Ch. NR 10 - Deer management units 73C (Iowa and Grant counties) and 75 (Iowa and Lafayette counties).
Summary of Final Regulatory Flexibility Analysis:
The proposed rules are applicable to individual hunters and landowners; therefore, a final regulatory flexibility analysis is not required.
Summary of Comments by Legislative Review Committees:
The proposed rules were reviewed by the Assembly committee on natural Resources and the Senate Committee on Agriculture, Environmental Resources and Campaign Finance Reform. On February 17, 1999, the Assembly Committee on Natural Resources extended the review period for 30 days. No public hearing was scheduled during that time.
Chs. Psy 1 through 5 - Requirements for examination and licensure of psychologists, renewal and conduct.
Summary of Final Regulatory Flexibility Analysis:
These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1)(a), Stats.
Summary of Comments:
No comments were reported.
S. PD 6.04 (5) - Multiple appointments on the same case.
Summary of Final Regulatory Flexibility Analysis:
These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1)(a), Stats.
Summary of Comments:
No comments were reported.
S. PI 3.03 - Alternative teacher permits.
Summary of Final Regulatory Flexibility Analysis:
These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1)(a), Stats.
Summary of Comments:
No comments were reported.
S. Tax 11.68 - Construction contractors.
Summary of Final Regulatory Flexibility Analysis:
The proposed rule order does not have a significant economic impact on a substantial number of small businesses.
Summary of Comments:
No comments were reported.
S. Tax 11.70 - Printed material exemptions and the sales and use tax treatment of advertising agencies.
Summary of Final Regulatory Flexibility Analysis:
This proposed rule order does not have a significant economic impact on a a substantial number of small businesses.
Summary of Comments:
No comments were reported.
E x e c u t i v e O r d e r s
The following is a listing of recent Executive Orders issued by the Governor.
Executive Order 370. Relating to the Appointment of a Hearing Officer.
Executive Order 371. Relating to a Proclamation that the Flag of the United States and the Flag of the State of Wisconsin be Flown at Half-Staff on Memorial Day.
Public Notices
Public Notice
Health and Family Services
(Medical Assistance Reimbursement of Hospitals)
The State of Wisconsin reimburses hospitals for medical services provided to low-income persons under the authority of Title XIX of the Federal Social Security Act and ss. 49.43 to 49.47, Wisconsin Statutes. The State's Department of Health and Family Services administers this program which is called Medicaid or Medical Assistance (MA). Federal statutes and regulations require state plans, one for outpatient services and one for inpatient services, which provide the methods and standards for paying for hospital outpatient and inpatient services.
Summary
State plans are now in effect for the reimbursement of outpatient hospital services and inpatient hospital services. The Department is proposing to make several changes in these plans effective July 1, 1999. Many of these changes are included in the proposed 1999-2001 state budget. Upon enactment of the 1999-2001 state budget, certain of these proposed changes will be modified if necessary to effectuate the mandates included in the budget act.
Outpatient Hospital Services
Proposed changes in the state plan for reimbursement for outpatient hospital services may include:
1. Adjustment of the percentages by which base year outpatient costs are increased for the July 1999 through June 2001 biennium to implement the payment adjustments included in the 1999-2001 budget act.
2. Revision of the rural hospital adjustment percentages to ensure that payments do not exceed authorized funds. The amount paid for this adjustment would not change. However, this modification would cause a redistribution of the funds among qualifying hospitals.
3. Modification of supplemental payments to essential access city hospitals (EACH) to maintain compliance with federal payment limits. This modification would not change the total amount paid. It would, however, adjust the amount paid through outpatient payments versus inpatient payments.
4. For the indigent care allowance, adjustment of the maximum available funding, modification of the criteria for a hospital to qualify for an allowance, and modification of the methodology for distributing the available funds to qualifying hospitals in order to carry out provisions of 1999-2001 budget act and to maintain compliance with federal payment limits.
5. Criteria for funding of critical access hospitals to implement a provision the 1999-2001 budget act. Qualifying criteria include designation by Medicare and Wisconsin Medicaid as a critical access hospital. Establish a methodology to allow qualifying hospitals to receive reasonable cost reimbursement. Payments for this adjustment would maintain compliance with federal payment limits.
6. Establishment of qualifying criteria and a distribution methodology for a supplemental payment to certain hospitals to implement a provision of the 1999-2001 budget act.
Inpatient Hospital Services
Proposed changes in the state plan for reimbursement for inpatient hospital services may include:
1. For the payment system which is based on diagnosis-related groups (DRG's), adjustment of DRG weighting factors, standard DRG base rates, area wage indices, and capital and medical education payments to implement the overall rate adjustment provided by the 1999-2001 budget act.
2. Revision of the rural hospital adjustment percentages to ensure that payments do not exceed authorized funds. The total amount paid for this adjustment would not change. However, this modification would cause a redistribution of the funds among qualifying hospitals.
3. Updating of the disproportionate share adjustment parameters to recognize a more current proportion of services provided by hospitals to Medicaid recipients.
4. Revision of the indirect medical education adjustment percentage to meet the requirements of the 1999-2001 budget act relating to hospitals located in Wisconsin. The formula used to calculate the indirect medical education percentage includes a multiplier factor that when revised affects the amount of funds distributed to qualifying hospitals.
5. Modification of the direct medical education payment and the indirect medical education adjustment in order to meet the requirements of the 1999-2001 budget act relating to hospitals not located in Wisconsin.
6. Modification of supplemental payments to essential access city hospitals (EACH) to maintain compliance with federal payment limits. This modification would not change the total amount paid. It would, however, adjust the amount paid through inpatient versus outpatient.
7. For the indigent care allowance, adjustment of the maximum available funding, modification of the criteria for a hospital to qualify for an allowance, and modification of the methodology for distributing the available funds to qualifying hospitals in order to carry out provisions of the 1999-2001 budget act and to maintain compliance with federal payment limits.
8. For the general assistance disproportionate share supplement, adjustment of the maximum available funding, modification of the criteria for a hospital to qualify for the supplement, and modification of the methodology for distributing the available funds to qualifying hospitals in order to carry out provisions of the 1999-2001 budget act and to maintain compliance with federal payment limits.
9. Criteria for funding of critical access hospitals to implement a provision of the 1999-2001 budget act. Qualifying criteria include designation by Medicare and Wisconsin Medicaid as a critical access hospital. Establish a methodology to allow qualifying hospitals to receive reasonable cost reimbursement. Payments for this adjustment would maintain compliance with federal payment limits.
Implementation of the above changes to the State Plans for inpatient hospital services and outpatient hospital services is expected to increase annual expenditures of the Wisconsin Medical Assistance Program by $7.1 million all-funds for state fiscal year 1999-2000. This amount is the combination of $9.8 million all-funds of expected increases and $2.7 million all-funds of expected decreases.
Copies of Proposed Changes and Proposed Payment Rates
Copies of the proposed changes will be sent to the main office of every county social service or human service department where they will be available for public review. For more information, interested persons may fax or write to:
Hospitals, Physicians and Clinics Unit
Division of Health Care Financing
Department of Health and Family Services
P. O. Box 309
Madison, WI 53701-0309
FAX (608) 266-1096
Written Comments
Written comments on the proposed changes are welcome and should be sent to the above address. The comments received on the changes will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily at:
Division of Health Care Financing
Room 350, State Office Building
