Feed for /2005/related/proposals/ab907 PDF
AB907,8,223 153.05 (3) (a) Upon request of the department for health care information
24relating to health care providers other than hospitals and ambulatory surgery
25centers and, if s. 153.455 (4) applies, for health care claims information as specified

1in sub. (1) (c)
, state agencies shall provide that health care information to the
2department for use in preparing reports under this chapter.
AB907, s. 22 3Section 22. 153.05 (3) (c) of the statutes is created to read:
AB907,8,94 153.05 (3) (c) Upon request of the data organization under contract under sub.
5(2r) for health care claims information, insurers and administrators may provide the
6health care claims information to the data organization for use in preparing reports
7and developing and maintaining a central data repository under this chapter, and,
8if s. 153.455 (4) applies, insurers and administrators may provide the health care
9claims information as requested by the department.
AB907, s. 23 10Section 23. 153.05 (5) (a) of the statutes is amended to read:
AB907,8,1511 153.05 (5) (a) Unless sub. (13) applies, subject to s. 153.455, the department
12may require health care providers other than hospitals and ambulatory surgery
13centers to submit to the department health care information specified by rule under
14s. 153.75 (1) (n) for the preparation of reports, plans, and recommendations in the
15form specified by the department by rule.
AB907, s. 24 16Section 24. 153.05 (5) (c) of the statutes is created to read:
AB907,8,2417 153.05 (5) (c) Subject to s. 153.455 (1) to (3), the data organization under
18contract under sub. (2r) may request insurers and administrators to submit to the
19data organization health care claims information for the preparation of reports,
20plans, and recommendations in the form specified by the data organization,
21including in standard electronic format. If s. 153.455 (4) applies, the department
22may request submission of the health care claims information from insurers and
23administrators in the form specified by the department, including in standard
24electronic format.
AB907, s. 25 25Section 25. 153.05 (6r) of the statutes is repealed.
AB907, s. 26
1Section 26. 153.05 (8) (a) of the statutes is amended to read:
AB907,9,132 153.05 (8) (a) Unless sub. (13) applies, subject to s. 153.455, the department
3shall collect, analyze and disseminate, in language that is understandable to
4laypersons, claims information and other health care information, as adjusted for
5case mix and severity, under the provisions of this chapter, as determined by rules
6promulgated by the department, from health care providers, other than hospitals
7and ambulatory surgery centers, specified by rules promulgated by the department.
8Data from those health care providers may be obtained through sampling techniques
9in lieu of collection of data on all patient encounters and data collection procedures
10shall minimize unnecessary duplication and administrative burdens. If the
11department collects from health care plans data that is specific to health care
12providers other than hospitals and ambulatory surgery centers, the department
13shall attempt to avoid collecting the same data from those health care providers.
AB907, s. 27 14Section 27. 153.05 (8) (c) of the statutes is created to read:
AB907,9,2415 153.05 (8) (c) Subject to s. 153.455 (1) to (3), the data organization under
16contract under sub. (2r) may request, analyze, and publicly report, in language that
17is understandable to laypersons, health care claims information, as adjusted for case
18mix and severity, from insurers and administrators. Data from these sources may
19be obtained through sampling techniques in lieu of collection of data on all insureds,
20and data collection procedures shall minimize unnecessary duplication and
21administrative burdens. If s. 153.455 (4) applies, the department may request health
22care claims information, which may be voluntarily provided by insurers and
23administrators, and may perform or contract for the performance of the other duties
24specified for the data organization under this paragraph.
AB907, s. 28 25Section 28. 153.05 (9) (a) of the statutes is amended to read:
AB907,10,5
1153.05 (9) (a) The Subject to s. 153.455, the department shall provide
2orientation and training to health care providers, other than hospitals and
3ambulatory surgery centers, who submit data under this chapter, to explain the
4process of data collection and analysis and the procedures for data verification,
5comment, interpretation, and release.
AB907, s. 29 6Section 29. 153.05 (9) (c) of the statutes is created to read:
AB907,10,137 153.05 (9) (c) Subject to s. 153.455 (1) to (3), the data organization under
8contract under sub. (2r) shall provide orientation and training to insurers and
9administrators that submit data under this chapter, to explain the process of data
10collection and analysis and the procedures for data verification, comment,
11interpretation, and release. If s. 153.455 (4) applies, the department may perform
12or contract for the performance of the duties specified for the data organization under
13this paragraph.
AB907, s. 30 14Section 30. 153.05 (12) (a) of the statutes is amended to read:
AB907,10,1715 153.05 (12) (a) The Subject to s. 153.455, the department shall, to the extent
16possible and upon request, assist members of the public in interpreting data in
17health care information disseminated by the department.
AB907, s. 31 18Section 31. 153.05 (12) (c) of the statutes is created to read:
AB907,10,2419 153.05 (12) (c) The data organization under contract under sub. (2r) shall,
20subject to s. 153.455 (1) to (3), to the extent possible and upon request, assist
21members of the public in interpreting data in health care information disseminated
22by the data organization. If s. 153.455 (4) applies, the department may perform or
23contract for the performance of the duties specified for the data organization under
24this paragraph.
AB907, s. 32 25Section 32. 153.07 of the statutes is repealed.
AB907, s. 33
1Section 33. 153.10 (1) of the statutes is amended to read:
AB907,11,92 153.10 (1) The Subject to s. 153.455, the department shall prepare, and submit
3to the governor and the chief clerk of each house of the legislature for distribution
4to the legislature under s. 13.172 (2), standard reports concerning health care
5providers other than hospitals and ambulatory surgery centers that the department
6prepares and shall collect information necessary for preparation of those reports. If
7s. 153.455 (4) applies, the department shall include in the reports under this
8subsection reports concerning any health care claims information the department
9collects or contracts to collect under s. 153.05.
AB907, s. 34 10Section 34. 153.22 (1) of the statutes is renumbered 153.22.
AB907, s. 35 11Section 35. 153.45 (intro.) of the statutes is created to read:
AB907,11,1212 153.45 (intro.) Subject to s. 153.455:
AB907, s. 36 13Section 36 . 153.45 (1) (b) 9. of the statutes is amended to read:
AB907,11,1814 153.45 (1) (b) 9. Information that contains the name of a health care provider
15that is not a hospital or ambulatory surgery center, if the independent review board
16department first reviews and approves the release or if the department promulgates
17rules that specify circumstances under which the independent review board need not
18review and approve the release
.
AB907, s. 37 19Section 37. 153.45 (1) (b) 11. of the statutes is amended to read:
AB907,11,2120 153.45 (1) (b) 11. Information other than patient-identifiable data, as defined
21in s. 153.50 (1) (b), as approved by the independent review board department.
AB907, s. 38 22Section 38. 153.45 (1) (c) (intro.) of the statutes is amended to read:
AB907,12,923 153.45 (1) (c) (intro.) Custom-designed reports containing portions of the data
24under par. (b). Of information submitted by health care providers that are not
25hospitals or ambulatory surgery centers, requests under this paragraph for data

1elements other than those available for public use data files under par. (b), including
2the patient's month and year of birth, require review and approval by the
3independent review board before the data elements may be released.
Information
4that contains the name of a health care provider that is not a hospital or ambulatory
5surgery center may be released only if the independent review board department
6first reviews and approves the release or if the department promulgates rules that
7specify circumstances under which the independent review board need not review
8and approve the release
. Reports under this paragraph may include the patient's zip
9code only if at least one of the following applies:
AB907, s. 39 10Section 39. 153.45 (6) of the statutes is repealed.
AB907, s. 40 11Section 40. 153.455 of the statutes is created to read:
AB907,12,17 12153.455 Data organization; contract contingency. (1) Except as provided
13in subs. (2), (3), and (4), beginning on the date, if any, that is 60 days after the contract
14under s. 153.05 (2r) takes effect, the department shall cease collecting, for calendar
15quarters that occur after that date, health care information as specified under s. HFS
16120.14 (1), 2005 Wis. Adm. Code, in effect on the effective date of this subsection ....
17[revisor inserts date].
AB907,12,18 18(2) Subsection (1) does not apply to ss. 153.21 (1) and 153.60 (1).
AB907,13,6 19(3) Beginning on the date, if any, that the secretary of health and family
20services and the secretary of employee trust funds determine that the data
21organization is not in compliance with the contract under s. 153.05 (2r) with respect
22to the performance of the collection and public reporting of information regarding the
23cost, quality, and effectiveness of health care, including the development and
24maintenance of a centralized data repository, or determine that there is insufficient
25statewide participation under the requirements of the contract, the secretaries may

1modify or terminate the contract. If the secretaries terminate the contract, they shall
2recommend to the department of administration that that department use a
3competitive request-for-proposal process to solicit offers from other organizations
4for performance of the services required of the data organization under the
5terminated contract. If no organization responds to the request for proposals or if a
6successor contract cannot be achieved, sub. (4) applies.
AB907,13,16 7(4) If the contract with the data organization is terminated under sub. (3) and
8no organization responds to the request for proposals or a successor contract cannot
9be achieved, the department, in its capacity as a public health authority, shall collect
10health care information, including as specified under s. HFS 120.14 (1), Wis. Adm.
11Code, in effect on the effective date of this subsection .... [revisors inserts date], and
12may request health care claims information, which may be voluntarily provided by
13insurers or administrators, under this chapter; shall analyze and disseminate, or
14contract for the performance of analysis and dissemination of, the health care
15information; and may analyze and disseminate, or may contract for the performance
16of analysis and dissemination of, the health care claims information.
AB907, s. 41 17Section 41. 153.50 (intro.) of the statutes is created to read:
AB907,13,1818 153.50 (intro.) Subject to s. 153.455:
AB907, s. 42 19Section 42. 153.50 (1) (b) 1m. of the statutes is created to read:
AB907,13,2220 153.50 (1) (b) 1m. "Patient-identifiable data" does not include calculated
21variables that are derived from patient-identifiable data and the dissemination of
22which does not permit patient identification.
AB907, s. 43 23Section 43. 153.50 (1) (b) 2. (intro.) of the statutes is amended to read:
AB907,14,3
1153.50 (1) (b) 2. (intro.) "Patient-identifiable data", for information submitted
2by health care providers who are not hospitals or ambulatory surgery centers and by
3insurers and administrators
, means all of the following data elements:
AB907, s. 44 4Section 44. 153.50 (3) (intro.) of the statutes is amended to read:
AB907,14,95 153.50 (3) Measures to ensure protection of patient identity. (intro.) To
6ensure that the identity of patients is protected when information obtained by the
7department or, by the entity under contract under s. 153.05 (2m) (a), or by the data
8organization under contract under s. 153.05 (2r)
is disseminated, the department
9and, the entity, and the data organization shall do all of the following:
AB907, s. 45 10Section 45. 153.50 (3) (a) of the statutes is amended to read:
AB907,14,1411 153.50 (3) (a) Aggregate any data element category containing small numbers.
12The department, in so doing, shall use procedures that are developed by the
13department and approved by the board and that follow commonly accepted
14statistical methodology.
AB907, s. 46 15Section 46. 153.50 (3) (b) (intro.) of the statutes is amended to read:
AB907,14,1816 153.50 (3) (b) (intro.) Remove and destroy all of the following data elements on
17the uniform patient billing forms that are received by the department or by, the
18entity, or the data organization under the requirements of this chapter:
AB907, s. 47 19Section 47. 153.50 (3) (d) of the statutes is amended to read:
AB907,14,2220 153.50 (3) (d) Require that a purchaser of data under this chapter sign and have
21notarized the data use agreement of the department or of, the entity specified in par.
22(c)
, or the data organization, as applicable.
AB907, s. 48 23Section 48. 153.50 (3m) of the statutes is amended to read:
AB907,15,524 153.50 (3m) Health care provider Provider, administrator, or insurer
25measures to ensure patient identity protection.
A health care provider that is not

1a hospital or ambulatory surgery center or an insurer or an administrator shall,
2before submitting information required by the department, or by the data
3organization under contract under s. 153.05 (2r),
under this chapter, convert to a
4payer category code as specified by the department or the data organization, as
5applicable,
any names of an insured's payer or other insured's payer.
AB907, s. 49 6Section 49. 153.50 (4) (a) (intro.) of the statutes is amended to read:
AB907,15,97 153.50 (4) (a) (intro.) Except as specified in par. pars. (b) and (c), under the
8procedures specified in sub. (5), release of patient-identifiable data may be made
9only to any of the following:
AB907, s. 50 10Section 50. 153.50 (4) (a) 1. a. of the statutes is amended to read:
AB907,15,1411 153.50 (4) (a) 1. a. An agent of the department who is responsible for the
12patient-identifiable data in the department, in order to store the data and ensure the
13accuracy of the information in the database of the department or to create a
14calculated variable that is derived from the patient-identifiable data
.
AB907, s. 51 15Section 51. 153.50 (4) (a) 1. b. of the statutes is amended to read:
AB907,15,1916 153.50 (4) (a) 1. b. An agent of the entity under contract under s. 153.05 (2m)
17(a) who is responsible for the patient-identifiable data of the entity, in order to store
18the data and ensure the accuracy of the information in the database of the entity or
19to create a calculated variable that is derived from the patient-identifiable data
.
AB907, s. 52 20Section 52. 153.50 (4) (a) 1. c. of the statutes is created to read:
AB907,15,2521 153.50 (4) (a) 1. c. An agent of the data organization under contract under s.
22153.05 (2r) who is responsible for the patient-identifiable data of the data
23organization, in order to store the data and ensure the accuracy of the information
24in the database of the data organization or to create a calculated variable that is
25derived from the patient-identifiable data.
AB907, s. 53
1Section 53. 153.50 (4) (a) 2. of the statutes is amended to read:
AB907,16,82 153.50 (4) (a) 2. A health care provider that is not a hospital or ambulatory
3surgery center or the agent of such a health care provider, to ensure the accuracy of
4the information in the database of the department or the data organization under
5contract under s. 153.05 (2r)
, or a health care provider that is a hospital or
6ambulatory surgery center or the agent of such a health care provider, to ensure the
7accuracy of the information in the database of the entity under contract under s.
8153.05 (2m) (a).
AB907, s. 54 9Section 54. 153.50 (4) (a) 3. of the statutes is amended to read:
AB907,16,1310 153.50 (4) (a) 3. The department or its agent, for purposes of epidemiological
11investigation, or, with respect to information from health care providers that are not
12hospitals or ambulatory surgery centers, the department or the data organization
13under contract under s. 153.05 (2r),
to eliminate the need for duplicative databases.
AB907, s. 55 14Section 55. 153.50 (4) (c) of the statutes is created to read:
AB907,16,1715 153.50 (4) (c) The data organization under contract under s. 153.05 (2r) may
16not share health care claims data collected by the data organization unless the
17sharing is in compliance with 42 USC 1320d-2 and 1320d-4 and 45 CFR 164.
AB907, s. 56 18Section 56. 153.50 (5) (a) (intro.) of the statutes is amended to read:
AB907,16,2419 153.50 (5) (a) (intro.) The department or , an entity that is under contract under
20s. 153.05 (2m) (a), or a data organization that is under contract under s. 153.05 (2r)
21may not release or provide access to patient-identifiable data to a person authorized
22under sub. (4) (a) unless the authorized person requests the department or, entity,
23or data organization, in writing, to release the patient-identifiable data. The request
24shall include all of the following:
AB907, s. 57 25Section 57. 153.50 (5) (b) (intro.) of the statutes is amended to read:
AB907,17,4
1153.50 (5) (b) (intro.) Upon receipt of a request under par. (a), the department
2or, entity under contract under s. 153.05 (2m) (a) , or data organization, whichever
3is appropriate applicable, shall, as soon as practicable, comply with the request or
4notify the requester, in writing, of all of the following:
AB907, s. 58 5Section 58. 153.50 (5) (b) 1. of the statutes is amended to read:
AB907,17,76 153.50 (5) (b) 1. That the department or , entity, or data organization, as
7applicable,
is denying the request in whole or in part.
AB907, s. 59 8Section 59. 153.60 (title) of the statutes is amended to read:
AB907,17,9 9153.60 (title) Assessments to fund operations of department and board.
AB907, s. 60 10Section 60. 153.60 (intro.) of the statutes is created to read:
AB907,17,1111 153.60 (intro.) Subject to s. 153.455:
AB907, s. 61 12Section 61 . 153.60 (1) of the statutes, as affected by Wisconsin Act 25, is
13amended to read:
AB907,18,2014 153.60 (1) The department shall, by the first October 1 after the
15commencement of each fiscal year, estimate the total amount of expenditures under
16this chapter for the department and the board for that fiscal year for data collection,
17database development and maintenance, generation of data files and standard
18reports, orientation and training provided under s. 153.05 (9) (a) and, maintaining
19the board, and contracting with the data organization under s. 153.05 (2r). The
20department shall assess the estimated total amount for that fiscal year, less the
21estimated total amount to be received for purposes of administration of this chapter
22under s. 20.435 (1) (hi) during the fiscal year and the unencumbered balance of the
23amount received for purposes of administration of this chapter under s. 20.435 (1)
24(hi) from the prior fiscal year, to health care providers, other than hospitals and
25ambulatory surgery centers, who are in a class of health care providers from whom

1the department collects data under this chapter in a manner specified by the
2department by rule. The department shall obtain approval from the board for the
3amounts of assessments for health care providers other than hospitals and
4ambulatory surgery centers.
The department shall work together with the
5department of regulation and licensing to develop a mechanism for collecting
6assessments from health care providers other than hospitals and ambulatory
7surgery centers. No health care provider that is not a facility may be assessed under
8this subsection an amount that exceeds $75 per fiscal year.
If the department
9proposes to increase the assessment for a health care provider that is not a facility
10to a specific amount that exceeds $70 per fiscal year, the department shall submit a
11request to the joint committee on finance for approval to increase the assessment by
12that amount. If the cochairpersons of the committee do not notify the secretary
13within 14 working days after the date of the department's submittal that the
14committee intends to schedule a meeting to review the request, the department may
15increase the assessment by the requested amount. If, within 14 working days after
16the date of the department's request submittal, the cochairpersons of the committee
17notify the secretary that the committee intends to schedule a meeting to review the
18request, the the department may increase the assessment only as approved by the
19committee.
All payments of assessments shall be credited to the appropriation under
20s. 20.435 (1) (hg).
AB907, s. 62 21Section 62 . 153.60 (1) of the statutes, as affected by 2005 Wisconsin Act ....
22(this act), is amended to read:
AB907,19,2523 153.60 (1) The department shall, by the first October 1 after the
24commencement of each fiscal year, estimate the total amount of expenditures under
25this chapter for the department and the board for that fiscal year for data collection,

1database development and maintenance, generation of data files and standard
2reports, orientation and training provided under s. 153.05 (9) (a) , maintaining the
3board,
and contracting with the data organization under s. 153.05 (2r). The
4department shall assess the estimated total amount for that fiscal year, less the
5estimated total amount to be received for purposes of administration of this chapter
6under s. 20.435 (1) (hi) during the fiscal year and the unencumbered balance of the
7amount received for purposes of administration of this chapter under s. 20.435 (1)
8(hi) from the prior fiscal year, to health care providers, other than hospitals and
9ambulatory surgery centers, who are in a class of health care providers from whom
10the department collects data under this chapter in a manner specified by the
11department by rule. The department shall work together with the department of
12regulation and licensing to develop a mechanism for collecting assessments from
13health care providers other than hospitals and ambulatory surgery centers. If the
14department proposes to increase the assessment for a health care provider that is not
15a facility to a specific amount that exceeds $70 per fiscal year, the department shall
16submit a request to the joint committee on finance for approval to increase the
17assessment by that amount. If the cochairpersons of the committee do not notify the
18secretary within 14 working days after the date of the department's submittal that
19the committee intends to schedule a meeting to review the request, the department
20may increase the assessment by the requested amount. If, within 14 working days
21after the date of the department's request submittal, the cochairpersons of the
22committee notify the secretary that the committee intends to schedule a meeting to
23review the request, the department may increase the assessment only as approved
24by the committee. All payments of assessments shall be credited to the appropriation
25under s. 20.435 (1) (hg).
AB907, s. 63
1Section 63. 153.60 (3) of the statutes, as affected by 2005 Wisconsin Act 25,
2is repealed.
AB907, s. 64 3Section 64. 153.65 (1) of the statutes, as affected by 2005 Wisconsin Act 25,
4is amended to read:
AB907,20,115 153.65 (1) The Subject to s. 153.455, the department may, but is not required
6to, provide, upon request from a person, a data compilation or a special report based
7on the information collected by the department. The department shall establish user
8fees for the provision of these compilations or reports, payable by the requester,
9which shall be sufficient to fund the actual necessary and direct cost of the
10compilation or report. All moneys collected under this subsection shall be credited
11to the appropriation under s. 20.435 (1) (hi).
AB907, s. 65 12Section 65. 153.67 of the statutes is repealed.
AB907, s. 66 13Section 66 . 153.75 (1) (intro.) of the statutes is amended to read:
AB907,20,1514 153.75 (1) (intro.) Following approval by the board, the The department shall
15promulgate the following rules:
AB907, s. 67 16Section 67 . 153.75 (1) (intro.) of the statutes, as affected by 2005 Wisconsin
17Act .... (this act), is amended to read:
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