153.05 Cross-reference
Cross Reference: See also ch.
HFS 120, Wis. adm. code.
153.07
153.07
Board powers and duties. 153.07(1)
(1) The board shall advise the department with regard to the collection, analysis and dissemination of health care information required by this chapter.
153.07(3)
(3) The board shall approve all rules which are proposed by the department for promulgation to implement this chapter.
153.07(4)
(4) The board and the department shall jointly do all of the following:
153.07(4)(b)
(b) Provide oversight on the standard reports under this chapter, including the reports under
ss. 153.20 and
153.21.
153.07(4)(c)
(c) Develop the overall strategy and direction for implementation of this chapter.
153.07(4)(d)
(d) Provide information on their activities to the interagency coordinating council created under
s. 15.107 (7).
153.08
153.08
Hospital rate increases or charges in excess of rates. 153.08(1)(b)
(b) Notwithstanding
s. 153.01 (5), "hospital" has the meaning given in
s. 50.33 (2), except that "hospital" does not include a center for the developmentally disabled as defined in
s. 51.01 (3).
153.08(1)(c)
(c) "Rates" means individual charges of a hospital for the services that it provides.
153.08(2)
(2) No hospital may increase its rates or charge any payer an amount exceeding its rates that are in effect on May 12, 1992, unless the hospital first causes to be published a class 1 notice under
ch. 985 in a newspaper likely to give notice in the area where the hospital is located, no sooner than 45 days and no later than 30 days before the proposed rate change is to take effect. The notice shall describe the proposed rate change.
153.08(3)
(3) This section does not apply to a hospital that proposes to increase its rates during the course of the hospital's fiscal year by any amount or amounts that, in the aggregate, do not exceed the percentage amount that is the percentage difference between the consumer price index reported for the 12-month period ending on December 31 of the preceding year and the consumer price index reported for the 12-month period ending on December 31 of the year prior to the preceding year.
153.08(4)
(4) A hospital shall publish a class 1 notice under
ch. 985 at least 10 days prior to the institution by the hospital of a rate increase.
153.10
153.10
Health care data reports. The department shall prepare, and submit to the governor and the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2), standard reports that the department prepares and shall collect information necessary for preparation of those reports.
153.10 History
History: 1987 a. 399;
1997 a. 27,
231.
153.20
153.20
Uncompensated health care services report. 153.20(1)(1) The department shall prepare, and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2), an annual report setting forth the number of patients to whom uncompensated health care services were provided by each hospital and the total charges for the uncompensated health care services provided to the patients for the preceding year, together with the number of patients and the total charges that were projected by the hospital for that year in the plan filed under
sub. (2).
153.20(2)
(2) Every hospital shall file with the department an annual plan setting forth the projected number of patients to whom uncompensated health care services will be provided by the hospital and the projected total charges for the uncompensated health care services to be provided to the patients for the ensuing year.
153.21
153.21
Consumer guide. The department shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2) an annual guide to assist consumers in selecting health care providers and health care plans. The guide shall be written in language that is understandable to lay persons. The department shall widely publicize and distribute the guide to consumers.
153.21 History
History: 1997 a. 231.
153.45
153.45
Release of data. 153.45(1)(1) After completion of data verification, comment and review procedures specified by the department by rule, the department shall release data, together with comments, if any, in the following forms:
153.45(1)(b)1.1. For information that is submitted by hospitals or ambulatory surgery centers, public use data files that do not permit the identification of specific patients, employers or health care providers, as defined by rules promulgated by the department. The identification of patients, employers or health care providers shall be protected by all necessary means, including the deletion of patient identifiers and the use of calculated variables and aggregated variables.
153.45(1)(b)2.
2. For information that is submitted by health care providers other than hospitals or ambulatory surgery centers, public use data files that do not permit the identification of specific patients, employers or health care providers, as defined by rules promulgated by the department. The identification of patients, employers or health care providers shall be protected by all necessary means, including the deletion of patient identifiers; the use of calculated variables and aggregated variables; the specification of counties as to residence, rather than zip codes; the use of 5-year categories for age, rather than exact age; not releasing information concerning a patient's race or ethnicity or dates of admission, discharge, procedures or visits; and masking sensitive diagnoses and procedures by use of larger diagnostic and procedure categories. Public use data files under this subdivision may include only the following:
153.45(1)(b)2.g.
g. The name and address of the facility in which the patient's services were rendered.
153.45(1)(b)2.i.
i. Information that contains the name of a health care provider that is not a hospital or ambulatory surgery center, if the independent review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the independent review board need not review and approve the release.
153.45(1)(b)2.j.
j. Calendar quarters of service, except if the department specifies by rule that the number of data elements included in the public use data file is too small to enable protection of patient confidentiality.
153.45(1)(c)
(c) Custom-designed reports containing portions of the data under
par. (b). Of information submitted by health care providers that are not hospitals or ambulatory surgery centers, requests under this paragraph for data elements other than those available for public use data files under
par. (b) 2., including the patient's month and year of birth, require review and approval by the independent review board before the data elements may be released. Information that contains the name of a health care provider that is not a hospital or ambulatory surgery center may be released only if the independent review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the independent review board need not review and approve the release. Reports under this paragraph may include the patient's zip code only if at least one of the following applies:
153.45(1)(c)1.
1. Other potentially identifying data elements are not released.
153.45(1)(c)2.
2. Population density is sufficient to mask patient identity.
153.45(1)(c)3.
3. Other potentially identifying data elements are grouped to provide population density sufficient to protect identity.
153.45(1)(c)4.
4. Multiple years of data elements are added to protect identity.
153.45(1m)
(1m) After completion of data verification and review procedures specified by the department by rule, the department may, but is not required to, release special data compilations.
153.45(2)
(2) The department shall provide to other entities the data necessary to fulfill their statutory mandates for epidemiological purposes or to minimize the duplicate collection of similar data elements.
153.45(3)
(3) The department may, but is not required to, release health care provider-specific and employer-specific data, except in public use data files as specified under
sub. (1) (b), in a manner that is specified in rules promulgated by the department.
153.45(4)
(4) The department shall prohibit purchasers of data from rereleasing individual data elements of health care data files.
153.45(5)
(5) The department may not release any health care information that is subject to rules promulgated under
s. 153.75 (1) (b) until the verification, comment and review procedures required under those rules have been complied with. Nothing in this subsection prohibits release of health care provider-specific information to the health care provider to whom the information relates.
153.45(6)
(6) The department may not sell or distribute databases of information, from health care providers who are not hospitals or ambulatory surgery centers, that are able to be linked with public use data files, unless first approved by the independent review board.
153.50
153.50
Protection of patient confidentiality. 153.50(1)(b)1.1. "Patient-identifiable data", for information submitted by hospitals and ambulatory surgery centers, means all of the following data elements:
153.50(1)(b)2.
2. "Patient-identifiable data", for information submitted by health care providers who are not hospitals or ambulatory surgery centers, means all of the following data elements:
153.50(1)(b)2.b.
b. Whether the patient's condition is related to employment, and occurrence and place of an auto accident or other accident.
153.50(1)(b)2.c.
c. Date of first symptom of current illness, of current injury or of current pregnancy.
153.50(1)(b)2.d.
d. First date of the patient's same or similar illness, if any.
153.50(1)(b)2.e.
e. Dates that the patient has been unable to work in his or her current occupation.
153.50(1)(c)
(c) "Small number" means a number that is insufficiently large to be statistically significant, as determined by the department.
153.50(3)
(3) Departmental measures to ensure protection of patient identity. To ensure that the identity of patients is protected when information obtained by the department is disseminated, the department shall do all of the following:
153.50(3)(a)
(a) Aggregate any data element category containing small numbers, using procedures that are developed by the department and approved by the board and that follow commonly accepted statistical methodology.
153.50(3)(b)
(b) Remove and destroy all of the following data elements on the uniform patient billing forms that are received by the department under the requirements of this chapter:
153.50(3)(b)3.
3. Any other insured's name, employer name and date of birth.
153.50(3)(b)4.
4. The signature of the patient or other authorized signature.
