The bill requires any health care provider providing care to an injured employee
to use an electronic billing system and be able to receive payments electronically.
Health care records in electronic format
Current law requires a health care provider, upon request by an injured
employee, employer, insurer, or DWD, to provide that person with any written
material that is reasonably related to an injury for which the employee claims
worker's compensation in paper format upon payment of the actual costs of
preparing the certified duplicate, not to exceed the greater of 45 cents per page or
$7.50 per request, plus the actual costs of postage, or in electronic format upon
payment of $26 per request.
This bill requires such material to be provided in electronic format unless the
requester is unable to receive the material in electronic format or otherwise
specifically requests the material in paper format.
Dispensing of opiates
The bill prohibits a practitioner from dispensing more than a seven-day supply
of an opiate to treat an injury for which an employer or insurer is liable under the
worker's compensation law. The bill provides that a supply greater than a seven-day
supply dispensed by a practitioner is considered to be unnecessary treatment
without the need for a written opinion on the necessity of the treatment.
Opiates and independent medical examinations
The bill requires that if a health care provider conducts an independent medical
examination and concludes that an employee has sustained a work-related injury
but that opiates that have been prescribed to the employee for the injury are not
medically necessary, any report prepared by the health care provider that
recommends the cessation of those opiates must include certain information,
including a discussion of alternative treatments, a proposed plan of discontinuation
of opiate therapy consistent with any applicable guidelines issued by a state
credentialing board, and a statement regarding coverage for addiction treatment.
Notice; requirement to post
The bill requires each employer to post, in each workplace, a notice in a form
approved by DWD setting forth employees' rights under the worker's compensation
law. DWD must include in the notice information to educate injured employees
regarding opiate therapies, opiate addiction, and alternative treatments for pain.
Program administration
Confidential records; disclosure to certain agencies
Under current law, subject to a number of exceptions, certain records of DWD,
DHA, or the Labor and Industry Review Commission that reveal information about
injured employees are confidential and not subject to disclosure under the public
records law or a subpoena. The bill creates another exception for records requested
by the Department of Health Services, a county department of social services, or a
county department of human services, if the request is limited to the name and
address of the employee who is the subject of the record, the name and address of the
employee's employer, and any financial information about that employee contained
in the record.
Coordination regarding pain management
The bill requires DWD to coordinate with the Department of Safety and
Professional Services and its attached credentialing boards and to educate injured
employees about treatments and about devices approved by the federal Food and
Drug Administration for chronic pain related to injuries compensable under the
worker's compensation law that, in lieu of or in combination with medication, may
reasonably be required to cure or provide relief from injured employees' pain and
about the fact that such treatments and devices may constitute covered medical
expenses under the worker's compensation law.
Hearing loss calculation
The bill requires DWD to conduct an analysis regarding the methods of
calculation of hearing loss under the worker's compensation law in this state and
how they compare to the methods of calculation used in the worker's compensation
laws of other states, as well as an analysis of how improvements in technology should
guide future decisions regarding how to calculate hearing loss for worker's
compensation purposes in this state. DWD must, within six months after the
effective date of the bill, issue a report of its findings to the Council on Worker's
Compensation.
Minimum permanent partial disability ratings
The bill requires DWD to report to the Council on Worker's Compensation on
DWD's progress in carrying out its duties related to reviewing and revising the
minimum permanent partial disability ratings that DWD has promulgated by rule
for certain amputation levels, losses of motion, sensory losses, and surgical
procedures resulting from injuries for which permanent partial disability is claimed.
Other changes
The bill makes various other changes regarding the administration of the
worker's compensation law, including:
1. Changes regarding the financing of the worker's compensation law,
including creating a separate appropriation to pay for certain reimbursements for
supplemental benefit payments.
2. Giving DWD authority to take certain actions under the worker's
compensation law with respect to which DHA has authority under current law,
including allowing DWD to issue orders or take other action in certain cases.
3. Allowing DWD to conduct alternative dispute resolution activities for certain
cases.
4. Granting explicit rule-making authority to DWD to carry out the worker's
compensation law.
5. Transferring from DWD to DHA the authority to grant licenses for
non-attorneys to appear in worker's compensation cases.
6. Prohibiting DHA from promulgating rules that conflict with DWD's rules
and requiring DHA to comply with DWD's rules.
General coverage
Employers subject to worker's compensation law
Under current law, every person who usually employs three or more employees
for services performed in this state is subject to the worker's compensation law. This
bill provides that every person who at any time employs three or more employees for
services performed in this state is subject to the worker's compensation law and
specifies that a person becomes subject to that law on the day on which the person
employs three or more employees for services performed in this state.
Long-term care providers; clarification
The bill makes clarifications regarding individuals who perform services for
persons receiving long-term care benefits under certain long-term care programs
and who do not otherwise have worker's compensation coverage for those services to
confirm that they are considered to be employees, for worker's compensation
purposes, of the entities providing financial management services for the persons
receiving the benefits.
For further information see the state and local 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:
SB665,2
3Section
2. 20.445 (1) (ra) of the statutes is amended to read:
SB665,8,44
20.445
(1) (ra)
Worker's compensation operations fund; administration. From
5the worker's compensation operations fund, the amounts in the schedule for the
6administration of the worker's compensation program by the department, for
7assistance to the department of justice in investigating and prosecuting fraudulent
8activity related to worker's compensation, for transfer to the uninsured employers
9fund under s. 102.81 (1) (c), and for transfer to the appropriation accounts under par.
10(rp) and s. 20.427 (1) (ra). All moneys received under ss. 102.28 (2) (b) and 102.75
11(1) shall be credited to this appropriation account. From this appropriation, an
12amount not to exceed $5,000 may be expended each fiscal year for payment of
13expenses for travel and research by the council on worker's compensation, an amount
14not to exceed $500,000 may be transferred in each fiscal year to the uninsured
1employers fund under s. 102.81 (1) (c), the amount in the schedule under par. (rp)
2shall be transferred to the appropriation account under par. (rp), and the amount in
3the schedule under s. 20.427 (1) (ra) shall be transferred to the appropriation account
4under s. 20.427 (1) (ra).
SB665,3
5Section
3. 20.445 (1) (rc) of the statutes is created to read:
SB665,8,106
20.445
(1) (rc)
Worker's compensation operations fund; supplemental benefits. 7From the worker's compensation operations fund, the amounts in the schedule for
8providing reimbursement to insurance carriers paying supplemental benefits under
9s. 102.44 (1) (c). All moneys received under s. 102.75 (1g) shall be credited to this
10appropriation account.
SB665,4
11Section
4. 20.445 (1) (sm) of the statutes is amended to read:
SB665,8,1812
20.445
(1) (sm)
Uninsured employers fund; payments. From the uninsured
13employers fund,
a sum sufficient to make all moneys received from sources identified
14under s. 102.80 (1m) for the purpose of making the payments under s. 102.81 (1) and
15to obtain reinsurance under s. 102.81 (2). No moneys may be expended or
16encumbered under this paragraph until the first day of the first July beginning after
17the day that the secretary of workforce development files the certificate under s.
18102.80 (3) (a).
SB665,5
19Section
5. 46.27 (5m) of the statutes is amended to read:
SB665,8,2520
46.27
(5m) Worker's compensation coverage. An individual who is
21performing services for a person receiving long-term care benefits under this section
22on a self-directed basis and who does not otherwise have worker's compensation
23coverage for those services is considered
, for purposes of worker's compensation
24coverage, to be an employee of the entity that is providing financial management
25services for that person.
SB665,6
1Section
6. 46.275 (4m) of the statutes is amended to read:
SB665,9,72
46.275
(4m) Worker's compensation coverage. An individual who is
3performing services for a person receiving long-term care benefits under this section
4on a self-directed basis and who does not otherwise have worker's compensation
5coverage for those services is considered
, for purposes of worker's compensation
6coverage, to be an employee of the entity that is providing financial management
7services for that person.
SB665,7
8Section
7. 46.277 (3r) of the statutes is amended to read:
SB665,9,149
46.277
(3r) Worker's compensation coverage. An individual who is
10performing services for a person receiving long-term care benefits under this section
11on a self-directed basis and who does not otherwise have worker's compensation
12coverage for those services is considered
, for purposes of worker's compensation
13coverage, to be an employee of the entity that is providing financial management
14services for that person.
SB665,8
15Section
8. 46.281 (1k) of the statutes is amended to read:
SB665,9,2116
46.281
(1k) Worker's compensation coverage. An individual who is
17performing services for a person receiving the Family Care benefit, or benefits under
18Family Care Partnership, on a self-directed basis and who does not otherwise have
19worker's compensation coverage for those services is considered
, for purposes of
20worker's compensation coverage, to be an employee of the entity that is providing
21financial management services for that person.
SB665,9
22Section
9. 46.2897 (3) of the statutes is amended to read:
SB665,9,2523
46.2897
(3) Worker's compensation coverage. An individual who is
24performing services for a person participating in the self-directed services option
25and who does not otherwise have worker's compensation coverage for those services
1is considered
, for purposes of worker's compensation coverage, to be an employee of
2the entity that is providing financial management services for that person.
SB665,10
3Section
10. 46.995 (3) of the statutes is amended to read:
SB665,10,94
46.995
(3) An individual who is performing services for a person receiving
5long-term care benefits under any children's long-term support waiver program on
6a self-directed basis and who does not otherwise have worker's compensation
7coverage for those services is considered
, for purposes of worker's compensation
8coverage, to be an employee of the entity that is providing financial management
9services for that person.
SB665,11
10Section
11. 73.0301 (1) (d) 3m. of the statutes is amended to read:
SB665,10,1311
73.0301
(1) (d) 3m. A license or certificate issued by the department of
12workforce development under s.
102.17 (1) (c), 103.275 (2) (b), 103.34 (3) (c), 103.91
13(1), 103.92 (3), 104.07 (1) or (2), or 105.13 (1).
SB665,12
14Section
12. 73.0301 (1) (d) 15. of the statutes is created to read:
SB665,10,1615
73.0301
(1) (d) 15. A license issued by the division of hearings and appeals
16under s. 102.17 (1) (c).
SB665,13
17Section
13. 73.0301 (1) (e) of the statutes is amended to read:
SB665,10,2518
73.0301
(1) (e) “Licensing department" means the department of
19administration;
the division of hearings and appeals; the department of agriculture,
20trade and consumer protection; the board of commissioners of public lands; the
21department of children and families; the ethics commission; the department of
22financial institutions; the department of health services; the department of natural
23resources; the department of public instruction; the department of safety and
24professional services; the department of workforce development; the office of the
25commissioner of insurance; or the department of transportation.
SB665,14
1Section
14. 102.04 (1) (b) 1. of the statutes is amended to read:
SB665,11,72
102.04
(1) (b) 1. Every person who
usually at any time employs 3 or more
3employees for services performed in this state, whether in one or more trades,
4businesses, professions, or occupations, and whether in one or more locations.
A
5person who employs 3 or more employees for services performed in this state becomes
6subject to this chapter on the day on which the person employs 3 or more such
7employees.
SB665,15
8Section
15. 102.04 (1) (b) 2. of the statutes is amended to read:
SB665,11,129
102.04
(1) (b) 2. Every person who
usually employs less than 3 employees,
10provided the person has paid wages of $500 or more in any calendar quarter for
11services performed in this state. Such
employer
a person shall become subject
to this
12chapter on the 10th day of the month next succeeding such quarter.
SB665,16
13Section
16. 102.11 (1) (intro.) of the statutes is amended to read:
SB665,12,414
102.11
(1) (intro.) The average weekly earnings for temporary disability,
15permanent total disability, or death benefits for injury in each calendar year on or
16after January 1, 1982, shall be not less than $30 nor more than the wage rate that
17results in a maximum compensation rate of 110 percent of the state's average weekly
18earnings as determined under s. 108.05 as of June 30 of the previous year. The
19average weekly earnings for permanent partial disability shall be not less than $30
20and, for permanent partial disability for injuries occurring on or after
March 2, 2016,
21and before January 1, 2017, not more than $513, resulting in a maximum
22compensation rate of $342, and, for permanent partial disability for injuries
23occurring on or after January 1, 2017, not more than $543, resulting in a maximum
24compensation rate of $362
, for permanent partial disability for injuries occurring on
25or after the effective date of this subsection .... [LRB inserts date], and before January
11, 2019, not more than $573, resulting in a maximum compensation rate of $382, and,
2for permanent partial disability for injuries occurring on or after January 1, 2019,
3not more than $610.50, resulting in a maximum compensation rate of $407. Between
4such limits the average weekly earnings shall be determined as follows:
SB665,17
5Section
17. 102.13 (1) (bm) of the statutes is created to read:
SB665,12,76
102.13
(1) (bm) 1. In this paragraph, “opiate” has the meaning given in s. 961.01
7(16).
SB665,12,158
2. If a physician, chiropractor, psychologist, dentist, physician assistant,
9advanced practice nurse prescriber, or podiatrist conducts an examination under
10par. (a) and concludes that the employee has sustained a work-related injury but
11that opiates that have been prescribed to the employee for the injury are not
12medically necessary, any report prepared by the physician, chiropractor,
13psychologist, dentist, physician assistant, advanced practice nurse prescriber, or
14podiatrist that recommends the cessation of those opiates shall include all of the
15following:
SB665,12,1816
a. A discussion of alternative treatments or medical devices for the injured
17employee's pain and, if opining that alternative treatments are also unnecessary, an
18explanation as to why such alternative treatments are unnecessary.
SB665,12,2019
b. A proposed plan of discontinuation of opiate therapy consistent with any
20applicable guidelines concerning opiates issued under s. 440.035 (2m).
SB665,13,321
c. If the physician, chiropractor, psychologist, dentist, physician assistant,
22advanced practice nurse prescriber, or podiatrist opines that the injured employee
23has developed behaviors indicative of opioid use disorder related to the injury, a
24statement to the employee that the employer or insurer will pay for, and assist the
25employee in obtaining, a physician referral for addiction treatment. In that case, the
1employer or insurer shall advise the employee that opiates prescribed as a result of
2the injury will continue to be paid for by the employer or insurer until the employee
3is referred for addiction treatment.
SB665,18
4Section
18. 102.13 (2) (b) of the statutes is amended to read:
SB665,13,215
102.13
(2) (b) A physician, chiropractor, podiatrist, psychologist, dentist,
6physician assistant, advanced practice nurse prescriber, hospital, or health service
7provider shall furnish
a legible, certified duplicate of the written material requested
8under par. (a) in electronic format upon payment of $26 per request, unless the
9requester is unable to receive the material in electronic format or otherwise
10specifically requests the material in paper format, in which case the physician,
11chiropractor, podiatrist, psychologist, dentist, physician assistant, advanced
12practice nurse prescriber, hospital, or health service provider shall furnish a legible,
13certified duplicate of the
written material
requested under par. (a) in paper format
14upon payment of the actual costs of preparing the certified duplicate, not to exceed
15the greater of 45 cents per page or $7.50 per request, plus the actual costs of postage
,
16or shall furnish a legible, certified duplicate of that material in electronic format
17upon payment of $26 per request. Any person who refuses to provide certified
18duplicates of written material in the person's custody that is requested under par. (a)
19shall be liable for reasonable and necessary costs and, notwithstanding s. 814.04 (1),
20reasonable attorney fees incurred in enforcing the requester's right to the duplicates
21under par. (a).
SB665,19
22Section
19. 102.13 (2) (c) of the statutes is amended to read:
SB665,14,1323
102.13
(2) (c) Except as provided in this paragraph, if an injured employee has
24a period of temporary disability that exceeds 3 weeks or a permanent disability, if the
25injured employee has undergone surgery to treat his or her injury, other than surgery
1to correct a hernia, or if the injured employee sustained an eye injury requiring
2medical treatment on 3 or more occasions off the employer's premises, the
3department may by rule require the insurer or self-insured employer to submit to
4the department a final report of the employee's treating practitioner. The
5department may not require an insurer or self-insured employer to submit to the
6department a final report of an employee's treating practitioner when the insurer or
7self-insured employer denies the employee's claim for compensation in its entirety
8and the employee does not contest that denial. A treating practitioner shall complete
9a final report on a timely basis and may charge a reasonable fee for the completion
10of the final report, not to exceed $100, but may not require prepayment of that fee.
11An Subject to s. 102.16 (2) (i), an insurer or self-insured employer that disputes the
12reasonableness of a fee charged for the completion of a treatment practitioner's final
13report may submit that dispute to the department for resolution under s. 102.16 (2).
SB665,20
14Section
20. 102.14 (title) of the statutes is amended to read:
SB665,14,16
15102.14 (title)
Jurisdiction
, powers, and duties of department and
16division; advisory committee council.
SB665,21
17Section
21. 102.14 of the statutes is renumbered 102.14 (1m).
SB665,22
18Section
22. 102.14 (2m) of the statutes is created to read:
SB665,15,219
102.14
(2m) The department of workforce development shall coordinate with
20the department of safety and professional services and credentialing boards, as
21defined in s. 440.01 (2) (bm), and shall educate injured employees about treatments
22and about devices approved by the federal food and drug administration for chronic
23pain related to injuries compensable under this chapter that, in lieu of or in
24combination with medication, may reasonably be required to cure or provide relief
1from injured employees' pain and about the fact that such treatments and devices
2may constitute covered medical expenses under this chapter.
SB665,23
3Section
23. 102.15 (title) of the statutes is amended to read:
SB665,15,4
4102.15 (title)
Rules of procedure; transcripts.
SB665,24
5Section
24. 102.15 (1) of the statutes is renumbered 102.15 (1r) and amended
6to read:
SB665,15,127
102.15
(1r) Subject to this chapter, the The division may
adopt its own 8promulgate rules
as necessary to carry out its duties and functions under this
9chapter, except that notwithstanding s. 227.11, the division may only promulgate
10rules of procedure
and may change the same from time to time. The division may not
11promulgate any rule that conflicts with, and shall comply with, rules promulgated
12by the department under this chapter.
SB665,25
13Section
25
. 102.15 (1g) of the statutes is created to read:
SB665,15,1814
102.15
(1g) The department may promulgate rules as necessary to carry out
15its duties and functions under this chapter. The provisions of s. 103.005 relating to
16the adoption, publication, modification, and court review of rules or general orders
17of the department shall apply to all rules promulgated or general orders adopted
18under this chapter.
SB665,26
19Section
26. 102.16 (1) (b) of the statutes is renumbered 102.16 (1) (b) 1. and
20amended to read: