By
Senator
Hansen
; cosponsored by Representatives J. Lehman and Zepnick.
To committee on Senate Organization.
Senate Bill 172
Relating to: requiring certain college students to be vaccinated against or be informed about meningococcal disease.
By
Senators
Schultz, S. Fitzgerald and Breske; cosponsored by Representatives Kreibich, Gard, Jensen, Huebsch, Gronemus, Schneider, Jeskewitz, Ward, Freese, Pettis, McCormick, Ott, Seratti, Suder, Shilling, Wasserman, Lothian, Hahn, Gottlieb, Balow, Olsen and Bies.
To committee on Higher Education and Tourism.
Senate Bill 173
Relating to: the agricultural producer security program, granting rule-making authority, and making an appropriation.
By
Senators
Brown, Schultz, Lassa and Roessler; cosponsored by Representatives Ott, Gronemus, Gunderson, Pettis, Loeffelholz, Musser, Freese, Townsend and Petrowski.
To committee on Agriculture, Financial Institutions and Insurance.
Senate Bill 174
Relating to: claiming the technology zone tax credit.
By
Senators
Harsdorf, Lassa, Jauch, Zien, Schultz, Kanavas, Stepp, Wirch and Roessler; cosponsored by Representatives Suder, Nass, Vruwink, Hahn, Pettis, Albers, Friske, Seratti, Towns, McCormick, Hines, Jensen, Ainsworth, Townsend, Krawczyk and Petrowski.
To committee on Economic Development, Job Creation and Housing.
Senate Bill 175
Relating to: requiring instruction in public schools on the history of organized labor in America and the collective bargaining process.
By
Senators
Hansen, Decker, Chvala, Robson and Plale; cosponsored by Representatives Zepnick, J. Lehman, Kreuser, Richards, Vruwink, Morris, Balow, Sinicki, Black, Pocan, Berceau and Steinbrink.
To committee on Education, Ethics and Elections.
Senate Bill 176
Relating to: authorizing municipal insurance mutuals to provide property insurance.
By
Senators
Schultz, S. Fitzgerald, Cowles and Roessler; cosponsored by Representatives Ladwig, Gard, Albers, Ainsworth, Ott, Gronemus, Krawczyk, Taylor, Turner, Hines and Huber.
To committee on Agriculture, Financial Institutions and Insurance.
__________________
State of Wisconsin
Office of the Governor
May 19, 2003
To the Honorable, the Senate:
The following bill(s), originating in the Senate, have been approved, signed and deposited in the office of the Secretary of State:
Sincerely,
Jim Doyle
Governor
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State of Wisconsin
Office of the Secretary of State
To the Honorable, the Senate:
Sincerely,
Douglas La follette
Secretary of State
State of Wisconsin
Commissioner of Insurance
May 12, 2003
The Honorable, The Legislature:
In accordance with s.
601.427(9), Wis. Stat., I am pleased to submit this report to the Wisconsin Legislature. This report is to evaluate the impact that
1995 Wisconsin Act 10 has had on the following:
(a) The number of health care providers practicing in Wisconsin.
(b) The fees that health care providers pay under s.
655.27(3), Wis. Stats.
(c) The premiums that health care providers pay for health care liability insurance.
The evaluation performed included the collection and analysis of statistics regarding the number of health care providers and premiums charged for health care liability insurance. Analysis of these statistics determined the only discernable effect on these areas has been an estimated $88 million dollars reduction in the actuarially determined assessment levels under s, 655.27 (3), Wis. Stats., over the last seven years.
The attached report provides information regarding the background of Act 10, the statistics collected and the analysis performed.
Sincerely,
Jorge Gomez
Commissioner
State of Wisconsin
Claims Board
May 19, 2003
The Honorable, The Senate:
Enclosed is the report of the State Claims Board covering the claims heard on April 25, 2003.
The amounts recommended for payment under $5,000 on claims included in this report have, under the provisions of s.
16.007, Stats., been paid directly by the Board.
The Board is preparing the bill(s) on the recommended award(s) over $5,000, if any, and will submit such to the Joint Finance Committee for legislative introduction.
This report is for the information of the Legislature. The Board would appreciate your acceptance and spreading of it upon the Journal to inform the members of the Legislature.
Sincerely,
John E. Rothschild
Secretary
The State Claims Board conducted hearings at the Department of Administration Building, St. Croix Room, Madison, Wisconsin, on April 25, 2003, upon the following claims:
Claimant Agency Amount
1. Julie & Mike Health and $5,000.00
Savidusky Family Services
2. University Avenue Wisconsin State $350.00
Stamps Fair Park
3. Mullins Cheese, Inc. Agriculture, Trade $17,568.12
& Consumer Protection
4. Colleen Eidt Revenue $3,540.94
5. George T. Harrell Revenue $5,980.39
6. Jeffrey LaBudda Employee Trust Funds $1,016.14
In addition, the following claims were considered and decided without hearings:
Claimant Agency Amount
7. Frank T. Teumer Natural Resources $1,529.75
8. Martha Gesch Revenue $21,000.00
9. Kimberly M. Aldridge Health and Family $3,191.76
Services
10. Chris Hendrickson Health and Family $1,142.15
Services/Administration
11. Millers Classified Administration $1,563.17
Insurance
12. Thomas M. Barcz Administration $941.05
13. Robert L. Collins-Bey Corrections $2,221.25
14. Berrell Freeman Corrections $800.00
15. David K. Dellis Corrections $82.25
The Board Finds:
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1. Mike and Julie Savidusky
of Madison, Wisconsin claim $5,000.00 for medical expenses not covered by the BadgerCare program. In 2001, the claimants were invited on a wedding related three-day cruise to the Bahamas, with all expenses paid by their hosts. The claimants were participants in the BadgerCare program. Before leaving on the trip, Mr. Savidusky consulted their Dean Health Plan Medicaid/BadgerCare Handbook to determine if they needed to purchase the health insurance offered by the cruise line. Nothing in the handbook indicated that BadgerCare had any geographic restrictions on coverage, it simply stated, "For severe emergencies, go to the nearest hospital, clinic or doctor." Based on this information, they believed they would be covered during the trip and therefore did not purchase the additional insurance. During the trip, while walking on the beach in Nassau, Ms. Savidusky suffered a grand mal seizure, during which she stopped breathing and had no pulse. Her husband administered CPR and Ms. Savidusky was hospitalized for six days. The hospital required payment up front and a family friend loaned money to the claimants to cover the bill. Mr.Savidusky made several calls to Dean Health while in the Bahamas and after they returned home and was assured each time that the costs would be covered by BadgerCare. Two months later BadgerCare informed the claimants that their medical expenses would not be covered because treatment occurred outside the territory of the US, Mexico and/or Canada – a restriction allegedly set forth in a document titled Eligibility and Benefits Handbook. The claimants state that they have never received any handbook by this name. The claimants filed a grievance with Dean Health, which was denied based on the geographic restriction. Dean Health alleged that it was the State's responsibility to provide the claimants with the Eligibility and Benefits Handbook. The claimants filed an appeal with the State's Division of Hearing and Appeals. Administrative Law Judge, Kenneth Adler, ruled that coverage could not be granted because of the geographic restrictions set forth in the BadgerCare rules, but also stated that the claimants might have a case in equity. Judge Adler noted that although DHFS claimed that the claimants "should" have received a copy of the Eligibility and Benefits Handbook, they could not verify that the claimants' caseworker had ever provided it to them and, in fact, no one from DHFS was even able to produce a copy of this handbook. The claimants state that they relied on the only rules that they were given, which made no mention of geographic restrictions. The medical expenses they incurred totaled $7,070.75. Based on their legal research, the claimants do not believe that they have a legal claim against Dean Care. The claimants are aware of the Board's $5,000.00 limit and, rather than dealing with additional delays that would be caused by legislation required for the full amount, they request payment of $5,000 to cover the majority of their expenses.
DHFS does not contest payment of this claim. Although the medical services provided to the claimants in the Bahamas are not covered under the laws governing the BadgerCare program, DHFS admits that this lack of coverage may not have been made clear to the claimants prior to their trip. DHFS has no objection to approval of this claim by the Claims Board but points to the fact that there is no DHFS appropriation to recommend as a payment source. Section
HFS 104.01(11) prohibits direct recipient reimbursement with program funds and it appears that the provider has already been paid.
The Board concludes there has been an insufficient showing of negligence on the part of the state, its officers, agents or employees and this claim is neither one for which the state is legally liable nor one which the state should assume and pay based on equitable principles.
