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DHS 120.11(4)(c) (c) The department shall notify each identified physician using the physician's last known address on file with the department of safety and professional services or information provided by the facility that may be more current.
DHS 120.11(4)(d) (d) The notice shall include all of the following:
DHS 120.11(4)(d)1. 1. A message marked “urgent: dated material."
DHS 120.11(4)(d)2. 2. An indication that the physician has 10 working days from the date the notice was sent to notify the department that the physician intends to review the requested data before the data is released.
DHS 120.11(4)(d)3. 3. A statement informing the physician that the department will not provide further notice of the physician's right to review if the physician chooses not to review the data at that time.
DHS 120.11(4)(d)4. 4. Instructions on how the physician may obtain the data.
DHS 120.11(4)(e)1.1. If a physician files a timely request to review data before release, the department shall make the data available to the physician as it is submitted to the department. The department's report shall contain a “permission to change" authorization form that may be duplicated in the event of multiple problems.
DHS 120.11(4)(e)2. 2. If the physician wants to dispute the data, the physician shall attest to the problem associated with the data on the authorization form, and an authorized representative of the facility shall indicate on the form if the facility agrees to the change.
DHS 120.11(4)(e)3. 3. The physician shall return the form to the department within 20 working days after the date on which the data were made available to the physician.
DHS 120.11(4)(e)4. 4. When the department receives the signed “permission to change" form, the department shall change the data within the facility dataset before its release.
DHS 120.11(4)(e)5. 5. If the facility does not agree to the physician's change, the physician may submit his or her written comments on the data to the department within the same 20 working days after the date of the department transmittal. The facility shall also submit its reason for concluding that the submitted data are correct within the same 20 working days. The department may not change the data submitted by the facility, but shall include both sets of comments with the data released to data requesters.
DHS 120.11(4)(e)6. 6. A physician desiring to comment on data he or she submits shall submit his or her comments in a standard electronic word processing format. Comments shall be limited to a maximum of 1000 words. All comments shall be submitted no later than the 20th working day following the department's transmittal.
DHS 120.11(4)(f) (f) If the department receives comments from a physician after the release of data, the department shall retain the comments and provide them as part of the documentation released to future data requesters. The department shall note as caveats to the completed data the subsequent discovery of data errors by either the department or the data submitter after the release of data.
DHS 120.11 History History: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 01-051: am. (1) and (3) (d) 1., Register September 2001 No. 549 eff. 10-1-01; CR 03-033: am. (3) (c), (d) 1. (intro.), (4) (e) 1. and 2., r. (3) (f) Register December 2003 No. 576, eff. 1-1-04; correction in (4) (c) made under s. 13.92 (4) (b) 6., Stats., Register February 2012 No. 674.
DHS 120.12 DHS 120.12Data to be submitted by hospitals.
DHS 120.12(1)(1)Uncompensated health care plan.
DHS 120.12(1)(a)(a) Data to be collected. Hospitals shall provide all of the following data:
DHS 120.12(1)(a)1. 1. A set of definitions describing terms used by the hospital throughout the uncompensated health care plan.
DHS 120.12(1)(a)2. 2. The procedures the hospital uses to determine a patient's ability to pay for health care services received and to verify financial information from the patient.
DHS 120.12(1)(a)3. 3. The hospital's means of informing the public about charity care available at that hospital and a description of the procedure for obtaining the care.
DHS 120.12(1)(a)4. 4. The amount of any state loan funds, excluding fund proceeds from the Wisconsin health and educational facilities authority, outstanding with a continuing obligation during the previous year.
DHS 120.12(1)(b) (b) Data submission procedures.
DHS 120.12(1)(b)1.1. Every hospital shall annually file with the department within 120 calendar days following the close of the hospital's fiscal year the plan required under par. (a).
DHS 120.12 Note Note: Health care providers who are required to send their information directly to the department should use the following address: Bureau of Health Information and Policy, P. O. Box 2659, Madison, Wisconsin 53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street, Madison, Wisconsin.
DHS 120.12(1)(b)2. 2. The department may grant an extension of a deadline specified under subd. 1. only when the hospital adequately justifies to the department the hospital's need for additional time. In this subdivision, “adequate justification" means a delay due to a strike, fire, natural disaster or delay due to catastrophic computer failure. A hospital desiring an extension shall submit a request for an extension in writing to the department at least 10 calendar days before the date the data are due. The department may grant an extension for up to 30 calendar days.
DHS 120.12(1)(c) (c) Data verification, review and comment procedures.
DHS 120.12(1)(c)1.1. Each hospital shall review the plan for accuracy and completeness prior to submitting the plan to the department.
DHS 120.12(1)(c)2. 2. The department shall notify a hospital if the plan or any elements of the plan appear to contain questionable data.
DHS 120.12(1)(c)3. 3. The hospital shall either verify the accuracy of the plan or send a corrected plan to the department within 10 working days from the date the department notified the hospital of the questionable data.
DHS 120.12(1)(c)4.a.a. Within the same 10-working day period under subd. 3., the chief executive officer or designee of each hospital shall submit to the department a signed affirmation statement.
DHS 120.12(1)(c)4.b. b. Hospitals submitting affirmation statements to the department electronically shall use a digital signature approved by the department and returned by the hospital during the timeframes for data submission specified by the department. A signature on the electronic data affirmation statement represents the signatory's acknowledgment that the data is accurate and the data submitter may no longer submit revised data.
DHS 120.12(1)(c)4.c. c. If the department discovers data errors after the department's release of the data or if a hospital representative notifies the department of data errors after the department's release of the data, the department shall note the data errors as caveats to the completed datasets.
DHS 120.12(1)(d) (d) Data adjustment methods. There shall be no adjustment methods for uncompensated health care services report data submitted by hospitals.
DHS 120.12(1)(e) (e) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this subsection.
DHS 120.12(2) (2)Hospital fiscal survey.
DHS 120.12(2)(a)(a) Definition. In this subsection, “mental health institute" has the meaning given in s. 51.01 (12), Stats.
DHS 120.12(2)(b) (b) Data to be collected.
DHS 120.12(2)(b)1.1. `General hospital data.' Hospitals shall report all of the following financial data to the department in the format specified by the department, in accordance with this subsection and department instructions that are based on guidelines from the 2003 update of the Health Care Organizations — AICPA Audit and Accounting Guide, published by the American institute of certified public accountants, generally accepted accounting principles and the national annual survey of hospitals conducted by the American hospital association.
DHS 120.12(2)(b)1.a. a. Gross revenue the hospital derives from services it provides to patients and the sources of that revenue.
DHS 120.12(2)(b)1.b. b. Deductions from gross revenue the hospital derives from services it provides to patients and the sources of that revenue, including contractual adjustments, charity care and other noncontractual deductions.
DHS 120.12(2)(b)1.c. c. Net revenue from service to patients.
DHS 120.12(2)(b)1.d. d. Other revenue.
DHS 120.12(2)(b)1.e. e. Total revenue.
DHS 120.12(2)(b)1.f. f. Payroll expenses.
DHS 120.12(2)(b)1.g. g. Nonpayroll expenses.
DHS 120.12(2)(b)1.h. h. Total expenses.
DHS 120.12(2)(b)1.i. i. Expenses for education activities approved by medicare under 42 CFR 412.113 (b) and 412.118 as excerpted from total expenses.
DHS 120.12(2)(b)1.j. j. Nonoperating gains and losses.
DHS 120.12(2)(b)1.k. k. Net income.
DHS 120.12(2)(b)1.L. L. Unrestricted assets.
DHS 120.12(2)(b)1.m. m. Unrestricted liabilities and fund balances.
DHS 120.12(2)(b)1.n. n. Restricted hospital funds.
DHS 120.12(2)(b)1.o. o. Total gross revenue figures for the current and previous fiscal years.
DHS 120.12(2)(b)1.p. p. Total net revenue figures for the current and previous fiscal years.
DHS 120.12(2)(b)1.q. q. The dollar difference between gross and net revenue figures for the current and previous fiscal years.
DHS 120.12(2)(b)1.r. r. The amount of the dollar difference between gross and net revenue figures attributable to a price change, the amount attributable to a utilization change and the amount attributable to any other cause for the current and previous fiscal years.
DHS 120.12(2)(b)2. 2. `Prior year hospital uncompensated care charge data.' The number of patients obtaining uncompensated health care services from the hospital in its most recently completed fiscal year, and the total accrued charges for those services, as determined by all of the following:
DHS 120.12(2)(b)2.a. a. The number of patients whose accrued charges were attributed to charity care in that fiscal year.
DHS 120.12(2)(b)2.b. b. The total accrued charges for charity care, based on revenue foregone at full established rates, in that fiscal year.
DHS 120.12(2)(b)2.c. c. The number of patients whose accrued charges were determined to be a bad debt expense in that fiscal year.
DHS 120.12(2)(b)2.d. d. The total bad debt expense, as obtained from the hospital's final audited financial statements in that fiscal year.
DHS 120.12(2)(b)3. 3. `Anticipated hospital uncompensated care charge data.' The projected number of patients anticipated to obtain uncompensated health care services from the hospital in its ensuing fiscal year, and the projected charges for those services, as determined by all of the following:
DHS 120.12(2)(b)3.a. a. The hospital's projected number of patients anticipated to obtain charity care for that fiscal year.
DHS 120.12(2)(b)3.b. b. The hospital's projected total charges attributed to charity care for that fiscal year.
DHS 120.12(2)(b)3.c. c. The hospital's projected number of patients anticipated to incur bad debt expenses.
DHS 120.12(2)(b)3.d. d. The hospital's projected total bad debt expense for that fiscal year.
DHS 120.12(2)(b)3.e. e. A rationale for the hospital's projections under subdpars. a. to d., considering the hospital's total patients and total accrued charges for the most recently completed fiscal year.
DHS 120.12(2)(b)4. 4. `Hospital uncompensated care obligation data.' If the hospital has a current obligation or obligations under 42 CFR Part 124, the hospital shall report the date or dates the obligation or obligations went into effect, the amount of the total federal assistance believed to be under obligation at the hospital and the date or dates the obligation or obligations will be satisfied.
DHS 120.12(2)(b)5. 5. `Hospitals other than mental health institutes.'
DHS 120.12(2)(b)5.a.a. Each hospital shall submit to the department an extract of the data requested by the department from its final audited financial statements. If the data requested by the department do not appear on the audited financial statements, the hospital shall gather the data from medicare cost reports, notes to the financial statements or other internal hospital financial records. A hospital need not alter the way it otherwise records its financial data in order to comply with this subdivision.
DHS 120.12(2)(b)5.b. b. If a hospital is jointly operated in connection with a nursing home, a home health agency or other organization, the hospital shall submit the data specified under subd. 1. a. to k. for the hospital unit only.
DHS 120.12(2)(b)5.c. c. If a hospital is jointly operated in connection with a nursing home, a home health agency or other organization, the hospital shall submit the data specified under subd. 1. L. to m. for the hospital unit only. If the hospital unit data cannot be separated from the total facility data, the hospital shall report the data for the total facility.
DHS 120.12(2)(b)5.d. d. County-owned psychiatric or alcohol and other drug abuse hospitals are not required to submit any data specified under subd. 1. L. to m.
DHS 120.12(2)(b)6. 6. `Mental health institutes.'
DHS 120.12(2)(b)6.a.a. A mental health institute shall submit to the department an extract of the data requested by the department for a specific fiscal year from the mental health institute's audited or unaudited financial statements. If the audit report is not yet available, the mental health institute may provide unaudited financial statements. If the data requested do not appear on the financial statements, the mental health institute shall gather the data from medicare cost reports, notes to the financial statements or other internal mental health institute financial records.
DHS 120.12(2)(b)6.b. b. A mental health institute shall submit at least the dollar amounts for the items under subd. 1. a. through k. that are available from the state fiscal system.
DHS 120.12(2)(b)6.c. c. A mental health institute is not required to submit the data specified under subd. 1. L. through m.
DHS 120.12(2)(c) (c) Data submission procedures.
DHS 120.12(2)(c)1.1. A hospital shall submit to the department, no later than 120 calendar days following the close of the hospital's fiscal year, the dollar amounts of the financial data, as specified in par. (b).
DHS 120.12 Note Note: Health care providers who are required to send their information directly to the department should use the following address: Bureau of Health Information and Policy, P. O. Box 2659, Madison, Wisconsin 53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street, Madison, Wisconsin.
DHS 120.12(2)(c)2.a.a. Except as provided in subd. 2. b., the department may grant an extension of a deadline specified in subd. 1. only when the hospital adequately justifies to the department the hospital's need for additional time. In this subdivision, “adequate justification" means a delay due to a strike, fire, natural disaster or catastrophic computer failure. A hospital desiring an extension shall submit a request in writing to the department at least 10 calendar days prior to the date that the data are due. The department may grant an extension for up to 30 calendar days.
DHS 120.12(2)(c)2.b. b. The department may extend the deadline specified in subd. 1. for a mental health institute for up to 90 calendar days upon written request.
DHS 120.12(2)(d) (d) Data verification, review and comment procedures.
DHS 120.12(2)(d)1.1. Each hospital shall review the data for accuracy and completeness prior to submitting data to the department.
DHS 120.12(2)(d)2. 2. The department shall check the accuracy and completeness of all submitted financial data.
DHS 120.12(2)(d)3. 3. The department shall notify a hospital if any of the data appear questionable.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.