To find out more about the hearing, or to comment on the proposed rule, please write or phone:
Cheryl Bell-Marek
Division of Disability and Elder Services
P.O. Box 2969
Madison, WI 53701-2969
608-264-9896 or,
if you are hearing impaired,
(608) 266-1511 (TDD)
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 rule received at the above address no later than Wednesday, June 23, 2003, will be given the same consideration as testimony presented at the hearing.
Fiscal Estimate
A hospital may be designated as a critical access hospital if it satisfies federal and state requirements including requirements specified under ss.
HFS 124.37 through
124.41.
Section
HFS 124.39 (1) of the Wisconsin Administrative Code specifies state eligibility requirements for designation as a critical access hospital. A hospital must meet all of the following:
(a) A nonprofit or public hospital approved by the department to operate as a hospital.
(b) Located in an area outside of a metropolitan statistical area as defined in
42 USC 1395ww(d).
(c) Located more than a 35-mile drive from another hospital or certified by the department under sub. (2) as a necessary provider of health care services to residents in the area.
(d) A hospital that has a provider agreement to participate in Medicare in accordance with
42 CFR 485.612.
(e) A hospital that has not been designated by the federal health care financing administration as an urban hospital for the purposes of Medicare reimbursement.
The proposed rule change would expand the criteria for necessary providers under s.
HFS 124.39 (2) to rural hospitals, defined as hospitals located in a county that has at least a portion of a rural census tract of a metropolitan statistical are as determined under the most recent version of the Goldsmith Modification as provided in
42 CFR 412.103(a)(1), that meet the criteria under s.
HFS 123.39 (1) (a),
(d) and
(e).
Two counties in Wisconsin currently fall under Goldsmith Modification criteria: Douglas and Marathon. Three hospitals are located in these counties: St. Mary's in Superior, and NorthCentral Health Care Facility and Wausau Hospital in Wausau. None of these hospitals currently meet the requirements for a critical access hospital under s.
HFS 124.40. However, St. Mary's has expressed an interest in delicensing a number of its hospital beds. If St. Mary's were to delicense 137 beds, it would meet the requirements under 124.40 and could gain critical access hospital status under the proposed change.
If St. Mary's were to gain critical access hospital status, it would be eligible for inpatient and outpatient hospital cost-based reimbursement under fee-for-service Medicaid (MA), as well as increased federal Medicare payments. Under cost-based reimbursement, it is estimated St. Mary's would receive an MA increase of $285,200 AF ($118,400 GPR) annually. This increase includes the effect of eliminating Metropolitan Border Status Supplement payments. St. Mary's currently receives $152,500 AF in MA payments under the Metropolitan Border Status Supplement. Under cost-based reimbursement, St. Mary's would not be eligible for supplemental MA payments.
In addition, the Department would lose approximately $2,500 PR annually in bed licensing fees from St. Mary's due to the 137 delicensed beds.
Due to estimated increased MA payments and loss of bed licensing fees, this change has a state fiscal estimate of $287,700 AF ($118,400 GPR). This change has no fiscal effect for local governments.
Initial Regulatory Flexibility Analysis
The rule changes will not affect small businesses as “small business" is defined in s.
227.114 (1) (a), Stats.
Notice of Hearing
Notice is hereby given that pursuant to the authority granted under s.
601.41 (3), Stats., and the procedure set forth in under s.
227.18, Stats., OCI will hold a public hearing to consider the adoption of the attached proposed rulemaking order affecting s. Ins. 17.40 (1), (2), (3) and (4), Wis. Adm. Code requiring primary insurers and self-insurers to provide notice to the patients compensation fund of the filing of an out-of- state medical malpractice action against an insured Wisconsin health care provider.
Hearing Information
Date: May 14, 2003
Time: 10:00 a.m., or as soon thereafter as the matter may be reached
Place: Room 223, OCI, 125 S. Webster , Madison, WI
Written comments on the proposed rule will be accepted into the record and receive the same consideration as testimony presented at the hearing if they are received at OCI within 3 days following the date of the hearing. Written comments should be addressed to: Alice M. Shuman-Johnson, OCI, PO Box 7873, Madison WI 53707.
Initial Regulatory Flexibility Analysis
This rule does not impose any additional requirements on small businesses.
Copies of Rule and Contact Person
Inger Williams, Services Section
Office of the Commissioner of Insurance
(608) 264-8110
or at
121 East Wilson Street
PO Box 7873
Madison WI 53707-7873.
Analysis Prepared by the Office of the Commissioner of Insurance
Statutory authority: ss., 601.41 (3), 655.004, Stats.
Section
655.27 (5) (a) 2. of the Wisconsin statutes provides a person filing an action outside this state against a health care provider may recover from the patients compensation fund (“fund") only if the fund is notified of the action within 60 days of service of process on the health care provider or the employee of the health care provider when the rules
of procedure
of the jurisdiction in which the action is brought do not permit naming the fund as a party. Section
655.27 (5) (a) 2. further provides the board of governors may extend this 60 day time limit if it finds that enforcement of the time limit would be prejudicial to the purposes of the fund and would benefit neither insureds nor claimants.
Section
655.27 (5) (b) provides it is the responsibility of the insurer or self-insurer for the health care provider who is also covered by the fund to provide an adequate defense of the fund, to act in good faith and in a fiduciary relationship with respect to any claim affecting the fund.
In several recent cases, primary carriers have not given timely notice to the fund of the commencement of an out-of-state medical malpractice action potentially affecting the fund. This rule requires primary carriers and self-insurers to give written notice to the fund within 60 days of the primary insurer or self-insurer's first notice of the filing of an action outside this state, or within 60 days of service of process on the health care provider or employee thereof, whichever is later in time, so the fund is able to timely investigate and respond as appropriate to these claims. The rule also specifies the failure of the insurer or self-insurer to give timely notice will result in the board of governors denying fund coverage for the claim if it finds: a) the fund was prejudiced by the failure to give timely notice, and b) it was reasonably possible to give notice within the time limit. This standard of a finding of prejudice and that it was reasonably possible to give timely notice is patterned after a similar standard set forth in s.
631.81, Wis. Stats. The rule also provides if it was reasonably possible to give notice within the time limit
and the board of governors denies fund coverage under s.
17.40 (3) of the rule, the failure to give notice constitutes bad faith on the part of the insurer or self-insurer in violation of s.
655.27 (5) (b), Wis. Stats.
Fiscal Estimate
The Patients Compensation Fund (Fund) is a segregated fund. The proposed rule has no fiscal effect to the Fund or GPR.
Notice of Hearing
Notice is hereby given that pursuant to the authority granted under s.
601.41 (3), Stats., and the procedure set forth in under s.
227.18, Stats., OCI will hold a public hearing to consider the adoption of the attached proposed rulemaking order affecting s. Ins. 17.01 (3), 17.28 (6) and 17.285 (4), Wis. Adm. Code relating to annual patients compensation fund and mediation fund fees for the fiscal year beginning July 1, 2003 and relating to establishing a rate of compensation for fund peer review council members and consultants.
Hearing Information
Date: May 14, 2003
Time: 11:00 a.m., or as soon thereafter as the matter may be reached
Place: Room 223, OCI, 125 S. Webster , Madison, WI
Written comments on the proposed rule will be accepted into the record and receive the same consideration as testimony presented at the hearing if they are received at OCI within 3 days following the date of the hearing. Written comments should be addressed to: Alice M. Shuman-Johnson, OCI, PO Box 7873, Madison WI 53707
Initial Regulatory Flexibility Analysis
This rule does not impose any additional requirements on small businesses.
Copies of Rule and Contact Person
A copy of the full text of the proposed rule changes and fiscal estimate may be obtained from the OCI internet WEB site at
http://www.state.wi.us/agencies/oci/ocirules.htm or by contacting Inger Williams, Services Section, Office of the Commissioner of Insurance, at (608) 264-8110 or at 121 East Wilson Street, PO Box 7873, Madison WI 53707-7873.
Analysis Prepared by the Office of the Commissioner of Insurance
The commissioner of insurance, with the approval of the board of governors (board) of the patients compensation fund (fund), is required to establish by administrative rule the annual fees which participating health care providers must pay to the fund. This rule establishes those fees for the fiscal year beginning July 1, 2003. These fees represent a 5% increase compared with fees paid for the 2002-03 fiscal year. The board approved these fees at its meeting on February 26, 2003, based on the recommendation of the board's actuarial and underwriting committee.
The board is also required to promulgate by rule the annual fees for the operation of the patients compensation mediation system, based on the recommendation of the director of state courts. This rule implements the funding level recommendation of the board's actuarial and underwriting committee by establishing mediation panel fees for the next fiscal year at $19.00 for physicians and $1.00 per occupied bed for hospitals, representing no increase from 2002-03 fiscal year mediation panel fees.
This rule also creates s. Ins. 17.285 (14) that establishes a rate of compensation for fund peer review council members and consultants of $250 per meeting attended or $250 per report filed by consultant based on the consultant's review of a file.
Fiscal Estimate
The Patients Compensation Fund (Fund) is a segregated fund. Annual Fund fees are established to become effective each July 1, based on actuarial estimates of the Fund's needs for payment of medical malpractice claims. The proposed fees were approved by the Fund's Board of Governors at its February 26, 2003 meeting.
There is no effect on GPR.
Estimated revenue from fees, for fiscal year 2003-2004, is approximately $28.8 million, which represents a 5% increase to fiscal year, 2002-2003 fee revenue.
Notice of Hearings
Natural Resources
(Fish, Game, etc., Chs.
NR 1—)
NOTICE IS HEREBY GIVEN that pursuant to ss.
29.041,
29.014 (1),
29.519 (1) (b) and
227.11 (2) (a), Stats., interpreting ss.
29.041,
29.014 (1) and
29.519 (1) (b), Stats., the Department of Natural Resources will hold public hearings on revisions to s.
NR 25.09, Wis. Adm. Code, relating to commercial netting of whitefish in Lake Michigan. Under current rules, commercial whitefish trap nets must be removed from waters of Lake Michigan south of Kewaunee from June 28 through Labor Day. The proposed rule would allow summer trap netting south of Kewaunee in two limited areas, one near Manitowoc and Two Rivers and one near Sheboygan. The maximum number of nets that can be used by any individual license holder in those areas during summer would be limited to three. New net marking requirements are created.
NOTICE IS HEREBY FURTHER GIVEN that pursuant to s.
227.114, Stats., the proposed rule may have an impact on small businesses.
Initial Regulatory Flexibility Analysis
a. Types of small businesses affected: Commercial fishers of whitefish.
b. Description of reporting and bookkeeping procedures required: No new procedures.
c. Description of professional skills required: No new skills.
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 FURTHER GIVEN that the hearings will be held on:
Wednesday, May 14, 2003 at 7:00 p.m.
