Monday State Office Building
1:00 p.m. 1 West Wilson Street
MADISON, WI
The hearing site is fully accessible to people with disabilities. Parking for people with disabilities is available in the parking lot behind the building or in the Doty Street Parking Ramp. People with disabilities may enter the building directly from the parking lot at the west end of the building or from Wilson Street through the side entrance at the east end of the building.
Analysis Prepared by the Department of Health and Family Services
The State of Wisconsin in 1981 established a Health Insurance Risk-Sharing Plan (HIRSP) for the purpose of making health insurance coverage available to medically uninsured residents of the state. One type of medical coverage provided by HIRSP is the Major Medical Plan. This type of coverage is called Plan 1. Eighty-eight percent of the 13,645 HIRSP policies in effect in March 2002 were of the Plan 1 type. Plan 1 has Option A ($1,000 deductible) or Option B ($2,500 deductible). The average premium rate increase for Plan 1 contained in these updated HIRSP rules is 25.4%. Rate increases for specific policyholders range from 19.2% to 27.8%, depending on a policyholder's age, gender, household income, deductible and zone of residence within Wisconsin. According to state law, HIRSP premiums must fund 60% of plan costs and cannot be less than 150% of the amount an individual would be charged for a comparable policy in the private market.
A second type of medical coverage provided by HIRSP is supplemental coverage for persons eligible for Medicare. This type of coverage is called Plan 2. Plan 2 has a $500 deductible. Twelve percent of the 13,645 HIRSP policies in effect in March 2002 were of the Plan 2 type. The average premium rate increase for Plan 2 contained in these updated HIRSP rules is 30.8%. Rate increases for specific policyholders range from 23.3% to 33.5%, depending on a policyholder's age, gender, household income, deductible and zone of residence within Wisconsin. These rate increases reflect general and industry-wide cost increases and adjust premiums in accordance with the authority and requirements set out in s.
149.14 (5m), Stats.
The department through these rules is amending two sections of the HIRSP program administrative rules:
1. The rules are updating HIRSP premium rates in ch.
HFS 119 in accordance with the authority and requirements set out in s.
149.143 (2) (a), Stats. The Department is required to set premium rates by rule. Rates must be calculated in accordance with generally accepted actuarial principles. Policyholders are to pay 60% of the costs of HIRSP. The HIRSP premium rate tables in ch.
HFS 119 are updated in accordance with these principles and requirements for the time-period beginning July 1, 2002.
2. The rules are also updating the total HIRSP insurer assessments and provider payment rates in accordance with the authority and requirements set out in s.
149.143 (2) (a) 3. and
4., Stats. With the approval of the HIRSP Board of Governors and as required by statute, the Department of Health and Family Services approved a methodology that reconciles HIRSP program costs, policyholder premiums, insurance assessments and collected health care provider contributions. The adjustments to the insurer assessments and the provider payment rates, contained in the updated HIRSP administrative rules for the time-period beginning July 1, 2002, are the result of this reconciliation process for calendar year 2001. The HIRSP Board of Governors has reviewed and approved these adjustments to policyholder premiums, insurer assessments and provider payment rates.
Identical emergency rules will be published to take effect on July 1, 2002.
Contact Person
To find out more about the hearing or to request a copy of the proposed rules, write or phone:
Randy McElhose
Division of Health Care Financing
P.O. Box 309, Room B274
Madison, WI 53701-0309
(608) 267-7127
or, if you are hearing impaired, (608) 266-1511 (TTY)
If you are hearing or visually impaired, do not speak English, or have other personal circumstances which might make communication at the hearing difficult and if you, therefore, require an interpreter, or a non-English, large-print or taped version of the hearing document, contact the person at the address or phone number above. A person requesting a non-English or sign language interpreter should make that request at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments on the proposed rules received at the above address no later than July 23, 2002 will be given the same consideration as testimony presented at the hearing.
Fiscal Estimate
These rules update HIRSP policyholder premium rates effective July 1, 2002. They also update HIRSP insurer assessments and provider payment rates for the 12-month period beginning July 1, 2002. These updates are being performed to reflect changing HIRSP costs, and in accordance with a statute-specified methodology, in order to offset upcoming program costs. Annual fiscal updates to the HIRSP rules generally take effect in July each year. The fiscal updates contained in these rules were developed by an independent actuarial firm and reviewed and approved by the HIRSP Board of Governors. By law, the Board is a diverse body composed of consumers, insurers, health care providers, small business and other affected parties.
It is estimated that the proposed changes will increase HIRSP program revenues by $37,424,388 in State Fiscal Year 2003, compared to State Fiscal Year 2002. This amount is comprised of an increase of $6,385,533 in insurer assessments, an increased adjustment (levy) of $4,768,154 to provider payment rates, and an increase of $26,270,701 in policyholder premiums. Enrollment in HIRSP is expected to increase 36% in State Fiscal Year 2003. These rule changes will not, by themselves, affect the expenditures or revenues of local government. There is no local government involvement in the administration of HIRSP.
These adjustments to the policyholder premiums, provider payment rates and insurer assessments are proposed to occur July 1, 2002 as the result of a routine, annual update of HIRSP rules. A similar, budget-based update of HIRSP rules previously occurred in 1998, 1999, 2000 and 2001. Policyholder premiums will be adjusted as new HIRSP policies are initiated or renewed.
Initial Regulatory Flexibility Analysis
The rule changes will affect HIRSP policyholders, the Department of Health and Family Services and the Department's fiscal agent. The rule changes will not affect small businesses as “small business" is defined in s.
227.114 (1) (a), Stats. Although the program statutes and rules provide for the assessment of insurers to help finance HIRSP, no assessed insurer is a small business as defined in s.
227.114 (1) (a), Stats. Moreover, s.
149.143, Stats., prescribes how the amount of an insurer's assessment to help finance HIRSP is to be determined and, similarly, how the health care provider payment rate is to be calculated.
Notice of Hearings
Health and Family Services
(Health, Chs. HFS 110-)
Notice is hereby given that, pursuant to s.
149.143 (2) (a) 2.,
3. and
4. and
(3), Stats., the Department of Health and Family Services will hold public hearings to consider the proposed permanent and existing emergency amendment of s.
HFS 152.065 (6), relating to reimbursement of chronic renal disease, to amend s.
HFS 153.07 (4), relating to reimbursement for blood products and supplies used in the care of hemophilia and to amend s.
HFS 154.07 (4), relating to reimbursement for treatment of adults with cystic fibrosis. In each of the three rule chapters, the amendment increases the amount recipients must pay for prescription drugs under these chronic disease programs.
Hearing Information
The public hearings will be held:
July 11, 2002 Room BO201
Thursday Business Building
1:00 p.m. Waukesha County Technical College
800 Main Street
PEWAUKEE, WI 53702
July 12, 2002 Room E105
Friday Education Building
10:00 a.m. Mid-State Technical College
500 – 32nd Street North
WISCONSIN RAPIDS, WI 54494
The hearing sites are accessible to people with disabilities. At each of the two sites, parking for people with disabilities is available in the parking lot next to the building. People with disabilities may enter each building, at each site, directly from the parking lot.
Analysis Prepared by the Department of Health and Family Services
The Wisconsin Chronic Disease Program (WCDP) is the payer of last resort for Wisconsin citizens with medical problems relating to chronic renal disease, adult cystic fibrosis or hemophilia. The department administers the WCDP. The WCDP reimburses beneficiaries' dialysis and transplant services, home supplies, lab and x-ray services for chronic renal disease recipients.
The majority of WCDP's annual $5 million budget is for reimbursement of recipients' drug costs. WCDP copayments are currently $1 per prescription. These rules increase WCDP copayments to a total of $5 for each generic drug prescription and $10 for each brand name drug prescription. These new copayment amounts resemble those used by commercial health insurers. They were determined by the Department in consultation with its Chronic Renal Disease Program Advisory Committee.
The proposed rules potentially affect approximately 6,500 individuals with chronic renal disease, 200 individuals with hemophilia and 150 individuals with adult cystic fibrosis. Approximately 41% of persons enrolled in the program received state-funded benefits in state fiscal year 2000-01. The rest either incurred no expenses that were covered under WCDP, or their expenses did not exceed the required deductibles.
The Department issued emergency rules, identical to the proposed permanent rules, that took effect July 1, 2002. The Department intends the proposed permanent rules to replace the emergency rules. The public hearings will hear testimony with regard to both the proposed permanent rules and the existing emergency rules.
Contact Person
To find out more about the hearing or to request a copy of the proposed rules, write or phone:
Randy McElhose
Division of Health Care Financing
P.O. Box 309, Room B274
Madison, WI 53701-0309 (608) 267-7127 or, if you are hearing impaired, (608) 266-1511 (TTY).
If you are hearing or visually impaired, do not speak English, or have other personal circumstances which might make communication at the hearing difficult and if you, therefore, require an interpreter, or a non-English, large-print or taped version of the hearing document, contact the person at the address or phone number above. A person requesting a non-English or sign language interpreter should make that request at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments on the proposed rules received at the above address no later than July 22, 2002 will be given the same consideration as testimony presented at the hearing.
Fiscal Estimate
The fiscal impact of these proposed rules was developed and reviewed by Department staff, the program's fiscal agent, and the Department's chronic renal disease advisory committee. WCDP copayments are currently $1 per prescription. These rules increase WCDP copayments to a total of $5 for each generic drug prescription and $10 for each brand name drug prescription. The Department estimates that WCDP funding requirements resulting from a higher generic drug prescription copayment will be reduced by $69,100 [($5-$1) X 17,277 generic drug prescriptions]. The Department also estimates that WCDP funding requirements resulting from a higher brand name drug prescription copayment will be reduced by $206,400 [($10-$1) X 22,930 brand name drug prescriptions]. Therefore, the Department estimates the total annual state savings to be $69,100 + $206,400 = $275,500.
Initial Regulatory Flexibility Analysis
The rule changes will not affect small businesses as “small business" is defined in s.
227.114 (1) (a), Stats. The proposed WCDP rule changes affect the Department of Health and Family Services, the Department's fiscal agent and the program's enrollees.
Notice of Hearings
NOTICE IS HEREBY GIVEN that pursuant to ss.
27.01 (2),
29.014,
29.089 (3),
29.041 and
227.11, Stats., interpreting ss.
29.014,
29.089 (3) and
29.041, Stats., the Department of Natural Resources will hold public hearings relating to small game and expanded spring turkey hunting in state parks. Hunting for small game, including migratory and upland game birds, will be allowed at Governor Dodge, Mill Buff, Mirror Lake and Newport state parks. Spring turkey hunting during the first 3 periods only will be allowed with permits at Interstate, Newport and Willow River state parks. The proposed rule will sunset in 2005. The small game hunting will follow established Department rules except:
1. The proposed parks will be open to all small game species except those specifically exempted by the regional land leader.
2. The use of dogs for small game hunting will be permitted only for game birds.
3. Small game hunting will be permitted only between November 1 and December 15 (except where statewide or regional season ends earlier for a particular species). Bag limits applicable to the land surrounding the park would apply to the park as well.
4. Small game hunting will be permitted from one half-hour before sunrise until 12 noon.
5. Small game hunting will be by permit only.
NOTICE IS HEREBY FURTHER GIVEN that pursuant to s.
227.114, Stats., it is not anticipated that the proposed rule will have an economic impact on small businesses.
NOTICE IS HEREBY FURTHER GIVEN that the Department has made a preliminary determination that this action does not involve significant adverse environmental effects and does not need an environmental analysis under ch.
NR 150, Wis. Adm. Code. However, based on the comments received, the Department may prepare an environmental analysis before proceeding with the proposal. This environmental review document would summarize the Department's consideration of the impacts of the proposal and reasonable alternatives.
Hearing Information
NOTICE IS HEREBY GIVEN that the hearings will be held on:
Monday, July 15, 2002 at 7:00 p.m
Council Chambers
Dodgeville City Hall
100 E. Fountain St.
Dodgeville
Tuesday, July 16, 2002 at 7:00 p.m.
Community Room
St. Croix Co. Courthouse
1101 Carmichael Rd.
Hudson
Wednesday, July 17, 2002 at 7:00 p.m.
Community Center
Kilbourn Public Library
620 Elm Street
Wis. Dells
Thursday, July 18, 2002 at 7:00 p.m.
