Amendment AA6-SB306

SB306-AA6,24,25 619.04 (3) The plan shall operate subject to the supervision and approval of a board of governors consisting of 3 representatives of the insurance industry appointed by and to serve at the pleasure of the commissioner, a person to be named by the State Bar Association, a person to be named by the Wisconsin Academy of Trial Lawyers, 2 persons to be named by the Wisconsin Medical Society, a person to be named by the Wisconsin Hospital Association, the commissioner or a designated representative employed by the office of the commissioner, and 4 public members at least one of whom is named by the Wisconsin Nurses Association and at least 2 of whom are not attorneys or physicians and are not professionally affiliated with any hospital or insurance company, appointed by the governor for staggered 3-year terms. The commissioner or the commissioner's representative shall be the chairperson of the board of governors. Board members shall be compensated at the rate of $50 per diem plus actual and necessary travel expenses.

SB306-AA6, s. 10q Section 10q. 655.001 (7t) of the statutes is renumbered 655.001 (7t) (a) and amended to read:

SB306-AA6,25,8 655.001 (7t) (a) "Health Except as provided in par. (b), "health care practitioner" means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist.

SB306-AA6, s. 10r Section 10r. 655.001 (7t) (a) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is renumbered 655.001 (7t) and amended to read:

SB306-AA6,25,15 655.001 (7t) Except as provided in par. (b), "health "Health care practitioner" means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not under the direction and supervision of a physician or, nurse anesthetist, or nurse-midwife.

SB306-AA6, s. 10s Section 10s. 655.001 (7t) (b) of the statutes is created to read:

SB306-AA6,25,18 655.001 (7t) (b) "Health care practitioner" does not include a person licensed to practice nurse-midwifery under s. 441.15.

SB306-AA6, s. 10t Section 10t. 655.001 (7t) (b) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.

SB306-AA6, s. 10u Section 10u. 655.001 (9c) of the statutes is created to read:

SB306-AA6,25,23 655.001 (9c) "Nurse-midwife" means a person who is licensed to practice nurse-midwifery under s. 441.15.

SB306-AA6, s. 10v Section 10v. 655.002 (1) (a) of the statutes is amended to read:

SB306-AA6,26,3 655.002 (1) (a) A physician or , a nurse anesthetist, or a nurse-midwife for whom this state is a principal place of practice and who practices his or her profession in this state more than 240 hours in a fiscal year.

SB306-AA6, s. 10w Section 10w. 655.002 (1) (b) (intro.) of the statutes is amended to read:

SB306-AA6,26,6 655.002 (1) (b) (intro.) A physician or , a nurse anesthetist, or a nurse-midwife for whom Michigan is a principal place of practice, if all of the following apply:

SB306-AA6, s. 10x Section 10x. 655.002 (1) (b) 1. of the statutes is amended to read:

SB306-AA6,26,9 655.002 (1) (b) 1. The physician or, nurse anesthetist, or nurse-midwife is a resident of this state.

SB306-AA6, s. 10y Section 10y. 655.002 (1) (b) 2. of the statutes is amended to read:

SB306-AA6,26,13 655.002 (1) (b) 2. The physician or, nurse anesthetist, or nurse-midwife practices his or her profession in this state or in Michigan or a combination of both more than 240 hours in a fiscal year.

SB306-AA6, s. 10z Section 10z. 655.002 (1) (b) 3. of the statutes is amended to read:

SB306-AA6,26,19 655.002 (1) (b) 3. The physician or, nurse anesthetist, or nurse-midwife performs more procedures in a Michigan hospital than in any other hospital. In this subdivision, "Michigan hospital" means a hospital located in Michigan that is an affiliate of a corporation organized under the laws of this state that maintains its principal office and a hospital in this state.

SB306-AA6, s. 11a Section 11a. 655.002 (1) (c) of the statutes is amended to read:

SB306-AA6,27,3 655.002 (1) (c) A physician or, nurse anesthetist, or nurse-midwife who is exempt under s. 655.003 (1) or (3), or a nurse-midwife who is exempt under s. 655.003 (4), but who practices his or her profession outside the scope of the exemption and who fulfills the requirements under par. (a) in relation to that practice outside the scope of the exemption. For a physician or a, nurse anesthetist, or nurse-midwife who is subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is outside the scope of the exemption under s. 655.003 (1) or, (3), or (4).

SB306-AA6, s. 11b Section 11b. 655.002 (1) (d) of the statutes is amended to read:

SB306-AA6,27,8 655.002 (1) (d) A partnership comprised of physicians or, nurse anesthetists, or nurse-midwives and organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

SB306-AA6, s. 11c Section 11c. 655.002 (1) (e) of the statutes is amended to read:

SB306-AA6,27,12 655.002 (1) (e) A corporation organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

SB306-AA6, s. 11d Section 11d. 655.002 (1) (em) of the statutes is amended to read:

SB306-AA6,27,16 655.002 (1) (em) Any organization or enterprise not specified under par. (d) or (e) that is organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

SB306-AA6, s. 11e Section 11e. 655.002 (2) (a) of the statutes is amended to read:

SB306-AA6,27,21 655.002 (2) (a) A physician or, nurse anesthetist, or nurse-midwife for whom this state is a principal place of practice but who practices his or her profession fewer than 241 hours in a fiscal year, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession.

SB306-AA6, s. 11f Section 11f. 655.002 (2) (b) of the statutes is amended to read:

SB306-AA6,28,4 655.002 (2) (b) Except as provided in sub. (1) (b), a physician or, nurse anesthetist, or nurse-midwife for whom this state is not a principal place of practice, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession in this state. For a health care provider who elects to be subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is in this state and that is outside the scope of an exemption under s. 655.003 (1) or (3) or (4).

SB306-AA6, s. 11g Section 11g. 655.003 (1) of the statutes is amended to read:

SB306-AA6,28,9 655.003 (1) A physician or, a nurse anesthetist, or a nurse-midwife who is a state, county, or municipal employee, or federal employee or contractor covered under the federal tort claims act, as amended, and who is acting within the scope of his or her employment or contractual duties.

SB306-AA6, s. 11h Section 11h. 655.003 (3) of the statutes is amended to read:

SB306-AA6,28,15 655.003 (3) A physician or, a nurse anesthetist, or a nurse-midwife who provides professional services under the conditions described in s. 146.89 or 257.03 (1), with respect to those professional services provided by the physician or, nurse anesthetist, or nurse-midwife for which he or she is covered by s. 165.25 and considered an agent of the department, as provided in s. 165.25 (6) (b).

SB306-AA6, s. 11i Section 11i. 655.003 (4) of the statutes is created to read:

SB306-AA6,28,18 655.003 (4) A nurse-midwife who is considered to be an employee of the federal public health service under 42 USC 233 (g).

SB306-AA6, s. 11j Section 11j. 655.005 (2) (a) of the statutes is amended to read:

SB306-AA6,28,23 655.005 (2) (a) An employee of a health care provider if the employee is a physician or a nurse anesthetist or is a health care practitioner who is providing health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist.

SB306-AA6, s. 11k Section 11k. 655.005 (2) (a) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB306-AA6,29,4 655.005 (2) (a) An employee of a health care provider if the employee is a physician or a, nurse anesthetist, or nurse-midwife or is a health care practitioner who is providing health care services that are not under the direction and supervision of a physician or, nurse anesthetist, or nurse-midwife.

SB306-AA6, s. 11m Section 11m. 655.005 (2) (b) of the statutes is amended to read:

SB306-AA6,29,14 655.005 (2) (b) A service corporation organized under s. 180.1903 by health care professionals, as defined under s. 180.1901 (1m), if the board of governors determines that it is not the primary purpose of the service corporation to provide the medical services of physicians or, nurse anesthetists, or nurse-midwives. The board of governors may not determine under this paragraph that it is not the primary purpose of a service corporation to provide the medical services of physicians or, nurse anesthetists, or nurse-midwives unless more than 50% of the shareholders of the service corporation are neither not physicians nor, nurse anesthetists, or nurse-midwives.

SB306-AA6, s. 11n Section 11n. 655.23 (5m) of the statutes is amended to read:

SB306-AA6,29,18 655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of a physician or, nurse anesthetist, or nurse-midwife and his or her corporation, partnership, or other organization or enterprise under s. 655.002 (1) (d), (e), or (em).

SB306-AA6, s. 11p Section 11p. 655.27 (3) (a) 4. of the statutes is amended to read:

SB306-AA6,29,23 655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e), (em), or (f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or, nurse anesthetist , or nurse-midwife.

SB306-AA6, s. 11q Section 11q. 655.27 (3) (b) 2f. of the statutes is created to read:

SB306-AA6,30,5 655.27 (3) (b) 2f. With respect to fees paid by nurse-midwives, the rule may provide for a separate payment classification or for a payment classification that is combined with one or more other categories of health care providers, as the commissioner, after approval by the board of governors, determines is appropriate for pooling risks under the fund.

SB306-AA6, s. 11r Section 11r. 655.27 (3) (b) 2m. of the statutes is amended to read:

SB306-AA6,30,13 655.27 (3) (b) 2m. In addition to the fees and payment classifications described under subds. 1. and 2. to 2f., the commissioner, after approval by the board of governors, may by rule establish a separate payment classification for physicians satisfying s. 655.002 (1) (b) and, a separate fee for nurse anesthetists satisfying s. 655.002 (1) (b), and a separate fee for nurse-midwives satisfying s. 655.002 (1) (b) which take into account the loss experience of health care providers for whom Michigan is a principal place of practice.

SB306-AA6, s. 11s Section 11s. 655.275 (5) (b) 3. of the statutes is created to read:

SB306-AA6,30,16 655.275 (5) (b) 3. If a claim was paid for damages arising out of the rendering of care by a nurse-midwife, with at least one nurse-midwife.".

SB306-AA6,30,17 9. Page 9, line 24: delete " Section 11" and substitute "Section 11v".

SB306-AA6,30,18 10. Page 9, line 24: after that line insert:

SB306-AA6,30,19 " Section 11w. Nonstatutory provisions.

SB306-AA6,30,24 (1) Expiration of term of member on board of governors. Notwithstanding the length of terms specified for the members of the board of governors under section 619.04 (3) of the statutes, as affected by this act, the initial public member named by the Wisconsin Nurses Association shall be appointed for a term expiring on May 1, 2015.

SB306-AA6,31,10 (2) Notice of effective date of rule for fees. The commissioner of insurance shall promulgate a rule under section 655.27 (3) (b) of the statutes, as affected by this act, that takes into account participation in the injured patients and families compensation fund by nurse-midwives. The rule may provide for a separate payment classification or for a payment classification that is combined with one or more other categories of health care providers, as the commissioner, after approval by the board of governors, determines is appropriate for pooling risks under the fund. When the rule has been promulgated and is in effect, the commissioner of insurance shall publish a notice in the Wisconsin Administrative Register that specifies the effective date of the rule.

SB306-AA6, s. 11x Section 11x. Initial applicability.

SB306-AA6,31,16 (1) The treatment of section 71.07 (9e) (h) of the statutes first applies to taxable years beginning on January 1 of the year in which this subsection takes effect, except that if this subsection takes effect on or after August 1 the treatment of section 71.07 (9e) (h) of the statutes first applies to taxable years beginning on January 1 of the year following the year in which this subsection takes effect.".

SB306-AA6,31,17 11. Page 10, line 5: after that line insert:

SB306-AA6,32,2 "(2) Injured patients and families compensation fund. The treatment of sections 655.002 (1) (a), (b) (intro.) 1., 2., and 3., (c), (d), (e), and (em) and (2) (a) and (b), 655.003 (1), (3), and (4), 655.005 (2) (a) (by Section 11k) and (b), 655.23 (5m), 655.27 (3) (a) 4. and (b) 2f. and 2m., and 655.275 (5) (b) 3. of the statutes, the repeal of section 655.001 (7t) (b) of the statutes, and the renumbering and amendment of section 655.001 (7t) (a) of the statutes take effect on the first day of the 3rd month beginning after the date published by the commissioner of insurance in the Wisconsin Administrative Register under Section 11w (2) of this act.".

SB306-AA6,32,3 (End)