There is no state fiscal effect, and there are no local government costs. No funding sources or ch.
20 appropriations are affected. There are no long-range fiscal implications.
Contact Person
A copy of the proposed rule and fiscal estimate may be obtained at no charge from Mark Schlei, Deputy General Counsel, Department of Financial Institutions, Office of the Secretary, P.O. Box 8861, Madison, WI 53708-8861, tel. (608) 267-1705. A copy of the proposed rule may also be obtained and reviewed at the Department of Financial Institutions' website,
www.wdfi.org.
Written comments regarding the proposed rule may be submitted to Mark Schlei, Deputy General Counsel, Department of Financial Institutions, Office of the Secretary, P.O. Box 8861, Madison, WI 53708-8861, tel. (608) 267-1705, or via the department's website contact page, e-mail the secretary. Written comments must be received by the conclusion of the hearing.
Notice of Hearings
Health and Family Services
(Medical Assistance, Chs.
HFS 100-)
Hearing Information
The public hearings will be held:
Date & Time
|
Location
|
July 27, 2005
Wednesday
1:00 p.m. to 3:00 p.m.
|
500 Forest St.
Marathon County Courthouse
Room 131
Wausau, WI
|
July 28, 2005
Thursday
10:00 a.m. to noon
|
500 Riverview Ave.
Room 1053
Waukesha, WI
|
The hearing site is fully accessible to people with disabilities. 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.
Written comments may be submitted at the public hearing, or in lieu of attending a public hearing written comments can be submitted by regular mail or email to the contact person listed below. Written comments may also be submitted to the Department using the Wisconsin Administrative Rules Internet website at the web address listed below.
Deadline for Comment Submission
The deadline for submitting comments is 4:30 p.m., on Friday, August 12, 2005.
Analysis Prepared by the Department of Health and Family Services
The Department proposes to revise ss.
HFS 107.113 (5) and
107.12 (2) relating to the number of hours a nurse may provide private duty nursing services, including care to ventilator-dependent recipients, for reimbursement by Medicaid. Specifically, the proposed revisions will become more flexible to facilitate scheduling but restrict the total number of hours a nurse may work and still receive Medicaid reimbursement for such services.
Effect on Small Business
The proposed changes will have a beneficial effect on home health care agencies and nurses in independent private duty nursing practice that offer private duty nursing services, by providing these entities and their consumers with better scheduling flexibility.
Fiscal Estimate
The Department is updating and clarifying some requirements in its Medical Assistance rules. Chapter
HFS 107 specifies the Wisconsin Medical Assistance (MA) covered services and reimbursement requirements for providers. As currently written, ch.
HFS 107 limits the amount of time a nurse may provide direct private duty nursing (PDN) or respiratory care services (RCS). In particular, s.
HFS 107.113 (5) (d), governing RCS, currently provides that “
[s
]ervices provided by one individual in excess of 12 continuous hours per day or 60 hours per week" are not covered services. The PDN rule has a similar limitation. That rule, s.
HFS 107.12 (2) (b), states that PDN “is limited to 12 continuous hours in each 24 hour period and no more than 60 hours in a calendar week," and that “[a] prior authorization request for 2 consecutive 12-hour periods shall not be approved."
The Department has determined that strict adherence to the preceding requirements that are currently expressed in its administrative rules sometimes unnecessarily constrains the provision of needed personal care services and may therefore constitute an unjustified burden to both consumers and providers. Consequently, the Department is proposing to amend the rules to reduce these restrictions. Specifically, the Department is promulgating changes in the number of hours that private duty nurses and respiratory care nurses may work in a 24-hour period. The Department is further defining the 24-hour work period as a calendar day. For the purpose of scheduling breaks, it will retain the reference to any 24-hour period.
Under this revision to the rule, the total number of hours authorized for private duty nursing through the prior authorization process will not change. The rule change will help to simplify the scheduling of private duty nursing services. The Department does not expect any fiscal effect as a result of these changes.
Copy of Rule
A copy of the full text of the rules and the full text of the fiscal estimate, and other documents associated with this rulemaking may be obtained, at no charge, from the Wisconsin Administrative Rules website at
http://adminrules.wisconsin.gov. At this website you can also 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 electronically and view comments that others have submitted about the rule.
A copy of the full text of the rule and the fiscal estimate may also be obtained by contacting the Department's representative listed below:
Al Matano
Division of Health Care Financing,
Bureau of Fee-for-service Health Care Benefits
P.O. Box 309
One West Wilson Street, Room 350
(608) 267-6848
MatanA@dhfs.state.wi.us
Notice of Hearing
Insurance
NOTICE IS HEREBY GIVEN That pursuant to the authority granted under s.
601.41 (3), Stats., and the procedures 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 50.30, Wis. Adm. Code, relating to actuarial opinion and summary.
Hearing Information
Date: July 29, 2005
Time: 10:00 a.m., or as soon thereafter as the
matter may be reached
Place: OCI, Room 223,
125 South Webster St., 2nd Floor,
Madison, WI
Written comments or comments submitted through the Wisconsin Administrative Rule website at: https:// adminrules.wisconsin.gov on the proposed rule will be considered. The deadline for submitting comments is 4:00 p.m. on the 7th day after the date for the hearing stated in this Notice of Hearing.
Written comments should be sent to: Fred Nepple, OCI Rule Comment for Rule Ins 5030, Office of the Commissioner of Insurance, PO Box 7873, Madison WI 53707-7873
Analysis Prepared by the Office of the Commissioner Of Insurance (OCI)
OCI proposes this rule to require reports and other information relating to actuarial opinions prepared and field for property and casualty insurers, including nondomestic insurers licensed under ch.
618, Stats. Section
601.42, Stats., establishes the statutory authority to require reports and submission of other information from any person, including a licensed insurer, subject to regulation under the Insurance Code. Section
601.465, Stats., establishes OCI's authority to retain the reports and information as privileged and confidential.
Related Statutes or Rules: The proposed rule is intended to supplement the information required to be filed with insurer's annual financial statements under ch.
Ins 50, Wis. Adm. Code.
Summary: Section
Ins 50.30, Wis. Adm. Code, currently requires licensed property and casualty insurers that file a NAIC financial statement to also file an actuarial opinion. Under current law OCI may also ask an insurer to file the supporting actuarial summary and work papers. This proposed rule will require all domestic property and casualty insurers that are required to file an actuarial opinion to also file a supporting actuarial opinion summary. The proposed rule also notes that OCI, as under current law, may require a licensed non-domestic property and casualty insurer to file a summary and supporting work papers. The actuarial summary and work papers support the actuarial opinion, which is a public document, however the proposed rule notes the required supporting actuarial summary and work papers, with their detailed proprietary information, may be retained as confidential by OCI under s.
601.465, Stats.
Federal Comparison
Comparison with any existing or proposed federal regulation that is intended to address the activities to be regulated by the proposed rule: None
State Comparisons
All of the adjacent state insurance departments are considering seeking legislation or a rule or are in the process of promulgating a rule to put in effect the NAIC Model. However none have yet adopted the NAIC Model. Accordingly the current status is:
Iowa: None
Illinois: None
Minnesota: None
Michigan: None
Summary of factual data and analytical methodologies
This proposed rule is based on the NAIC Property and Casualty Actuarial Opinion Model Law. It reflects the experience and recommendations of insurance financial regulators relating to analysis of the subject matter of the currently required actuarial opinion.
Initial Regulatory Flexibility Analysis
NOTICE IS HEREBY FURTHER GIVEN That pursuant to s.
227.114, Stats., the proposed rule may have an impact on small businesses. The initial regulatory flexibility analysis is as follows:
a. Types of small businesses affected: Small mutual insurers.
b. Description of reporting and bookkeeping procedures required: The proposed rule requires filing of a summary of information derived from the already currently required actuarial analysis.
c. Description of professional skills required: The actuarial professional services currently required will also address requirements of the proposed rule.
There are only five mutual insurers that will be subject to the rule that are “small businesses." This is based on an analysis of financial statements filed by property and casualty insurers conducted by the bureau of financial analysis and examination. The assessment of fiscal and economic impact on these insurers is based on bureau of financial analysis and examination professional assessment, and the bureau's past experience in the analysis and examination of actuarial reports and opinions.
The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266- 7843 or at email address
Eileen.Mallow@oci.state.wi.us
Fiscal Estimate
The limited fiscal effect of the proposed rule on the insurers will be due to the cost of producing and submitting the Actuarial Opinion Summary. The Actuarial Opinion Summary will illustrate the difference between the insurer's recorded loss and loss adjustment expense reserves and the actuary's point estimates and/or range of reasonable estimates. This information is currently required to be included in the opining actuary's report, so including it in the Actuarial Opinion Summary will not involve significant additional work or expense.
The proposed rule also includes a conditional requirement. If the insurer has a one-year adverse development in excess of 5% of surplus during 3 of the last 5 years, the insurer's actuary must provide commentary. This requirement would not be applicable for most insurers in most years. Where it is applicable the actuary will have already considered the causes of the adverse trend and providing a commentary will not involve any significant additional cost.
Agency Contact Person
A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the WEB sites at:
http://oci.wi.gov/ocirules.htm
or by contacting Inger Williams, OCI Services Section, at:
Phone: (608) 264-8110
Address: 125 South Webster Street
2nd Floor Madison WI 53702
Mail: PO Box 7873, Madison WI 53707-7873
Submission of Comments
The deadline for submitting comments is 4:00 p.m. on the 14th day after the date for the hearing stated in the Notice of Hearing.
Mailing address:
Fred Nepple
Legal Unit - OCI Rule Comment for Rule Ins 5030
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Street address:
Fred Nepple
Legal Unit - OCI Rule Comment for Rule Ins 5030
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53702
Notice of Hearing
Marriage and Family Therapy,
Professional Counseling and Social Work Examining Board
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Marriage and Family Therapy, Professional Counseling and Social Work Examining Board in ss.
15.08 (5) (b),
227.11 (2) and
457.03 (2), Stats., and interpreting s.
457.03 (2), Stats., the Marriage and Family Therapy, Professional Counseling and Social Work Examining Board will hold a public hearing at the time and place indicated below to consider an order to amend s.
MPSW 20.02 (18), relating to recordkeeping by marriage and family therapists, professional counselors and social workers.
Hearing Date, Time and Location
Date: August 2, 2005
Time: 9:30 a.m.
Location: 1400 East Washington Avenue
Room 179A
Madison, Wisconsin
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Department of Regulation and Licensing, Office of Legal Counsel, P.O. Box 8935, Madison, Wisconsin 53708, or by email to
pamela.haack@drl.state.wi.us. Written comments must be received on or before
August 12, 2005 to be included in the record of rule-making proceedings.
Analysis Prepared by the Dept. of Regulation and Licensing
