SECTION 34. HFS 120.11 (3) (f) is repealed.
SECTION 35. HFS 120.11 (4) (e) 1. and 2. are amended to read:
HFS 120.11 (4) (e) 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 transmittalreport shall contain a “permission to change" authorization form that may be duplicated in the event of multiple problems.
2. If the physician wants to dispute the data, the physician shall describe on the formattest 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.
SECTION 36. HFS 120.12 (1) (b) 2., (2) (b) 1., (c) 2. a., (3) (b) 11., (c) 1. and 3., (5) (b) 2. and 4. are amended to read:
HFS 120.12 (1) (b) 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
failuresystem malfunction. 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.
(2) (b) Data to be collected. 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 July 1998 version
2003 update of the Audits of Providers of Health Care ServicesHealth 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.
(c) 2. 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 failuresystem malfunction. 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.
(3) (b) 11. Swing–bed utilization, if applicable, including average number of swing beds, admissionsdischarges and days of care.
(c) 1. A hospital shall submit to the department the data specified in par. (a)(b) according to a schedule specified by the department.
3. The department may grant an extension of a deadline specified in this paragraph 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 failuresystem malfunction. A hospital desiring an extension shall submit a request for an extension 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.
(5) (b) 2. Hospitals shall send the data to the department within 3045 calendar days of the last day of each calendar quarter using the department's electronic submission system. Calendar quarters shall begin on January 1, April 1, July 1 and October 1 and shall end on March 31, June 30, September 30 and December 31.
4. The department may grant an extension of the time limits specified under subd. 2. 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 failuresystem malfunction. A hospital desiring an extension shall submit a request for an extension 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.
SECTION 37. HFS 120.12 (5m) (a) 30. and 31. are created to read:
HFS 120.12 (5m) (a) 30. Patient race.
31. Patient ethnicity.
SECTION 38. HFS 120.12 (5m) (b) 2., 4. and 5. a. and (6) (a) and (c) 2. and 3. are amended to read:
HFS 120.12 (5m) (b) 2. Within 3045 calendar days after the last day of each calendar quarter, each hospital shall submit to the department the data specified in par. (a) using the department's electronic data submission system. Calendar quarters shall begin on January 1, April 1, July 1 and October 1 and shall end on March 31, June 30, September 30 and December 31.
4. The department may grant an extension of the deadline specified under subd. 2. 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 failuresystem malfunction. 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.
5. a. To ensure confidentiality, hospitals using qualified vendors to submit data shall provide an original trading partner agreement to the department that has been signed and notarized by the qualified vendor and the hospital.
(6) (a)
Definition. In this subsection “hospital–
affiliated ambulatory surgical center" means an entity that is owned by a hospital and is operated exclusively for the purpose of providing surgical services to patients not requiring hospitalization, has an agreement with the federal
health care financing administrationcenters for medicare and medicaid services under
42 CFR 416.25 and
416.30 to participate as an ambulatory surgery center, and meets the conditions set forth in
42 CFR 416.25 to
416.49.
(c) 2. Within 3045 calendar days after the end of each calendar quarter, each hospital shall submit to the department the surgical data specified in par. (a) for all ambulatory patient surgical procedures using the department's electronic submission system. The department's electronic submission system shall be described in the department's data submission manual. Calendar quarters shall begin on January 1, April 1, July 1 and October 1 and shall end on March 31, June 30, September 30 and December 31.
3. The department may grant an extension of the deadline specified under subd. 2. 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 failuresystem malfunction. 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.
SECTION 39. HFS 120.13 (2) (a) and (b) are amended to read:
HFS 120.13 (2) (a) Each freestanding ambulatory surgery center shall electronically submit to the department, as described in the department's data submission manual, all data elements specified in sub. (1) for all ambulatory patient surgical procedures within 3045 calendar days after the end of each calendar quarter. Calendar quarters shall begin on January 1, April 1, July 1 and October 1 and shall end on March 31, June 30, September 30 and December 31. The method of submission, data formats and coding specifications shall be defined in the department's data submission manual.
(b) The department may grant an extension of the time limits specified under par. (a) only when the center adequately justifies to the department the center's need for additional time. In this paragraph, “adequate justification" means a delay due to a strike, fire, natural disaster or catastrophic computer failuresystem malfunction. A center desiring an extension shall submit a request for an extension 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.
SECTION 40. HFS 120.14 (1) (b) 1. and (note), 2. to 6. (intro) and (c) 2. (intro) are amended to read:
HFS 120.14 (1) (b) Data submission procedures. 1. Non–exempt physicians shall submit claims information to the department in an electronic format using secure methods specified in a data submission manual provided by the department. Physicians shall send the information using an internet browser technology, over a secure internet protocol, using authentication and encryption to assure the safe transmission of data to the department. Physicians who submit data through a qualified vendor shall require their vendor to comply with the requirements specified in this paragraph. In addition, qualified vendors shall sign a trading partner agreement.
Note:
Qualified vendors may be either internal to a clinic or medical group or an external organization. A copy of the data submission manual is provided to each data submitting entity. Copies of the manual are also available at
http://www.dhfs.state.wi.us/healthcareinfo
or by writing to the Bureau of Health Information at P.O. Box 309, Madison, WI 53701–0309.
2. Each physician shall submit his or her monthly data to the department within 30 calendar days following the close of the reporting period. The department shall provide instructions on submission in a data submission manual.
3. The department may grant an extension of the deadline specified under subd. 2. only when the physician or physician's qualified vendor adequately justifies to the department the physician's or physician's qualified vendor's need for additional time. In this subdivision, “adequate justification" means a delay due to a strike, fire, natural disaster or catastrophic computer failuresystem malfunction. A physician or physician's qualified vendor desiring an extension shall submit a request for an extension 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.
4. a. To ensure confidentiality of the data is maintained, physicians using qualified vendors to submit data shall provide to the department an originalevidence of a signed trading partner agreement that has been signed and notarized bybetween the qualified vendor and the physician in a format specified within the data submission manual.
b. A Physiciansphysician or his or her delegated representative shall be accountable for their
his or her qualified vendor's failure to submit and edit data in the format required by the department.
5. A health care provider that is not a hospital or ambulatory surgery center shall, before submitting information required by the department under this chapter, convert any names of an insured's payer or other insured's payer to a payer category code as specified by the department in it'sits data submission manual.
6. A health care provider or qualified vendor may not submit information that uses any of the following as a patient account number:
(c) 2. If the physician submitsThe department may not retain or release any of the following data elements, the department shall immediately return the information to the physician, or, if the department subsequently discovers the data, the department shall permanently destroy, delete or make non-identifiable the data from its database if the department receives the elements:
SECTION 41. HFS 120.14 (1) (c) 3. is renumbered 120.14(1) (c) 4m. and amended to read:
HFS 120.14 (1) (c) 4m. If the data submitted by a physician or qualified vendor passes the department's editing processes, the department shall send a data profile to the physician or their qualified vendor indicating what has been sent and an affirmation statement. The physician or their qualified vendor shall review the profile and verify the accuracy of the profile's data.
SECTION 42. HFS 120.14 (1) (c) 4. b. is amended to read:
HFS 120.14 (1) (c) 4. b. The physician or the physician's qualified vendor shall correct all data errors
resulting from checks performed under this paragraphidentified by the department as requiring correction via either the department's, physician's or qualified vendor's data editing system and complete resubmissions of the corrected
shall return corrected data to the department within 15 calendar days after the physician's or the physician's qualified vendor's receipt ofreceived the data summary.
SECTION 43. HFS 120.14 (1) (c) 4. c. is repealed.
SECTION 44. HFS 120.14 (1) (c) 5. (intro) and b., 9., (e) 1. and 4. and (3) (b) 2. are amended to read:
HFS 120.14 (1) (c) 5. The physician or his or her delegated representative shall review the final data profile for accuracy and completeness and shall supply the department within 30 calendar days from the day the data is due to the bureau of health information office with the following:
b. A signed affirmation statement. Physicians A physician or the physician's delegated representative submitting affirmation statements to the department electronically shall use a digital signature approved by the department and returned by the physician or the physician's delegated representative during the timeframes for data submission specified by the department. A physician's or the physician's delegated representative's signature on the electronic data affirmation statement represents the physician's or the physician's delegated representative's acknowledgment that the data is accurate and the data submitter may no longer submit revised data.
9. The department may grant an extension for up to 15 calendar days beyond the 15 calendar days specified in subd. 4. b. if the physician or the physician's qualified vendor adequately justifies to the department the physician's need for additional time. In this subdivision, “adequate justification" means a delay due to a strike, fire, natural disaster or catastrophic computer failuresystem malfunction.
(e) 1. Physicians practicing anytime during calendar year 1998 and submitting claims data to the department electronically to any payer shall continue to submit their practice data to the department electronically.
4. The department shall report all exceptions granted by the department under subd. 3. to the board of health care information.
(3) (b) 2. The department may grant an extension of a deadline specified in subd. 1. for submission of information only when the physician adequately justifies to the department the physician's need for additional time. In this subdivision, “adequate justification'' means a delay due to a labor strike, fire, natural disaster or catastrophic computer failuresystem malfunction. A physician or physician's qualified vendor desiring an extension shall submit a request for an extension 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. Physicians who have been granted an extension by the department shall submit their data directly to the department.
SECTION 45. HFS 120.15 (3) (b) is amended to read:
HFS 120.15 (3) (b) The department may grant an extension of a deadline specified in par. (a) for submission of health care provider information only when the health care provider adequately justifies to the department the health care provider's need for additional time. In this paragraph, “adequate justification" means a delay due to a labor strike, fire, natural disaster or catastrophic computer
failuresystem malfunction. A health care provider desiring an extension shall submit a request for an extension 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. Health care providers who have been granted an extension by the department shall submit their data directly to the department.
SECTION 46. HFS 120.20 (3) (b) is amended to read:
HFS 120.20 (3) (b) Data collected under ss. HFS
120.12120.11 to 120.16 shall not be subject to inspection, copying or receipt as specified in the open record provisions under s.
19.35 (1), Stats.
SECTION 47. HFS 120.21 (1) (a) is amended to read:
HFS 120.21 (1) (a) The annual hospital fiscal year survey.
SECTION 48. HFS 120.22 (1) (a) 1. is amended to read:
HFS 120.22 (1) (a) 1. The annual hospital fiscal year survey.
SECTION 49. HFS 124.05 (3) (h) is amended to read:
HFS 124.05 (3) (h) Cancer reporting. Every hospital shall report to the department all malignant neoplasms that are diagnosed by the hospital diagnoses and all malignant neoplasms diagnosed elsewhere if the individual is subsequently admitted to the hospital. The hospital shall report of each malignant neoplasm shall be made on a form prescribed or approved by the department prescribes or approves and shall be submittedsubmit the report to the department within 6 months after the diagnosis is made or within 6 months after the individual's first admission to the hospital if the neoplasm is diagnosed elsewhere, as appropriate. In this paragraph,“ malignant neoplasm" means an in situ or invasive tumor of the human body, but does not include a squamous cell carcinoma or basal cell carcinoma arising in the skin or an in situ carcinoma of the cervix uteri.
SECTION 50. HFS 124.12 (5) (b) 11. is amended to read:
HFS 124.12 (5) (b) 11. A statement specifying categories of personnel duly authorized to accept and implement medical staff orders. All orders shall be recorded and authenticated. All verbal and telephone orders shall be authenticated by the prescribing member of the medical staff in writing within 2472 hours of receipt.
SECTION 51. HFS 132.42 (3) (a) is amended to read:
HFS 132.42 (3) PHYSICAL HEALTH CERTIFICATIONS. (a) New employees. Every employee shall be certified in writing by a physician or physician extender as having been screened for tuberculosis infection and being free from clinically apparent communicable disease within 90 days before beginning workprior to employment for evidence of infection.
SECTION 52. HFS 132.42 (4) is repealed and recreated to read:
HFS 132.42 (4) DISEASE SURVEILLANCE AND CONTROL. When an employee or prospective employee has a contagious infection, he or she may not perform employment duties in the nursing home until the nursing home makes safe accommodations to prevent the infection's spread.
Note: The Americans with Disabilities Act and Rehabilitation Act of 1973 prohibits the termination or non-hiring of an employee based solely on an employee having an infectious disease, illness or condition.
SECTION 53. HFS 132.44 (1) (b) is repealed.
SECTION 54. HFS 132.51 (2) (b) 1. is repealed and recreated to read:
HFS 132.51 (2) (b) 1. 'Communicable disease management.' The nursing home shall have the ability to manage persons with communicable disease the nursing home admits or retains.
SECTION 55. HFS 132.52 (2) (c) is amended to read:
HFS 132.52 (2) (c) Receipt of certification in writing from a physician or physician extender that the person is free of airborne or other communicable tuberculosisdisease and clinically apparent communicable disease, or an order for procedures to treat and limit the spread of any
communicable disease the person may be found to have.
SECTION 56. HFS 132.66 (1) (d) is repealed.
SECTION 57. HFS 133.03 (8) (b) is amended to read:
HFS 133.03 (8) (b) If a home health agency wants to contest a department action specified in par. (a), it shall file a written request for a hearing under s.
227.44, Stats., with the department of administration's division of hearing
s and appeals within 10 days of receipt of notice of the contested action.
SECTION 58. HFS 134 (title) is amended to read:
HFS 134 Facilities for the Developmentally DisabledServing People with Developmental Disabilities
SECTION 59. HFS 134.11 is amended to read:
HFS 134.11 Authority and purpose. This chapter is promulgated under the authority of s.
50.02 (2) and
(3), Stats., to provide conditions of licensure for facilities that primarily serve
developmentally disabled personspeople with developmental disabilities who require active treatment. This chapter is intended to protect and promote the health, safety and well–being of residents of these facilities.
SECTION 60. HFS 134.12 (1) is amended to read:
HFS 134.12 Scope. (1) APPLICABILITY.
All facilities that provide care primarily for developmentally disabled persons who require active treatment, including facilities owned and operated by the state, a county, a municipality or another public body, are subject to this chapter. A facility that is regulated as a community-based residential facility defined in s.
50.01 (1), Stats., or a nursing home, defined in s.
50.01 (3), Stats., on July 1, 1988 is subject to this chapter rather than to ch.
HFS 83 or
132 if it is a facility
for the developmentally disabledserving people with developmental disabilities.
SECTION 61. HFS 134.13 (7) and (note), (10) (a), (12), (13), (17) and (39) (intro) are amended to read:
HFS 134.13 (7) “Center for the developmentally disabled" means a department-operated residential institution for the care of developmentally disabled personspeople with developmental disabilities.
Note: There are 3 state centers for developmentally disabled personspeople with developmental disabilities in Wisconsin: Central Center, Northern Center and Southern Center.
(10) (a) Eligible for registration as a dietitian by the commission on dietetic registration of the American dietetic association under its requirements in effect on January 17, 1982
and certified with the state of Wisconsin under s. 448.78, Stats.; or
(12) “Facility" means a facility for the developmentally disabledserving people with developmental disabilities.
(13) “FDD" or “facility for the developmentally disabledserving people with developmental disabilities" means a residential facility with a capacity of 3 or more residents in which nursing care is provided to any resident and which primarily serves residents who are developmentally disabledhave developmental disabilites and who require and receive active treatment.
(17) “Interdisciplinary team" means the persons employed by a facility or under contract to a facility who are responsible for planning the program and delivering the services relevant to a resident's care needswho possess the knowledge, skills and expertise necessary to accurately identify the comprehensive array of the client's needs and design a program that is responsive to those needs.
(39) (intro) “QMRP" or “qualified mental retardation professional" means a person who has specialized training in mental retardation or at least one year of experience in treating or working with mentally retarded personspeople with mental retardation or other developmental disabilities, and is one of the following:
SECTION 62. HFS 134.14 (1), (2) (a) (intro) and (5m) are amended to read:
HFS 134.14 Licensure. (1) APPLICATION. Application for a license to operate a facility for the developmentally disabledserving people with developmental disabilities shall be made on a form provided by the department.
