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Rule-Making Notices
Notice of Hearing
Insurance
Notice is hereby given that pursuant to the authority granted under section 601.41 (3), Stats., and the procedures set forth in under sections 227.18 and 227.24 (4), Stats., OCI will hold a public hearing to consider the adoption of the attached proposed rulemaking order affecting sections Ins 17.01 (3) and 17.28, Wis. Adm. Code, relating to Injured Patients and Families Compensation Fund annual fund fees and mediation panel fees for fiscal year 2013 and affecting small business.
Hearing Information
Date: Tuesday, June 19, 2012
Time: 10.:00 a.m.
(or as soon thereafter as the matter may be reached)
Location: OCI
2nd Floor Room 227
125 South Webster St.
Madison, WI 53703
Comments
Written comments can be mailed to:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 1728
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Written comments can be hand delivered to:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 1728
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53703-3474
Comments can be emailed to:
Julie E. Walsh
Comments submitted through the Wisconsin Administrative Rule Web site at:
http://adminrules.wisconsin.gov
on the proposed rule will be considered.
The deadline for submitting comments is 4:00 p.m. on the 14th day after the date for the hearing stated in this Notice of Hearing.
Copies
A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the OCI internet Web site at http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, Public Information and Communications, OCI, at: inger.williams@wisconsin.gov, (608) 264-8110, 125 South Webster Street – 2nd Floor, Madison WI or PO Box 7873, Madison WI 53707-7873.
Analysis Prepared by the Office of the Commissioner of Insurance
Statutes interpreted
Sections 655.27 (3), and 655.61, Wis. Stats.
Statutory authority
Sections 601.41 (3), 655.004, 655.27 (3) (b), and 655.61, Wis. Stats.
Explanation of OCI's authority to promulgate the proposed rule under these statutes
The injured patients and families compensation fund (fund), was established by and operated under ch. 655, Stats. The commissioner of insurance with approval of the board of governors (board) is required to annually set the fees for the fund and the medical mediation panel by administrative rule. Section 655.04, Stats., provides that the director of state courts and the commissioner may promulgate rules necessary to enable them to perform their responsibilities under this chapter. Pursuant to s. 655.27 (3) (b), Stats., the commissioner, after approval by the board, shall by rule set the fees to the fund and s. 655.61, Stats., requires the board, by rule, to set the fees charged to health care providers at a level sufficient to provide the necessary revenue to fund the medical mediation panels. Further, s. 601.41 (3), Stats., provides that the commissioner shall have rule-making authority pursuant to s. 227.11 (2), Stats.
Related statutes or rules
None.
Plain language analysis and summary of the proposed rule
This proposed rule establishes the fees that participating health care providers must pay to the fund for the fiscal year beginning July 1, 2012. These fees represent a 5% increase from fees paid for the 2011-12 fiscal year. The board approved these fees at its meeting on December 14, 2011, based on the recommendation of the board's actuarial and underwriting committee and reports of the fund's actuaries.
The board is also required to promulgate by rule the annual fees for the operation of the injured patients and families compensation medical mediation system, based on the recommendation of the director of state courts. The recommendation of the director of state courts was reviewed by the board's actuarial and underwriting committee. This rule implements the funding level approved by the board by establishing mediation panel fees for the next fiscal year at $22.50 for physicians and $4.50 per occupied bed for hospitals, representing a decrease of $2.50 per physician and a decrease of $0.50 per occupied bed for hospitals from 2011-12 fiscal year mediation panel fees.
Summary of, and preliminary comparison with any existing or proposed federal regulation that is intended to address the activities to be regulated by the proposed rule
To the fund board's and OCI's knowledge there is no existing or proposed federal regulation that is intended to address fund rates, administration or to fund medical mediation panel activities.
Comparison of similar rules in adjacent states as found by OCI
To the fund board's and OCI's knowledge there are no similar rules in the adjacent states to compare this rule to as none of adjacent states have a fund created by statute where rates are directed to be established yearly by rule as is true in Wisconsin.
Summary of the factual data and analytical methodologies that OCI used in support of the proposed rule and how any related findings support the regulatory approach chosen for the proposed rule
This rule establishes annual fund fees and mediation panel fees pursuant to the requirements of the above-noted Wisconsin statutes. The recommendation to the board regarding the fund fee and the medical mediation panel assessment is developed by an actuarial firm under contract with the fund. The actuarial firm outlines its assumptions and trending data in a report to the board's actuarial and underwriting committee. After information is presented, the report and supporting documentation is discussed and results in a recommendation to the board. The chair of the actuarial and underwriting committee presents the information and the actuary's report to the board for consideration. This proposed rule reflects the rates approved by the board at the December 14, 2011 board meeting.
Analysis and supporting documentation that OCI used in support of OCI's determination of the rule's effect on small business under s. 227.114
This increase in fund fees will have an effect on some small businesses in Wisconsin, particularly those that employ physicians and other health care professionals. The mediation panel fee is assessed only on physicians and hospitals, not on corporations or other health care entities. The fund fee increases will affect only those small businesses that pay the fund fees and mediation panel fees on behalf of their employed physicians. However, the fund fee increase will not have a significant effect nor should it negatively affect the small business' ability to compete with other providers. Specifically for providers in the highest risk classification the fees will increase by $482 and for those in the lowest risk classification the increase is $73 for the fiscal year.
Summary of Fiscal Estimate
There will be no state or local government fiscal effect.
The increase in fees promulgated by this rule does not result in a significant fiscal effect on the private sector. Although a health care provider may pass this increase on to its patients, there will not be a significant fiscal effect on the private sector as a result of this proposed rule.
Effect on Small Business
This rule will have little or no effect on small businesses. The increase contained in the proposed rule will require providers to pay an increased fund fee which will increase the operational expenses for the providers. However, this increase is not considered to be significant and will have no effect on the provider's competitive abilities.
Initial regulatory flexibility analysis
This rule does not impose any additional requirements on small businesses.
Notice is hereby further given that pursuant to s. 227.114, Stats., the proposed rule may have an effect on small businesses. The initial regulatory flexibility analysis is as follows:
a. Types of small businesses affected:
Health care providers and possibly businesses to the extent any increase in fund fees is forwarded to employers.
b. Description of reporting and bookkeeping procedures required:
None beyond those currently required.
c. Description of professional skills required:
None beyond those currently required.
OCI Small business regulatory coordinator
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