The rules limit the fee a health care provider may charge to provide duplicate health care records. The proposed fee limit varies depending on the person making the request and, in some cases, the resultant number of copies generated by the request. If an individual (or the individual's personal representative on behalf of the individual) is requesting his or her own records, the provider may charge no more than $0.31 per page. Postage is extra. If a person is requesting another's records, the provider may charge no more than $12.50 per request if the request generates less than five copies plus $0.31 per page. The provider may charge no more than $15.00 per request if the request generates five or more copies plus $0.31 per page. The $12.50 and $15.00 amounts may be deemed a retrieval fee that individuals need not pay for copies of their own records.
For More Information
The Department posts information about each emergency rule and each proposed permanent rule it promulgates on its website at
http://adminrules.wisconsin.gov. At this website, you can view documents associated with this rule's promulgation, register to receive email notification whenever the Department posts new information about this rulemaking and, during the public comment period, you can submit comments on the rulemaking order and view comments that others have submitted about the rule.
If you do not have Internet access and would like to find out more about the hearing or to request a copy of the proposed rules, please contact:
Larry Hartzke
Office of Legal Counsel
P.O. Box 7850
Madison, WI 53707-7850
608-267-2943
If you are hearing or visually impaired, do not speak English, or have circumstances that might make communication at a 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 given above at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Deadline for Comment Submission
Written comments for this rule that are submitted using the Department's website or which the Department receives by mail or email at the above address no later than 5:00pm, December 30, 2003, will be given the same consideration as testimony presented at the hearing.
Fiscal estimate
The Department estimates that the proposed rules will increase costs and affect GPR and FED funding sources. Costs incurred by counties and tribes may also be affected.
Section
146.83 (3m), Stats., as created by
2001 Wisconsin Act 109 and s.
908.03 (6m) (d), Stats., as amended by
2001 Wisconsin Act 109, requires the Department prescribe by rule fees for reproducing patient medical records that are the maximum amount a health care provider may charge. The fee limits are to be based on an approximation of actual costs. The statutes allow health care providers to also charge for postage or other delivery costs.
Fee limits proposed in the rules are the Department's approximation of the total cost (retrieval, processing and copying) of reproducing medical records for persons other than the subject of the records when the records are requested by a person other the subject of the record. That limit is either $12.50 or $15.00 per request plus $0.31 per page. A second fee limit in the rules are the Department's approximation of the cost of copying records only (not including retrieval and processing costs) applicable to requests made by persons who are the subject of the requested records. That limit is $0.31 per page. The rules also specify a limit on what a health care provider may charge for certifying a record.
The fee limits apply to all persons and entities who request duplicate health care records under 146.83 and 908.03 (6m) (c) 3., Stats., and to all health care providers who supply those records, unless superceded by fees established by other applicable law. Such covered persons and entities include W-2 agencies, county district attorneys and corporation counsels and also state agencies not governed by other fee limits or fee scales.
The Disability Determination Bureau within DHFS routinely requests large volumes of medical records to adjudicate disability claims for the Social Security disability, Supplemental Security Income (SSI) and Medicaid disability programs. Under those programs, the Bureau expects 180,000 record request to be made in 2004. The average request generates 26 pages. The Department's Disability Determination Bureau (DDB) currently receives from the Social Security Administration (SSA) a maximum reimbursement of $20 per record request for SSI applications, regardless of the number of pages requested or supplied. Payments for SSI-related record requests are estimated to total $3.1 million in 2004. If all health care providers were to maximize their fee income by charging the amount in the proposed rule the Bureau would require an additional $465,000 in annual federal funding from SSA. Currently, the federal funding for DDB is through a federal block grant. It is uncertain whether the federal allocation would be increased for an increase in expenditures. If the block grant is not increased, DDB would have to fund increased costs using existing federal or state resources.
DDB expects record request costs for Medicaid (MA) disability programs to total $190,000 in 2004. Increased costs for records requested under MA disability programs would be incurred by the MA program. The proposed change could increase MA costs by $218,500 AF ($109,300 GPR) annually.
The other state programs that might be expected to request medical records are Food Stamp Certification, Worker's Compensation, W-2 Transitions, and Vocational Rehabilitation. The Worker's Compensation program will not be affected under this rule change. It operates under its own fee limits established in s.
102.13 (2) (b), Stats. and is therefore exempt from this rule. The Vocational Rehabilitation program, administered by the Department of Workforce Development, uses medical records in vocational assessments. The proposed increase in allowable medical record fees could increase DWD Division of Vocational Rehabilitation costs by $230,000 AF ($49,000 GPR) annually.
The W-2 Transitions and Food Stamp Certification programs are state programs administered by local agencies, including county and tribal run agencies. Local agencies request medical records to identify utilization of medical services by W-2 applicants and establish exemptions from food stamp work requirements. Costs for record requests are reimbursed with other administrative costs within set contract amounts provided to local agencies. Local agencies' W-2 costs are reimbursed through the W-2 contract, which is administered by DWD. County agency food stamp administrative costs are reimbursed through the Income Maintenance contract, administered by DHFS. The proposed increase in allowable medical record fees could increase costs for local agencies if contract amounts were not increased. Since medical record request costs are not reported under the W-2 and IM contracts as a separate cost items, increased costs to counties and tribes under this proposed change cannot be estimated.
Other possible increased costs to local units of government due the proposed change are unknown.
Initial Regulatory Flexibility Analysis
When an agency, such the Department, proposes a rule that may have an effect on small businesses (defined as entities that are independently owned and operated and not dominant in their field, and employ fewer than 25 full-time employees or have gross annual sales of less than $2.5 million), section
227.114, Stats., requires that agency to consider several methods for reducing the effect of the proposed rule on those small businesses. The revision of ch.
HFS 117 will affect many small businesses, principally law firms that request health care records on behalf of clients, and small health provider offices that maintain and supply their patients' health care records to those authorized to request those records. The fee limits specified in ch.
HFS 117 also will effect a small number of businesses that reproduce medical records on behalf of health care providers and transmit those records to authorized record requesters.
Chapter
HFS 117 does not require compliance with any reporting, bookkeeping or other procedures. Nor does the proposed rule impose new requirements for professional skills that are not currently required to comply with requests for copies of health care records. Given that the proposed rules do not require reporting, bookkeeping or other procedures and skills, the question of exempting particular small businesses from some or all of HFS 117's provisions is moot.
The Department also cannot estimate the effect of the proposed rule on the above small businesses other than to note that the fee limits the Department proposes to specify in HFS 117 are higher than those specified in the existing HFS 117 rules. The Department believes that exempting certain law firms and health care providers from the rule's applicability would be contrary to the legislature's intent that the rule, to the extent possible, specify a single fee limit for all parties. Similarly, the Department believes that specifying a lower fee limit for particular law firms (or a higher fee limit for particular health care providers) would also be contrary to legislative intent.
Notice of Hearings
Natural Resources
(Fish, Game, etc., Chs.
NR 1—)
NOTICE IS HEREBY GIVEN that pursuant to s.
227.11 (2) (a), Stats., interpreting s.
350.09 (7), Stats., the Department of Natural Resources will hold public hearings on revisions to ss.
NR 6.03 and
6.08, Wis. Adm. Code, relating to snowmobile noise testing procedures. Current statutes require snowmobiles to meet certain noise levels. For snowmobiles that are manufactured and sold or offered for sale in Wisconsin, the noise limit has been set at 78 decibels since 1975. For snowmobiles that are operated by the consumer in Wisconsin, noise emissions are limited to excessive or unusual levels.
The rule revisions are being proposed in order to provide a field-friendly test procedure (stationary test) for testing snowmobile noise emissions on consumer machines. The test procedures that are outlined in the proposed rule have been adopted by the Society of Automotive Engineers for law enforcement as a means to identify loud and obnoxious snowmobiles in the field. The proposed rule changes will also provide a definition for excessive or unusual noise that is referenced in statute and which is currently undefined.
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.
NOTICE IS HEREBY FURTHER GIVEN that the hearings will be held on:
Monday, December 15, 2003 at 11:00 a.m.
Room 100 (Terrace Room)
UW Marathon Co. Center
518 7th Avenue
Wausau
Thursday, December 18, 2003 at 1:30 p.m.
Room 511, GEF #2
101 South Webster St.
Madison
NOTICE IS HEREBY FURTHER GIVEN that pursuant to the Americans with Disabilities Act, reasonable accommodations, including the provision of informational material in an alternative format, will be provided for qualified individuals with disabilities upon request. Please call Karl Brooks at (608) 267-7455 with specific information on your request at least 10 days before the date of the scheduled hearing.
Written comments on the proposed rule may be submitted to Mr. Karl Brooks, Bureau of Law Enforcement, P.O. Box 7921, Madison, WI 53707 no later than December 30, 2003. Written comments will have the same weight and effect as oral statements presented at the hearings. A copy of the proposed rule [LE-40-03] and fiscal estimate may be obtained from Mr. Brooks.
Notice of Hearing
Natural Resources
(Fish, Game, etc., Chs.
NR 1—)
NOTICE IS HEREBY GIVEN that pursuant to ss.
29.014 (1),
29.041,
29.519 (1) (b) and
227.11 (2) (a), Stats., interpreting ss.
29.014 (1),
29.041 and
29.519 (1) (b), Stats., the Department of Natural Resources will hold public hearings on amendments to ss.
NR 20.20 (73) (j) 1. a. and
3. a. and
25.06 (2) (b) 1., Wis. Adm. Code, relating to fishing for yellow perch in Green Bay. The proposed rule postpones by 3 years the date when the sport fishing daily bag limit for yellow perch reverts from 10 fish to 25 fish and the annual total allowable commercial harvest of yellow perch from zone 1 reverts from 20,000 pounds to 200,000 pounds.
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: Yellow perch commercial fishers in Green Bay.
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.
NOTICE IS HEREBY FURTHER GIVEN that the hearings will be held on:
Thursday, December 11, 2003 at 1:30 p.m.
Council Chambers, Peshtigo Municipal Bldg.
331 French St.
Peshtigo
Bay Beach Wildlife Sanctuary
1660 E. Shore Drive
Green Bay
at 5:30 p.m.
NOTICE IS HEREBY FURTHER GIVEN that pursuant to the Americans with Disabilities Act, reasonable accommodations, including the provision of informational material in an alternative format, will be provided for qualified individuals with disabilities upon request. Please call Bill Horns at (608) 266-8782 with specific information on your request at least 10 days before the date of the scheduled hearing.
Written comments on the proposed rule may be submitted to Mr. Bill Horns, Bureau of Fisheries Management and Habitat Protection, P.O. Box 7921, Madison, WI 53707 no later than December 21, 2003. Written comments will have the same weight and effect as oral statements presented at the hearing. A copy of the proposed rule [FH-36-03] and fiscal estimate may be obtained from Mr. Horns.
Notice of Hearing
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),
29.516 (2) (d) and
29.519 (1) (b), Stats., the Department of Natural Resources will hold a public hearing on the creation of s.
NR 25.09(2)(b)2.f., Wis. Adm. Code, relating to trap net marking requirements. The proposed rule creates net marking requirements for commercial trap nets set in Lake Michigan and Green Bay from April 1 to October 25.
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 trap net fishers in Lake Michigan and Green Bay.
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.
NOTICE IS HEREBY FURTHER GIVEN that the hearing will be held on:
Friday, December 12, 2003 at 11:00 a.m.
Room 027, GEF #2
101 South Webster Street
Madison
NOTICE IS HEREBY FURTHER GIVEN that pursuant to the Americans with Disabilities Act, reasonable accommodations, including the provision of informational material in an alternative format, will be provided for qualified individuals with disabilities upon request. Please call Bill Horns at (608) 266-8782 with specific information on your request at least 10 days before the date of the scheduled hearing.
Written comments on the proposed rule may be submitted to Mr. Bill Horns, Bureau of Fisheries Management and Habitat Protection, P.O. Box 7921, Madison, WI 53707 no later than December 21, 2003. Written comments will have the same weight and effect as oral statements presented at the hearing. A copy of the proposed rule [FH-35-03] and fiscal estimate may be obtained from Mr. Horns.
Notice of Hearing
Natural Resources
(Environmental Protection-General, Chs.
NR 100—)
NOTICE IS HEREBY GIVEN that pursuant to ss.
87.30 (1) and
227.11 (2) (a), Stats., interpreting s.
87.30 (1), Stats., the Department of Natural Resources will hold a public hearing on the creation of s.
NR 116.03 (6m) and the amendment of s.
NR 116.15 (1) (a), Wis. Adm. Code, relating to decks on nonconforming structures in floodplains. The proposed rule will define a deck and provide that a deck may be added to a nonconforming building or a building with a nonconforming use in a floodplain.
