149.143 (1)
22(b) and amended to read:
SB45-SSA1-SA1,291,623 149.143 (1) (b) First, Next from premiums from eligible persons with coverage
24under s. 149.14 set, except as reduced under sub. (2m), at 150% of the rate that a

1standard risk would be charged under an individual policy providing substantially
2the same coverage and deductibles as are provided under the plan, including
3amounts received for premium and deductible subsidies under s. 149.144 and under
4the transfer to the fund from the appropriation account
under ss. s. 20.435 (5) (4) (ah)
5and 149.144, and from premiums collected from eligible persons with coverage under
6s. 149.146 set in accordance with s. 149.146 (2) (b).
SB45-SSA1-SA1, s. 2263b 7Section 2263b. 149.143 (1) (b) 1. b. of the statutes is repealed.
SB45-SSA1-SA1, s. 2263e 8Section 2263e. 149.143 (1) (b) 1. c. of the statutes is repealed.
SB45-SSA1-SA1, s. 2263m 9Section 2263m. 149.143 (1) (b) 1. d. of the statutes is repealed.
SB45-SSA1-SA1, s. 2263r 10Section 2263r. 149.143 (1) (b) 2. of the statutes is renumbered 149.143 (1) (c)
11and 149.143 (1) (c) (intro.) and 2., as renumbered, are amended to read:
SB45-SSA1-SA1,291,1212 149.143 (1) (c) (intro.) A total of 40% The remainder as follows:
SB45-SSA1-SA1,291,1413 2. Fifty percent from adjustments to provider payment rates, excluding
14adjustments to those rates under ss. s. 149.144 and 149.15 (3) (e).
SB45-SSA1-SA1, s. 2264b 15Section 2264b. 149.143 (2) (a) 1. of the statutes is repealed.
SB45-SSA1-SA1, s. 2264e 16Section 2264e. 149.143 (2) (a) 2. of the statutes is amended to read:
SB45-SSA1-SA1,291,2217 149.143 (2) (a) 2. After making the determinations under subd. 1., by By rule
18set premium rates for the new plan year, including the rates under s. 149.146 (2) (b),
19in the manner specified in sub. (1) (b) 1. a. and c. and such that a rate for coverage
20under s. 149.14 is not less than 150% nor more than 200% of the rate that a standard
21risk would be charged under an individual policy providing substantially the same
22coverage and deductibles as are provided under the plan
.
SB45-SSA1-SA1, s. 2264m 23Section 2264m. 149.143 (2) (a) 3. of the statutes is amended to read:
SB45-SSA1-SA1,292,224 149.143 (2) (a) 3. By rule set the total insurer assessments under s. 149.13 for
25the new plan year by estimating and setting the assessments at the amount

1necessary to equal the amounts specified in sub. (1) (b) 1. d. and 2. a. (c) 1. and notify
2the commissioner of the amount.
SB45-SSA1-SA1, s. 2264r 3Section 2264r. 149.143 (2) (a) 4. of the statutes is amended to read:
SB45-SSA1-SA1,292,74 149.143 (2) (a) 4. By the same rule as under subd. 3. adjust the provider
5payment rate for the new plan year by estimating and setting the rate at the level
6necessary to equal the amounts specified in sub. (1) (b) 1. d. and 2. b. (c) 2. and as
7provided in s. 149.145.
SB45-SSA1-SA1, s. 2265b 8Section 2265b. 149.143 (2) (b) of the statutes is amended to read:
SB45-SSA1-SA1,292,159 149.143 (2) (b) In setting the premium rates under par. (a) 2., the insurer
10assessment amount under par. (a) 3. and the provider payment rate under par. (a)
114. for the new plan year, the department shall include any increase or decrease
12necessary to reflect the amount, if any, by which the rates and amount and rate set
13under par. (a) for the current plan year differed from the rates and amount and rate
14which would have equaled the amounts specified in sub. (1) (b) (c) in the current plan
15year.".
SB45-SSA1-SA1,292,16 16950. Page 1165, line 15: delete "60% of".
SB45-SSA1-SA1,292,17 17951. Page 1165, line 20: delete "(1) (b) 1." and substitute "(1) (b).".
SB45-SSA1-SA1,292,18 18952. Page 1165, line 21: delete lines 21 to 24.
SB45-SSA1-SA1,292,19 19953. Page 1166, line 1: delete lines 1 to 8 and substitute:
SB45-SSA1-SA1,292,21 20" Section 2267c. 149.143 (3) (a) of the statutes is renumbered 149.143 (3) and
21amended to read:
SB45-SSA1-SA1,293,722 149.143 (3) If, during a plan year, the department determines that the amounts
23estimated to be received as a result of the rates and amount set under sub. (2) (a) 2.
24to 4. and any adjustments in insurer assessments and the provider payment rate

1under s. 149.144 will not be sufficient to cover plan costs, the department may by rule
2increase the premium rates set under sub. (2) (a) 2. for the remainder of the plan year,
3subject to s. 149.146 (2) (b) and the maximum specified in sub. (2) (a) 2., by rule

4increase the assessments set under sub. (2) (a) 3. for the remainder of the plan year,
5subject to sub. (1) (b) 2. a. (c) 1., and by the same rule under which assessments are
6increased adjust the provider payment rate set under sub. (2) (a) 4. for the remainder
7of the plan year, subject to sub. (1) (b) 2. b (c) 2.
SB45-SSA1-SA1, s. 2267g 8Section 2267g. 149.143 (3) (b) of the statutes is repealed.".
SB45-SSA1-SA1,293,9 9954. Page 1166, line 15: delete "sub." and substitute "subs.".
SB45-SSA1-SA1,293,10 10955. Page 1166, line 16: after "(b)" insert "and (2m) (b) 1".
SB45-SSA1-SA1,293,11 11956. Page 1167, line 19: delete "(a) and (b)" and substitute "(a) and (b)".
SB45-SSA1-SA1,293,12 12957. Page 1170, line 11: after that line insert:
SB45-SSA1-SA1,293,13 13" Section 2279m. 153.05 (4n) of the statutes is created to read:
SB45-SSA1-SA1,293,1714 153.05 (4n) The office shall provide the public service commission with
15information necessary for performance of duties of the public service commission
16under subch. II of ch. 196 and as requested of the office by the public service
17commission.".
SB45-SSA1-SA1,293,18 18958. Page 1170, line 18: after that line insert:
SB45-SSA1-SA1,293,20 19" Section 2280b. 153.45 (1) (b) of the statutes is renumbered 153.45 (1) (b) 1.
20and amended to read:
SB45-SSA1-SA1,294,321 153.45 (1) (b) 1. Public For information that is submitted by hospitals or
22ambulatory surgery centers, public
use data files which that do not permit the
23identification of specific patients, employers or health care providers, as defined by
24rules promulgated by the department. The identification of these groups patients,

1employers or health care providers
shall be protected by all necessary means,
2including the deletion of patient identifiers and the use of calculated variables and
3aggregated variables.
SB45-SSA1-SA1, s. 2280c 4Section 2280c. 153.45 (1) (b) 2. of the statutes is created to read:
SB45-SSA1-SA1,294,165 153.45 (1) (b) 2. For information that is submitted by health care providers
6other than hospitals or ambulatory surgery centers, public use data files that do not
7permit the identification of specific patients, employers or health care providers, as
8defined by rules promulgated by the department. The identification of patients,
9employers or health care providers shall be protected by all necessary means,
10including the deletion of patient identifiers; the use of calculated variables and
11aggregated variables; the specification of counties as to residence, rather than zip
12codes; the use of 5-year categories for age, rather than exact age; not releasing
13information concerning a patient's race or ethnicity or dates of admission, discharge,
14procedures or visits; and masking sensitive diagnoses and procedures by use of
15larger diagnostic and procedure categories. Public use data files under this
16subdivision may include only the following:
SB45-SSA1-SA1,294,1717 a. The patient's county of residence.
SB45-SSA1-SA1,294,1818 b. The payment source, by type.
SB45-SSA1-SA1,294,2019 c. The patient's age category, by 5-year intervals up to age 80 and a category
20of 80 years or older.
SB45-SSA1-SA1,294,2121 d. The patient's procedure code.
SB45-SSA1-SA1,294,2222 e. The patient's diagnosis code.
SB45-SSA1-SA1,294,2323 f. Charges assessed with respect to the procedure code.
SB45-SSA1-SA1,294,2524 g. The name and address of the facility in which the patient's services were
25rendered.
SB45-SSA1-SA1,295,1
1h. The patient's sex.
SB45-SSA1-SA1,295,62 i. Information that contains the name of a health care provider that is not a
3hospital or ambulatory surgery center, if the independent review board first reviews
4and approves the release or if the department promulgates rules that specify
5circumstances under which the independent review board need not review and
6approve the release.
SB45-SSA1-SA1,295,97 j. Calendar quarters of service, except if the department specifies by rule that
8the number of data elements included in the public use data file is too small to enable
9protection of patient confidentiality.
SB45-SSA1-SA1,295,1110 k. Information other than patient-identifiable data, as defined in s. 153.50 (1)
11(b), as approved by the independent review board.
SB45-SSA1-SA1, s. 2280e 12Section 2280e. 153.45 (1) (c) of the statutes is renumbered 153.45 (1) (c)
13(intro.) and amended to read:
SB45-SSA1-SA1,295,2514 153.45 (1) (c) (intro.) Custom-designed reports containing portions of the data
15under par. (b). Of information submitted by health care providers that are not
16hospitals or ambulatory surgery centers, requests under this paragraph for data
17elements other than those available for public use data files under par. (b) 2.,
18including the patient's month and year of birth, require review and approval by the
19independent review board before the data elements may be released. Information
20that contains the name of a health care provider that is not a hospital or ambulatory
21surgery center may be released only if the independent review board first reviews
22and approves the release or if the department promulgates rules that specify
23circumstances under which the independent review board need not review and
24approve the release. Reports under this paragraph may include the patient's zip code
25only if at least one of the following applies:
SB45-SSA1-SA1, s. 2280f
1Section 2280f. 153.45 (1) (c) 1. to 4. of the statutes are created to read:
SB45-SSA1-SA1,296,22 153.45 (1) (c) 1. Other potentially identifying data elements are not released.
SB45-SSA1-SA1,296,33 2. Population density is sufficient to mask patient identity.
SB45-SSA1-SA1,296,54 3. Other potentially identifying data elements are grouped to provide
5population density sufficient to protect identity.
SB45-SSA1-SA1,296,66 4. Multiple years of data elements are added to protect identity.
SB45-SSA1-SA1, s. 2280g 7Section 2280g. 153.45 (6) of the statutes is created to read:
SB45-SSA1-SA1,296,118 153.45 (6) The department may not sell or distribute data bases of information,
9from health care providers who are not hospitals or ambulatory surgery centers, that
10are able to be linked with public use data files, unless first approved by the
11independent review board.
SB45-SSA1-SA1, s. 2280ge 12Section 2280ge. 153.50 (1) (a) of the statutes is renumbered 153.01 (2m).
SB45-SSA1-SA1, s. 2280gg 13Section 2280gg. 153.50 (1) (b) of the statutes is renumbered 153.50 (1) (b) 1.,
14and 153.50 (1) (b) 1. (intro.), as renumbered, is amended to read:
SB45-SSA1-SA1,296,1715 153.50 (1) (b) 1. (intro.) "Patient-identifiable data", for information submitted
16by hospitals and ambulatory surgery centers,
means all of the following data
17elements:
SB45-SSA1-SA1, s. 2280gm 18Section 2280gm. 153.50 (1) (b) 2. of the statutes is created to read:
SB45-SSA1-SA1,296,2119 153.50 (1) (b) 2. "Patient-identifiable data", for information submitted by
20health care providers who are not hospitals or ambulatory surgery centers, means
21all of the following data elements:
SB45-SSA1-SA1,296,2222 a. Data elements specified in subd. 1. a. to g., L. and m.
SB45-SSA1-SA1,296,2423 b. Whether the patient's condition is related to employment, and occurrence
24and place of an auto accident or other accident.
SB45-SSA1-SA1,297,2
1c. Date of first symptom of current illness, of current injury or of current
2pregnancy.
SB45-SSA1-SA1,297,33 d. First date of patient's same or similar illness, if any.
SB45-SSA1-SA1,297,54 e. Dates that the patient has been unable to work in his or her current
5occupation.
SB45-SSA1-SA1,297,66 f. Dates of receipt by patient of medical service.
SB45-SSA1-SA1,297,77 g. The patient's city, town or village.
SB45-SSA1-SA1, s. 2280h 8Section 2280h. 153.50 (2) of the statutes is repealed.
SB45-SSA1-SA1, s. 2280i 9Section 2280i. 153.50 (3) (b) 7. of the statutes is created to read:
SB45-SSA1-SA1,297,1110 153.50 (3) (b) 7. The patient's account number, after use only as verification of
11data by the department.
SB45-SSA1-SA1, s. 2280j 12Section 2280j. 153.50 (3) (c) of the statutes is created to read:
SB45-SSA1-SA1,297,1613 153.50 (3) (c) Develop, for use by purchasers of data under this chapter, a data
14use agreement that specifies data use restrictions, appropriate uses of data and
15penalties for misuse of data, and notify prospective and current purchasers of data
16of the appropriate uses.
SB45-SSA1-SA1, s. 2280k 17Section 2280k. 153.50 (3) (d) of the statutes is created to read:
SB45-SSA1-SA1,297,1918 153.50 (3) (d) Require that a purchaser of data under this chapter sign and have
19notarized the data use agreement of the department specified in par. (c).
SB45-SSA1-SA1, s. 2280km 20Section 2280km. 153.50 (3m) of the statutes is created to read:
SB45-SSA1-SA1,297,2521 153.50 (3m) Healthcare provider measures to ensure patient identity
22protection.
A health care provider that is not a hospital or ambulatory surgery
23center shall, before submitting information required by the department under this
24chapter, convert to a payer category code as specified by the department any names
25of an insured's payer or other insured's payer.
SB45-SSA1-SA1, s. 2280kp
1Section 2280kp. 153.50 (4) (intro.) of the statutes is renumbered 153.50 (4)
2(a) (intro.) and amended to read:
SB45-SSA1-SA1,298,53 153.50 (4) (a) (intro.) Under Except as specified in par. (b), under the
4procedures specified in sub. (5), release of patient-identifiable data may be made
5only to any of the following:
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