LRB-2780/1
TJD:klm
2015 - 2016 LEGISLATURE
September 25, 2015 - Introduced by Representatives Nygren, Petryk, Novak,
Tauchen, Swearingen, Spiros, Jagler, A. Ott, Ripp, Kolste, Kerkman, Goyke,
Schraa, Horlacher, Murtha, Edming, VanderMeer, Allen, E. Brooks,
Kuglitsch, Mursau, Macco, Sanfelippo, Born, Skowronski, J. Ott, Ohnstad,
Sinicki, Loudenbeck, Genrich, Meyers, Spreitzer, Barca, Petersen, Subeck
and Billings, cosponsored by Senators Darling,
Gudex, Harsdorf, Marklein,
Olsen, Petrowski and Cowles. Referred to Committee on Health.
AB366,1,6
1An Act to repeal subchapter IV (title) of chapter 50 [precedes 50.90];
to amend
220.435 (6) (jm), 50.56 (3), 146.40 (1) (bo), 146.81 (1) (L) and 146.997 (1) (d) 18.;
3and
to create subchapter V (title) of chapter 50 [precedes 50.60], 50.60, 50.65
4and subchapter VI (title) of chapter 50 [precedes 50.90] of the statutes;
relating
5to: pain clinic certification and requirements, granting rule-making authority,
6and providing a penalty.
Analysis by the Legislative Reference Bureau
This bill requires certification of a pain clinic in order for it to operate. A pain
clinic must submit an application to the Department of Health Services (DHS),
which is required to issue the certificate of operation if the pain clinic meets the
requirements specified in the bill, has paid any required application fee, and meets
any requirements established by DHS. Each pain clinic location is certified
separately regardless of whether the clinic is operated under the same business
name, ownership, or management as another pain clinic. The bill requires a pain
clinic to have a medical director who is a physician that practices in Wisconsin and
requires a pain clinic to report annually to DHS certain information specified in the
bill. The bill also requires a physician or other health care provider at a pain clinic
authorized to prescribe pain medication to review for treatment purposes an
individual's records on the prescription drug monitoring database for use of other
pain medications.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB366,1
1Section
1. 20.435 (6) (jm) of the statutes is amended to read:
AB366,2,182
20.435
(6) (jm)
Licensing and support services. The amounts in the schedule
3for the purposes specified in ss. 48.685 (2) (am) and (b) 1., (3) (a), (am), (b), and (bm),
4and (5) (a), 49.45 (47), 50.02 (2), 50.025, 50.065 (2) (am) and (b) 1., (3) (a) and (b), and
5(5), 50.13, 50.135, 50.36 (2), 50.49 (2) (b), 50.495, 50.52 (2) (a), 50.57, 50.981, and
6146.40 (4r) (b) and (er), and subch.
IV VI of ch. 50 and to conduct health facilities plan
7and rule development activities, for accrediting nursing homes, convalescent homes,
8and homes for the aged, to conduct capital construction and remodeling plan reviews
9under ss. 50.02 (2) (b) and 50.36 (2), and for the costs of inspecting, licensing or
10certifying, and approving facilities, issuing permits, and providing technical
11assistance, that are not specified under any other paragraph in this subsection. All
12moneys received under ss. 48.685 (8), 49.45 (42) (c), 49.45 (47) (c), 50.02 (2), 50.025,
1350.065 (8), 50.13, 50.36 (2), 50.49 (2) (b), 50.495, 50.52 (2) (a), 50.57, 50.93 (1) (c), and
1450.981, all moneys received from fees for the costs of inspecting, licensing or
15certifying, and approving facilities, issuing permits, and providing technical
16assistance, that are not specified under any other paragraph in this subsection, and
17all moneys received under s. 50.135 (2) shall be credited to this appropriation
18account.
AB366,2
19Section
2. 50.56 (3) of the statutes is amended to read:
AB366,3,220
50.56
(3) Notwithstanding sub. (2), insofar as a conflict exists between this
21subchapter, or the rules promulgated under this subchapter, and subch. I, II or
IV
1VI, or the rules promulgated under subch. I, II or
IV VI, the provisions of this
2subchapter and the rules promulgated under this subchapter control.
AB366,3
3Section
3. Subchapter V (title) of chapter 50 [precedes 50.60] of the statutes
4is created to read:
AB366,4
8Section
4. 50.60 of the statutes is created to read:
AB366,3,10
950.60 Definitions; clinics. In this subchapter:
(1) "Advanced practice nurse
10prescriber" means an individual certified under s. 441.16 (2).
AB366,3,11
11(2) "Health care provider" has the meaning given in s. 146.81 (1) (a) to (hp).
AB366,3,12
12(3) "Pain clinic" means any of the following:
AB366,3,1813
(a) A privately owned facility at which a physician, advanced practice nurse
14prescriber, physician assistant, or other health care provider with prescribing
15privileges, who prescribes controlled substances, provides pain management
16services to patients, a majority of whom are prescribed opioids or opiates,
17benzodiazepines, barbiturates, or carisoprodol, and provides prescriptions for more
18than 90 days in a 12-month period.
AB366,3,2119
(b) Any privately owned facility or office that advertises or otherwise holds
20itself out as providing pain management services and that has one or more employees
21or contractors who prescribe a controlled substance for pain management.
AB366,3,22
22(4) "Physician assistant" has the meaning given in s. 448.01 (6).
AB366,5
23Section
5. 50.65 of the statutes is created to read:
AB366,3,25
2450.65 Pain clinics. (1)
Certification required. (a) No pain clinic may
25operate unless it holds a certificate to operate issued by the department.
AB366,4,5
1(b) A pain clinic shall submit to the department an application, on a form
2prescribed by the department, for a certificate. Each pain clinic location is certified
3separately regardless of whether the clinic is operated under the same business
4name, ownership, or management as another pain clinic. The department may
5charge an applicant a fee for applying for a certificate.
AB366,4,76
(c) A certified pain clinic that undergoes a change of majority ownership shall
7submit a new application for a certificate.
AB366,4,158
(d) A pain clinic shall have a medical director who is a physician that practices
9in this state. In the event that the medical director no longer meets the requirements
10of holding the position of medical director, the pain clinic shall notify the department
11within 10 business days of the identity of a physician who meets the requirements
12of medical director and who acts as medical director at that pain clinic. Failure to
13notify the department of an acting medical director within 10 days of the departure
14of the previous medical director may be a basis for the department to suspend the
15pain clinic's certification.
AB366,4,1916
(e) The department shall issue a certificate of operation to a pain clinic if the
17department finds that the pain clinic meets the requirements of this section, has paid
18any application fee required by the department, and meets any requirements
19established by the department.
AB366,4,23
20(2) Penalty for violation. (a) If the department finds that a pain clinic which
21was issued a certificate under this section no longer meets any requirement of this
22section or rules promulgated under this section or of requirements established by the
23department, the department may do any of the following:
AB366,4,2524
1. Suspend the certificate of the pain clinic until the department determines
25that the pain clinic demonstrates compliance.
AB366,5,1
12. Revoke the certificate of the pain clinic.
AB366,5,22
3. Impose a forfeiture of up to $1,000 per day for each day of continued violation.
AB366,5,43
(b) A pain clinic subject to a penalty under par. (a) is entitled to an appeal and
4a hearing under ch. 227.
AB366,5,6
5(3) Reporting. (a) Annually, a pain clinic shall report to the department all
6of the following:
AB366,5,87
1. The ratio of pain clinic staff to the number of individuals receiving pain
8treatment.
AB366,5,109
2. The number of individuals receiving pain treatment who are also receiving
10behavioral health services.
AB366,5,1211
3. The pain clinic staff's plan for tapering individuals off of pain medications,
12if applicable.
AB366,5,1413
4. The average mileage that individuals receiving pain treatment in the pain
14clinic are traveling to receive treatment in that clinic.
AB366,5,1715
(b) The pain clinic shall ensure that the information under par. (a) is provided
16in a manner that does not permit the identification of an individual who is receiving
17pain medication from the pain clinic.
AB366,5,21
18(4) Prescription monitoring. Before prescribing a pain medication, a
19physician or other health care provider at a pain clinic who is authorized to prescribe
20pain medication shall review for treatment purposes an individual's records on the
21prescription drug monitoring database for use of other pain medications.
AB366,5,22
22(5) Applicability. This section does not apply to any of the following:
AB366,5,2523
(a) A medical or dental school, nursing school, physician assistant training
24program, or outpatient clinic associated with any of the schools or training programs
25specified in this paragraph.
AB366,6,1
1(b) A hospital, as defined in s. 50.33 (2).
AB366,6,22
(c) Hospice, as defined in s. 50.90 (1).
AB366,6,33
(d) A nursing home, as defined in s. 50.01 (3).