SB762: Bill Text

SB762,23,19 155.01 (7) "Health care provider" means a nurse licensed or permitted under ch. 441, a chiropractor licensed under ch. 446, a dentist licensed under ch. 447, a physician, physician assistant, perfusionist, podiatrist, primary spinal care practitioner, physical therapist, physical therapist assistant, occupational therapist, or occupational therapy assistant licensed under ch. 448, a person practicing Christian Science treatment, an optometrist licensed under ch. 449, a psychologist licensed under ch. 455, a partnership thereof, a corporation or limited liability company thereof that provides health care services, a cooperative health care association organized under s. 185.981 that directly provides services through salaried employees in its own facility, or a home health agency, as defined in s. 50.49 (1) (a).

SB762,52 Section 52. 180.1901 (1m) (bw) of the statutes is created to read:

SB762,23,22 180.1901 (1m) (bw) Spinal medicine affiliated credentialing board under subch. VIII of ch. 448.

SB762,53 Section 53. 185.981 (1) of the statutes is amended to read:

SB762,24,4 185.981 (1) Cooperative associations may be organized under this chapter without capital stock, primarily to establish and operate in the state or in any county or counties in the state nonprofit plans or programs for health care, including hospital care, for their members and their members' dependents through contracts with physicians, medical societies, chiropractors, optometrists, dentists, dental societies, hospitals, podiatrists, primary spinal care practitioners, and others.

SB762,54 Section 54. 185.981 (2) of the statutes is amended to read:

SB762,24,22 185.981 (2) A cooperative association organized under this section shall operate only on a cooperative nonprofit basis and for the primary purpose of establishing, maintaining, and operating a voluntary nonprofit health, dental, or vision care plan or plans, or for constructing, operating, and maintaining nonprofit hospitals or other facilities whereby health care, including hospital, dental, or vision care, is provided to its members and to other persons or groups of persons who become subscribers to the plans, subject to s. 185.982 (2), under contracts that provide access to medical, surgical, chiropractic, vision, dental, or hospital care, other health care services, appliances, and supplies, by physicians and surgeons licensed and registered under ch. 448, podiatrists licensed under ch. 448, primary spinal care practitioners licensed under ch. 448, optometrists licensed under ch. 449, chiropractors licensed under ch. 446, dentists licensed under ch. 447, and other health care providers in their offices, in hospitals, in other facilities, and in the home. Nothing in this subsection precludes a cooperative association organized under this section from owning an interest in other entities for enhancing or improving member services or for investment or other purposes, as long as the association's primary purpose remains as provided in this subsection.

SB762,55 Section 55. 185.981 (3) of the statutes is amended to read:

SB762,25,7 185.981 (3) No cooperative association organized primarily for the purposes provided in ss. 185.981 to 185.983 shall be prevented from contracting with any hospital in this state for the rendition of such hospital care as is included within the cooperative association's plans because the hospital participates in a plan of any other cooperative association, or in a plan organized and operated under ss. 148.03 and 613.80. No hospital may discriminate against any physician and surgeon, chiropractor, dentist, or podiatrist, or primary spinal care practitioner with respect to the use of the hospital's facilities by reason of his or her participation in a health care plan of a cooperative.

SB762,56 Section 56. 185.981 (4) (a) of the statutes is amended to read:

SB762,25,17 185.981 (4) (a) Except as provided in par. (b), no contract by or on behalf of any such cooperative association shall provide for the payment of any cash, indemnity, or other material benefit by that association to the subscriber or the subscriber's estate on account of death, illness, or injury, but any such association may stipulate in its plans that it will pay any nonparticipating physician and surgeon, optometrist, chiropractor, dentist, podiatrist, primary spinal care practitioner, hospital, or other provider for hospital or other health care rendered to any covered person who is in need of a plan's benefits. The plans may prescribe monetary limitations with respect to the benefits.

SB762,57 Section 57. 185.982 (1) of the statutes is amended to read:

SB762,26,5 185.982 (1) No health care plan or contract issued by a cooperative association shall interfere with the manner or mode of the practice of medicine, optometry, chiropractic, dentistry, or podiatry, or spinal medicine, as defined in s. 448.971 (5), the manner or mode of providing wellness or other services, the relationship of physician, chiropractor, optometrist, dentist, podiatrist, primary spinal care practitioner, or other provider and patient, nor the responsibility of physician, chiropractor, optometrist, dentist, podiatrist, primary spinal care practitioner, or other provider to patient. Plans may require persons covered to utilize health care providers designated by the cooperative association. The cooperative association may provide health care services directly through providers who are employees of the cooperative association or through agreements with individual providers or groups of providers organized on a group practice or individual practice basis.

SB762,58 Section 58. 185.982 (2) of the statutes is amended to read:

SB762,26,14 185.982 (2) Any cooperative association operating voluntary health care plans under the provisions of this chapter may pay physicians and surgeons, optometrists, chiropractors, dentists, primary spinal care practitioners, or other providers on a salary, per person, or fee-for-service basis to provide health care to members of the association. Every cooperative association may offer its health care services to nonmembers. Any cooperative association that operates a hospital may make the hospital's facilities available to nonmembers and to nonparticipating physicians, optometrists, dentists, or other providers.

SB762,59 Section 59. 252.14 (1) (ar) 4r. of the statutes is created to read:

SB762,26,17 252.14 (1) (ar) 4r. A primary spinal care practitioner licensed under subch. VIII of ch. 448.

SB762,60 Section 60. 254.35 (3) (c) of the statutes is amended to read:

SB762,26,21 254.35 (3) (c) For a podiatric, spinal medicine, as defined in 448.971 (5), or veterinary site having an ionizing radiation installation, the fee shall be at least $36 for each site and at least $44 for each X-ray tube.

SB762,61 Section 61. 254.39 (1) of the statutes is amended to read:

SB762,27,2 254.39 (1) Nothing in this subchapter may be interpreted as limiting intentional exposure of persons to radiation for the purpose of analysis, diagnosis, therapy, and medical, spinal medicine, as defined in s. 448.971 (5), chiropractic, or dental research as authorized by law.

SB762,62 Section 62. 255.06 (1) (d) of the statutes is amended to read:

SB762,27,8 255.06 (1) (d) "Nurse practitioner" means a registered nurse licensed under ch. 441 or in a party state, as defined in s. 441.50 (2) (j), whose practice of professional nursing under s. 441.001 (4) includes performance of delegated medical services under the supervision of a physician, dentist, or podiatrist, or primary spinal care practitioner.

SB762,63 Section 63. 257.01 (5) (a) of the statutes, as affected by 2015 Wisconsin Act 55, is amended to read:

SB762,27,16 257.01 (5) (a) An individual who is licensed as a physician, a physician assistant, or a podiatrist, or a primary spinal care practitioner under ch. 448, licensed as a registered nurse, licensed practical nurse, or nurse-midwife under ch. 441, licensed as a dentist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary technician under ch. 89, or certified as a respiratory care practitioner under ch. 448.

SB762,64 Section 64. 257.01 (5) (b) of the statutes, as affected by 2015 Wisconsin Act 55, is amended to read:

SB762,28,2 257.01 (5) (b) An individual who was at any time within the previous 10 years, but is not currently, licensed as a physician, a physician assistant, or a podiatrist, or a primary spinal care practitioner under ch. 448, licensed as a registered nurse, licensed practical nurse or nurse-midwife, under ch. 441, licensed as a dentist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary technician under ch. 89, or certified as a respiratory care practitioner under ch. 448, if the individual's license or certification was never revoked, limited, suspended, or denied renewal.

SB762,65 Section 65. 287.07 (7) (c) 1. a. of the statutes is amended to read:

SB762,28,6 287.07 (7) (c) 1. a. "Clinic" means a place, other than a residence, that is used primarily for the provision of nursing, medical, podiatric, spinal medicine, as defined in s. 448.971 (5), dental, chiropractic, optometric or veterinary care and treatment.

SB762,66 Section 66. 341.14 (1a) of the statutes is amended to read:

SB762,29,2 341.14 (1a) If any resident of this state, who is registering or has registered an automobile, or a motor truck, dual purpose motor home or dual purpose farm truck which has a gross weight of not more than 8,000 pounds, a farm truck which has a gross weight of not more than 12,000 pounds or a motor home, submits a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from an advanced practice nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a primary spinal care practitioner licensed to practice spinal medicine in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal certifying to the department that the resident is a person with a disability that limits or impairs the ability to walk, the department shall procure, issue and deliver to the disabled person plates of a special design in lieu of plates which ordinarily would be issued for the vehicle, and shall renew the plates. The plates shall be so designed as to readily apprise law enforcement officers of the fact that the vehicle is owned by a nonveteran disabled person and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee shall be made for the issuance or renewal of such plates.

SB762,67 Section 67. 341.14 (1e) (a) of the statutes is amended to read:

SB762,29,25 341.14 (1e) (a) If any resident of this state, who is registering or has registered a motorcycle, submits a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from an advanced practice nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a primary spinal care practitioner licensed to practice spinal medicine in any state, from a chiropractor licensed to practice chiropractic in any state, from a Christian Science practitioner residing in this state and listed in the Christian Science journal, or from the U.S. department of veterans affairs certifying to the department that the resident is a person with a disability that limits or impairs the ability to walk, the department shall procure, issue and deliver to the disabled person a plate of a special design in lieu of the plate which ordinarily would be issued for the motorcycle, and shall renew the plate. The statement shall state whether the disability is permanent or temporary and, if temporary, the opinion of the physician, advanced practice nurse, public health nurse, physician assistant, podiatrist, primary spinal care practitioner, chiropractor, practitioner, or U.S. department of veterans affairs as to the duration of the disability. The plate shall be so designed as to readily apprise law enforcement officers of the fact that the motorcycle is owned by a disabled person and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee may be made for the issuance or renewal of the plate.

SB762,68 Section 68. 341.14 (1m) of the statutes is amended to read:

SB762,30,22 341.14 (1m) If any licensed driver submits to the department a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from a public health nurse certified or licensed to practice in any state, from an advanced practice nurse licensed to practice nursing in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a primary spinal care practitioner licensed to practice spinal medicine in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal certifying that another person who is regularly dependent on the licensed driver for transportation is a person with a disability that limits or impairs the ability to walk, the department shall issue and deliver to the licensed driver plates of a special design in lieu of the plates which ordinarily would be issued for the automobile or motor truck, dual purpose motor home or dual purpose farm truck having a gross weight of not more than 8,000 pounds, farm truck having a gross weight of not more than 12,000 pounds or motor home, and shall renew the plates. The plates shall be so designed as to readily apprise law enforcement officers of the fact that the vehicle is operated by a licensed driver on whom a disabled person is regularly dependent and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee may be made for the issuance or renewal of the plates. The plates shall conform to the plates required in sub. (1a).

SB762,69 Section 69. 341.14 (1q) of the statutes is amended to read:

SB762,31,18 341.14 (1q) If any employer who provides an automobile, or a motor truck, dual purpose motor home or dual purpose farm truck which has a gross weight of not more than 8,000 pounds, a farm truck which has a gross weight of not more than 12,000 pounds or a motor home, for an employee's use submits to the department a statement once every 4 years, as determined by the department, from a physician licensed to practice medicine in any state, from an advanced practice nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a primary spinal care practitioner licensed to practice spinal medicine in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal certifying that the employee is a person with a disability that limits or impairs the ability to walk, the department shall issue and deliver to such employer plates of a special design in lieu of the plates which ordinarily would be issued for the vehicle, and shall renew the plates. The plates shall be so designed as to readily apprise law enforcement officers of the fact that the vehicle is operated by a disabled person and is entitled to the parking privileges specified in s. 346.50 (2a). No charge in addition to the registration fee may be made for the issuance or renewal of the plates. The plates shall conform to the plates required in sub. (1a).

SB762,70 Section 70. 343.51 (1) of the statutes is amended to read:

SB762,32,18 343.51 (1) Any person who qualifies for registration plates of a special design under s. 341.14 (1), (1a), (1m), or (1q) or any other person with a disability that limits or impairs the ability to walk may request from the department a special identification card that will entitle any motor vehicle parked by, or under the direction of, the person, or a motor vehicle operated by or on behalf of the organization when used to transport such a person, to parking privileges under s. 346.50 (2), (2a), and (3). The department shall issue the card at a fee to be determined by the department, upon submission by the applicant, if the applicant is an individual rather than an organization, of a statement from a physician licensed to practice medicine in any state, from an advanced practice nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a primary spinal care practitioner licensed to practice spinal medicine in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal that the person is a person with a disability that limits or impairs the ability to walk. The statement shall state whether the disability is permanent or temporary and, if temporary, the opinion of the physician, advanced practice nurse, public health nurse, physician assistant, podiatrist, primary spinal care practitioner, chiropractor, or practitioner as to the duration of the disability. The department shall issue the card upon application by an organization on a form prescribed by the department if the department believes that the organization meets the requirements under this subsection.

SB762,71 Section 71. 343.62 (4) (a) 4. of the statutes is amended to read:

SB762,33,4 343.62 (4) (a) 4. The applicant submits with the application a statement completed within the immediately preceding 24 months, except as provided by rule, by a physician licensed to practice medicine in any state, from an advanced practice nurse licensed to practice nursing in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a primary spinal care practitioner licensed to practice spinal medicine in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state, and listed in the Christian Science journal certifying that, in the medical care provider's judgment, the applicant is physically fit to teach driving.

SB762,72 Section 72. 440.03 (13) (b) 53s. of the statutes is created to read:

SB762,33,6 440.03 (13) (b) 53s. Primary spinal care practitioner.

SB762,73 Section 73. 440.08 (2) (a) 60s. of the statutes is created to read:

SB762,33,9 440.08 (2) (a) 60s. Primary spinal care practitioner: December 15 of each even-numbered year.

SB762,74 Section 74. 441.001 (3) (a) of the statutes is amended to read:

SB762,33,19 441.001 (3) (a) "Practical nursing" means the performance for compensation of any simple acts in the care of convalescent, subacutely or chronically ill, injured or infirm persons, or of any act or procedure in the care of the more acutely ill, injured or infirm under the specific direction of a nurse, physician, podiatrist or primary spinal care practitioner licensed under ch. 448, dentist licensed under ch. 447 or optometrist licensed under ch. 449, or under an order of a person who is licensed to practice medicine, podiatry, spinal medicine, as defined in s. 448.971 (5), dentistry or optometry in another state if that person prepared the order after examining the patient in that other state and directs that the order be carried out in this state.

SB762,75 Section 75. 441.001 (4) (b) of the statutes is amended to read:

SB762,34,3 441.001 (4) (b) The execution of procedures and techniques in the treatment of the sick under the general or special supervision or direction of a physician, podiatrist, or primary spinal care practitioner licensed under ch. 448, dentist licensed under ch. 447, or optometrist licensed under ch. 449, or under an order of a person who is licensed to practice medicine, podiatry, spinal medicine, as defined in s. 448.971 (5), dentistry, or optometry in another state if the person making the order prepared the order after examining the patient in that other state and directs that the order be carried out in this state.

SB762,76 Section 76. 446.02 (6m) of the statutes is amended to read:

SB762,34,10 446.02 (6m) No chiropractor may provide counsel, direction, guidance, advice, or a recommendation to a patient regarding the health effects of vitamins, herbs, or nutritional supplements unless the chiropractor has been issued a certificate under sub. (2) (c). This subsection does not apply to a chiropractor licensed under this chapter who is certified as a dietician under subch. V of ch. 448 or who is a primary spinal care practitioner licensed under s. 448.9725.

SB762,77 Section 77. 446.02 (7d) (d) of the statutes is created to read:

SB762,34,14 446.02 (7d) (d) This subsection does not apply to a primary spinal care practitioner licensed under subch. VIII of ch. 448 with respect to treatment of a condition within the scope of that license.

SB762,78 Section 78. 446.026 (1) (a) of the statutes is amended to read:

SB762,34,19 446.026 (1) (a) No person may provide adjunctive services unless the person is a chiropractic technician and is under the direct, on-premises supervision of a chiropractor licensed under this chapter or a primary spinal care practitioner licensed under subch. VIII of ch. 448.

SB762,79 Section 79. 446.05 (1) of the statutes is renumbered 446.05 (1) (a).

SB762,80 Section 80. 446.05 (1) (b) of the statutes is created to read:

SB762,35,2 446.05 (1) (b) The examining board shall refer an allegation of a violation of subch. VIII of ch. 448 to the spinal medicine affiliated credentialing board for investigation, unless the alleged conduct also involves a violation of this chapter, in which case the examining board and the spinal medicine affiliated credentialing board shall consult concerning the investigation.

SB762,81 Section 81. 448.03 (2) (a) of the statutes is amended to read:

SB762,35,10 448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or practical nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry or dental hygiene under ch. 447, to practice spinal medicine under subch. VIII, to practice optometry under ch. 449, to practice acupuncture under ch. 451 or under any other statutory provision, or as otherwise provided by statute.

SB762,82 Section 82. 448.21 (1) (f) of the statutes is created to read:

SB762,35,13 448.21 (1) (f) The practice of spinal medicine within the meaning of s. 448.971 (5).

SB762,83 Section 83. 448.52 (2m) (a) of the statutes is amended to read:

SB762,35,18 448.52 (2m) (a) Except as provided in par. (b), a chiropractor licensed under ch. 446 or a primary spinal care practitioner under subch. VIII claiming to render physical therapy, if the physical therapy is provided by a physical therapist employed by the chiropractor or primary spinal care practitioner.

SB762,84 Section 84. 448.52 (2m) (b) of the statutes is amended to read:

SB762,35,21 448.52 (2m) (b) A chiropractor licensed under ch. 446 or a doctor of chiropractic licensed under subch. VIII claiming to render physical therapy modality services.

SB762,85 Section 85. 448.56 (1) of the statutes is amended to read:

SB762,36,12 448.56 (1) Written referral. Except as provided in this subsection and s. 448.52, a person may practice physical therapy only upon the written referral of a physician, physician assistant, chiropractor, dentist, podiatrist, primary spinal care practitioner, or advanced practice nurse prescriber certified under s. 441.16 (2). Written referral is not required if a physical therapist provides services in schools to children with disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the department of public instruction; provides services as part of a home health care agency; provides services to a patient in a nursing home pursuant to the patient's plan of care; provides services related to athletic activities, conditioning, or injury prevention; or provides services to an individual for a previously diagnosed medical condition after informing the individual's physician, physician assistant, chiropractor, dentist, podiatrist, primary spinal care practitioner, or advanced practice nurse prescriber certified under s. 441.16 (2) who made the diagnosis. The examining board may promulgate rules establishing additional services that are excepted from the written referral requirements of this subsection.

SB762,86 Section 86. 448.56 (1m) (b) of the statutes is amended to read:

SB762,36,19 448.56 (1m) (b) The examining board shall promulgate rules establishing the requirements that a physical therapist must satisfy if a physician, physician assistant, chiropractor, dentist, podiatrist, primary spinal care practitioner, or advanced practice nurse prescriber makes a written referral under sub. (1). The purpose of the rules shall be to ensure continuity of care between the physical therapist and the health care practitioner.

SB762,87 Section 87. 448.956 (1m) of the statutes is amended to read:

SB762,37,2 448.956 (1m) Subject to sub. (1) (a), a licensee may provide athletic training to an individual without a referral, except that a licensee may not provide athletic training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation setting unless the licensee has obtained a written referral for the individual from a practitioner licensed or certified under subch. II, III, IV, V, or, VII, or VIII of this chapter; under ch. 446; or under s. 441.16 (2).

SB762,88 Section 88. 448.956 (3) (c) of the statutes is amended to read:

SB762,37,8 448.956 (3) (c) Treat or rehabilitate an employee with an injury or illness that has resulted from an employment activity as directed, supervised, and inspected by a physician, as defined in s. 448.01 (5), or by a person licensed under subch. VIII or under s. 446.02, who has the power to direct, decide, and oversee the implementation of the treatment or rehabilitation.

SB762,89 Section 89. 448.956 (4) of the statutes is amended to read:

SB762,37,15 448.956 (4) If a licensee or the consulting physician of the licensee determines that a patient's medical condition is beyond the scope of practice of the licensee, the licensee shall, in accordance with the protocol established under sub. (1) (a), refer the patient to a health care practitioner who is licensed under ch. 446 or 447 or subch. II, III or, IV, or VIII of ch. 448 and who can provide appropriate treatment to the patient.

SB762,90 Section 90. Subchapter VIII of chapter 448 [precedes 448.971] of the statutes is created to read:

SB762,37,18 chapter 448

SB762,37,19 subchapter viii

SB762,37,21 spinal medicine affiliated credentialing board

SB762,37,22 448.971 Definitions. In this subchapter:

SB762,37,24 (1) "Affiliated credentialing board" means the spinal medicine affiliated credentialing board.

SB762,37,25 (2) "Licensee" means a person who is licensed under s. 448.9725.

SB762,38,1 (3) "Practice of chiropractic" has the meaning given in s. 446.01 (2).

SB762,38,4 (4) "Primary spinal care practitioner" means an individual possessing the degree of doctor of spinal medicine or equivalent degree as determined by the affiliated credentialing board.

SB762,38,9 (5) "Spinal medicine" means the integration and application of the practice of chiropractic and the practice of medicine and surgery that is limited to conditions of the spine and of the musculoskeletal, neuromuscular, and nervous systems and includes prescribing and administering drugs. The practice of spinal medicine does not include all of the following:

SB762,38,10 (a) Surgery.

SB762,38,12 (b) Administering a general anesthetic, except under the direction of a person licensed to practice medicine and surgery under subch. II.

SB762,38,18 448.9715 License required. (1) Except as provided in ss. 257.03 and 448.972, no person may practice spinal medicine, designate himself or herself as a primary spinal care practitioner, use or assume the title "primary spinal care practitioner," or append to the person's name the letters "P.S.C.P.," or any other title, letters, or designation that represents or may tend to represent the person as a primary spinal care practitioner unless the person is a licensee.