Rule-Making Notices (Hearing Notices)

  Small businesses that employ physicians or other health care professionals participating in the fund.

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

The OCI small business coordinator is Louie Cornelius and may be reached at phone number [phone] or by email at [e-mail].

Proposed Order Amending, Repealing, and Recreating a Rule

Rule No. Agency 145 — Sections Ins 17.01 (3) and Ins 17.28 (6), Wis. Admin. Code.

The Commissioner of Insurance proposes an order to amend s. Ins 17.01 (3), and to repeal and recreate s. Ins 17.28 (6), Wis. Admin. Code, relating to the Injured Patients and Families Compensation Fund annual fund and mediation panel fees, for the fiscal year beginning July 1, 2014 and affecting small business.

The statement of scope for this rule SS: 147-13, was approved by the Governor on November 18, 2013, published in Register No. 695, on November 30, 2013, and approved by the Commissioner on May 8, 2014.

Analysis Prepared by the Office of the Commissioner Of Insurance (OCI)

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

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. The proposed fees comply with the limitation delineated in s. 655.27 (3) (br), Stats. Section 655.004, 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

This proposed rule establishes the fees that participating health care providers must pay to the fund for the fiscal year beginning July 1, 2014. These fees represent a 10% decrease from fees paid for the 2013-2014 fiscal year. The board approved these fees at its meeting on December 18, 2013, 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 on March 19, 2014 by establishing mediation panel fees for the next fiscal year at $7.75 for physicians and $1.50 per occupied bed for hospitals, representing an increase of $7.75 per physician and an increase of $1.50 per occupied bed for hospitals from 2013-14 fiscal year mediation panel fees.

Summary of and comparison with any existing or proposed federal statutes and regulations

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 with rules in adjacent states

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.

A summary of the factual data and analytical methodologies that OCI used in support of the proposed rule:

None. This rule establishes annual fund 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 and reviewed annually by the fund's actuaries and the board's actuarial and underwriting committee. The actuarial and underwriting committee after review and discussion with the fund's actuaries present the information and the actuaries report to the board for consideration. This proposed rule reflects the rates approved by the board at the December 18, 2013 and March 19, 2014 board meetings.

Analysis and supporting documentation that OCI used in support of OCI's determination of the rule's effect on small business or in preparation of an economic impact analysis

This decrease in fund fees will have a positive effect on 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 providers. The mediation panel fees are increasing from the zero level of fiscal year 2013-2014 but are still lower than rates in fiscal year 2011-2012. The fund fee decrease will affect only those small businesses that pay the fund fees and mediation panel fees on behalf of their employed physicians. The fund fee decrease will not have a significant effect nor should it negatively affect the ability of small businesses to compete with other providers.

Effect on Small Business

This rule will have little or no effect on small businesses. The decrease contained in the proposed rule will require providers to pay reduced fund fees which will decrease the operational expenses for the providers. The increase in mediation panel fees promulgated by this rule should not result in a significant fiscal effect on the private sector.

A copy of any Comments and Opinion Prepared by the Board of Veterans Affairs under s. 45.03 (2m), Stats., for Rules Proposed by the Department of Veterans Affairs.

None.

Office of the Commissioner of Insurance Fiscal Estimate for Sections Ins 17.01 and 17.28 (6), Relating to Injured Patients and Families Compensation Fund Annual Fund Fees and Mediation Panel Fees for the Fiscal Year Beginning July 1, 2014 and Affecting Small Business

This rule change will have no significant effect on the private sector as this proposed rule reduces fees to participants in the fund and slightly increases mediation panel fees to $7.75 for physicians and $1.50 per occupied bed for hospitals. The fund is a segregated account and does not impact state funds. The rule decreases fees and therefore does not have an effect on county, city, village, town, school district, technical college district and sewerage district fiscal liabilities and revenues.

Agency Contact Person

A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the Web site at: http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, OCI Services Section, at:

Phone:   [phone]

Email:   [e-mail]

Address:   125 South Webster St — 2nd Floor

Mail:   PO Box 7873, Madison, WI 53707-7873

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA-2049 (C04/2011)					Division of Executive Budget and Finance 101 East Wilson Street, 10th Floor P.O. Box 7864 Madison, WI 53707-7864 FAX: [phone]
ADMINISTRATIVE RULES – FISCAL ESTIMATE
1.   Fiscal Estimate Version
X Original ⍽ Updated ⍽ Corrected
2.   Administrative Rule Chapter Title and Number   INS 1728
3.   Subject   Injured Patients and Families Compensation Fund Annual fund and Mediation Panel Fees for the fiscal year beginning July 1, 2014 and affecting small business
4.   State Fiscal Effect:
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues					⍽ Increase Costs ⍽ Yes ⍽ No   May be possible to absorb       within agency's budget. X Decrease Costs
5.   Fund Sources Affected: ⍽ GPR   ⍽ FED   ⍽ PRO   ⍽ PRS   X SEG   ⍽ SEG-S						6.   Affected Ch. 20, Stats. Appropriations: None
7.   Local Government Fiscal Effect:
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Revenues ⍽ Decrease Revenues			⍽ Increase Costs ⍽ Decrease Costs
8.   Local Government Units Affected: ⍽ Towns ⍽ Villages ⍽ Cities ⍽ Counties ⍽ School Districts ⍽ WTCS Districts ⍽Others: None
9.   Private Sector Fiscal Effect (small businesses only):

X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Revenues ⍽ Decrease Revenues ⍽ Yes X No   May have significant     economic impact on a     substantial number of     small businesses		⍽ Increase Costs ⍽ Yes ⍽ No   May have significant     economic impact on a     substantial number of     small businesses X Decrease Costs
10.   Types of Small Businesses Affected:
Small businesses that employ physicians or other health care professionals participating in the Fund.
11.   Fiscal Analysis Summary
No significant impact. For Fund fees a 10% decrease and although the rule proposes an increase from zero for mediation panel fees, the proposed fees are less than the 2011-2012 fees.
12.   Long-Range Fiscal Implications
None
13.   Name — Prepared by Julie E. Walsh		Telephone Number [phone]		Date May 9, 2014
14.   Name – Analyst Reviewer		Telephone Number		Date
Signature—Secretary or Designee		Telephone Number [phone]		Date

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA-2049 (R03/2012)	Division of Executive Budget and Finance 101 East Wilson Street, 10th Floor P.O. Box 7864 Madison, WI 53707-7864 FAX: [phone]
ADMINISTRATIVE RULES Fiscal Estimate & Economic Impact Analysis

1. Type of Estimate and Analysis
X Original   ⍽ Updated   ⍽ Corrected
2. Administrative Rule Chapter, Title and Number
Agency 145 Ch Ins 17.01 (3), and 17.28 (6)
3. Subject
Injured Patients and Families Compensation Fund Annual Fund fees and Mediation Panel Fees for the fiscal year beginning July 1, 2014.
4. Fund Sources Affected			5. Chapter 20, Stats. Appropriations Affected
⍽ GPR   ⍽ FED   ⍽ PRO   ⍽ PRS   X SEG   ⍽ SEG-S			None
6. Fiscal Effect of Implementing the Rule
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues		⍽ Increase Costs ⍽ Could Absorb Within Agency's Budget ⍽ Decrease Cost
7. The Rule Will Impact the Following (Check All That Apply)
⍽ State's Economy ⍽ Local Government Units		X Specific Businesses/Sectors ⍽ Public Utility Rate Payers X Small Businesses (if checked, complete Attachment A)
8. Would Implementation and Compliance Costs Be Greater Than $20 million? ⍽ Yes   X No
9. Policy Problem Addressed by the Rule
To establish the annual fees that participating health care providers must pay to the Injured Patients and Families Compensation Fund ("Fund") as required by s. 655.27 (3), Wis. Stats., for fiscal year beginning July 1, 2014. The proposed rule will also establish the mediation panel fees for fiscal year 2015 commencing on July 1, 2014. This rule provides the Fund with appropriate and adequate funding and solvency for future years. This is the main vehicle for achieving and maintaining the Fund's solvency.
10. Summary of the businesses, business sectors, associations representing business, local governmental units, and individuals that may be affected by the proposed rule that were contacted for comments.
OCI solicited comments generally through publication requesting comments from the public utilizing the OCI website. Additionally OCI solicited comments from businesses, individuals, and local government units related to the implementation and compliance costs. Solicitations were sent to health insurance members of OCI's Health and Life Insurance Advisory Council and interested parties. Members included health insurance companies, health insurance agent representatives, consumer representatives, provider representatives and representatives of small business. Additional solicitations were made to associations representing various affected parties and local government representatives including: •   Wisconsin Association of Health Plans •   Wisconsin Association of Health Underwriters •   Independent Insurance Agents Association of Wisconsin •   National Federation of Independent Business-Wisconsin •   Wisconsin Association of Nurse Anesthetists •   Wisconsin Manufacturers and Commerce •   Wisconsin Dental Association •   Wisconsin Medical Society •   Professional Insurance Agents of Wisconsin •   National Association of Insurance and Financial Advisors-Wisconsin •   Wisconsin Hospital Association •   Wisconsin Association for Justice •   The League of Wisconsin Municipalities •   Wisconsin Counties Association •   Wisconsin Towns Association •   Wisconsin Association of School Boards •   Wisconsin Association of School District Administrators
11. Identify the local governmental units that participated in the development of this EIA.
None beyond solicitation for comments.
12. Summary of Rule's Economic and Fiscal Impact on Specific Businesses, Business Sectors, Public Utility Rate Payers, Local Governmental Units and the State's Economy as a Whole (Include Implementation and Compliance Costs Expected to be Incurred)
All health care provider participants in the Fund as set forth in s. 655.002 (1), Wis. Stat., will be required to pay a 10% reduced assessment for their medical malpractice coverage under Ch.655, Wis. Stat. The impact is considered to be minimal and in fact positive to the participants. In addition there is a fee this fiscal year for mediation panel fees so while greater than fiscal year 2013-2014 fees of zero, the fees are lower than the fees for fiscal year 2011-2012.
13. Benefits of Implementing the Rule and Alternative(s) to Implementing the Rule
The proposed rule will benefit Fund participants by ensuring that fee revenue is adequate to cover anticipated administrative, operating and claims payments costs. The alternatives to this rule would be to establish a Fund fee increase, to maintain current fee amounts or to assess fees lower than the proposed 10% reduction in Fund fees. A greater reduction in fees would leave the Fund with inadequate funding to cover actuarially-based projected costs, while a fee increase or static fee level would present an unnecessary cost to Fund participants. The proposed rule does not significantly impact Wisconsin's economy, productivity, jobs or the overall economic competitiveness of Wisconsin. Wisconsin's health care marketplace is strengthened with an affordable layer of medical malpractice coverage. The Fund has existed in Wisconsin since 1975. Fund participants will benefit from a stable and solvent fund. Additionally, Fund participants should not experience increased compliance costs with the reduction of fund fees even with inclusion this year of mediation panel fees.
14. Long Range Implications of Implementing the Rule
The long-range implication of the rule as proposed will be an adequately funded and solvent Fund.
15. Compare With Approaches Being Used by Federal Government
Federal government does not address this subject matter.
16. Compare With Approaches Being Used by Neighboring States (Illinois, Iowa, Michigan and Minnesota)
None of the neighboring states have a patient compensation fund or a general program of state-sponsored liability insurance for physicians.
17. Contact Name				18. Contact Phone Number
Louie Cornelius				608-264-8113

This document can be made available in alternate formats to individuals with disabilities upon request.

ATTACHMENT A

1. Summary of Rule's Economic and Fiscal Impact on Small Businesses (Separately for each Small Business Sector, Include Implementation and Compliance Costs Expected to be Incurred)

The agency does not anticipate any implementation costs or additional compliance costs for fund participants. All health care provider participants in the Fund as set forth in s. 655.002 (1), Wis. Stat., will be required to pay the reduced assessment for their medical malpractice coverage under Ch. 655, Wis. Stat. In addition there is a fee this fiscal year for mediation panel fees however, while the fees are greater than fiscal year 2013-2014 fees of zero, the fees are lower than the fees for fiscal year 2011-2012.

2. Summary of the data sources used to measure the Rule's impact on Small Businesses

The Fund contracts for actuarial services to develop the documentation and analysis necessary for the Actuarial and Underwriting Committee of the Fund. The documentation includes an actuarially indicated rate level for break even financial projections against expected claims reflective of all physician classifications. Since some physicians are small employer practices this information does relay information to the Committee and Board for the impact on small businesses directly impacted by the proposal. The actuarial firm presents its analysis to the Actuarial and Underwriting Committee of the Fund Board of Governors. The Committee reviews all documentation and projections and makes a recommendation to the full Board of Governors for consideration. The Fund Board of Governors reviewed the Committee's recommendation at its December 18, 2013 meeting as well as the underlying analysis by the actuarial firm. Following deliberation, the Board of Governors affirmed the Committee's recommendation of a decrease of 10% for Fund fees and at the March 19, 2014 meeting affirmed the change to the mediation panel fees from last year's fees of zero to $7.75 for physicians and $1.50 per occupied bed for hospitals.

3. Did the agency consider the following methods to reduce the impact of the Rule on Small Businesses?

⍽ Less Stringent Compliance or Reporting Requirements ⍽ Less Stringent Schedules or Deadlines for Compliance or Reporting ⍽ Consolidation or Simplification of Reporting Requirements ⍽ Establishment of performance standards in lieu of Design or Operational Standards ⍽ Exemption of Small Businesses from some or all requirements X Other, describe: The Board of Governors discussed maintaining fees at 2014 levels but determined that such action was unnecessary in light of the Fund's present financial condition and the reduced fees would adequately fund the Fund for claims incurred during fiscal year 2015 without shifting the burden of funding to future years and providers.

4. Describe the methods incorporated into the Rule that will reduce its impact on Small Businesses

The proposed increase is below breakeven financing for the Fund but sufficient to cover anticipated claims, administrative and operating expenses.

5. Describe the Rule's Enforcement Provisions

This rule proposes fees. Failure to pay Fund fees is governed by s. Ins 17.01, Wis. Adm. Code, which requires the Fund to notify the medical examining board of each physician who has not paid the fee and notify the Department of Health Services of each hospital that has not paid the fee as required.

6. Did the Agency prepare a Cost Benefit Analysis (if Yes, attach to form)

⍽ Yes X No

Notice of Hearings

Public Instruction

rulemaking_notices CR 14-045 CR 14-045, EmR1411

NOTICE IS HEREBY GIVEN That pursuant to s. 120.13 (19), Stats., and interpreting s. 120.13 (19), Stats., the Department of Public Instruction will hold a public hearing as follows to consider the creation of Chapter PI 80, relating to community programs and services. This hearing will be regarding both the Chapter PI 80 emergency and permanent rule changes.

Hearing Information

Date:   Thursday, September 4, 2014
Time:   3:00 to 5:00 p.m.*
Location:   GEF 3 building
  Room 041
  125 South Webster St.
  Madison, WI

*For those who cannot attend the public hearing, comments received by the Department will be given the same weight as testimony.

The hearing site is fully accessible to persons with disabilities. If you require reasonable accommodation to access the meeting, please call Katie Schumacher at [phone], or leave a message with the Teletypewriter (TTY) at [phone], at least 10 days prior to the hearing date. Reasonable accommodation includes materials prepared in an alternative format, as provided under the Americans with Disabilities Act.

Place Where Comments Are to be Submitted and Deadline for Submission

The proposed administrative rule is available to review at http://pb.dpi.wi.gov/pb_rulespg or https://health.wisconsin.gov/admrules/public/Rmo?nRmoId=17063. Comments can be made by using the contact information below. Written comments on the proposed rules received no later than September 12, 2014, will be given the same consideration as testimony presented at the hearing.

Comments should be submitted to Katie Schumacher, Department of Public Instruction, Administrative Rules Coordinator and Small Business Regulatory Coordinator, 125 S. Webster Street, P.O. Box 7841, Madison, WI 53707-7841 or at [e-mail].

Analysis Prepared by the Department of Public Instruction

Statute interpreted

Section 120.13 (19), Stats.

Statutory authority

120.13 School board powers. The school board of a common or union high school district may do all things reasonable to promote the cause of education, including establishing, providing and improving school district programs, functions and activities for the benefit of pupils, and including all of the following:

(19) Community programs and services. Establish and maintain community education, training, recreational, cultural or athletic programs and services, outside the regular curricular and extracurricular programs for pupils, under such terms and conditions as the school board prescribes. The school board may establish and collect fees to cover all or part of the costs of such programs and services. The school board may not expend moneys on ineligible costs, as defined by the department by rule. Costs associated with such programs and services shall not be included in the school district's shared cost under s. 121.07 (6).

Explanation of agency authority

Under s. 120.13 (19), Stats., the Department is required to define ineligible costs by rule.

Related statute or rule

N/A.

Plain language analysis

Ineligible costs means school district costs that are not the actual, additional costs to operate community programs and services. First, costs are ineligible if they are not costs to operate community programs and services. Community programs and services do not include any program that is limited to only school district pupils or any program or service whose schedule presents a significant barrier for age-appropriate school district residents to participate in the program or service. Second, costs must not only be costs to operate community programs and services to be eligible but also must be actual, additional costs. Ineligible costs include costs that would be incurred by the school district if the community programs and services were not provided by the school district.

Summary of, and comparison with, existing or proposed federal regulations

N/A.

Comparison with rules in adjacent states

No information.

Summary of factual data and analytical methodologies

Under current law, a school district may establish community education, training, recreational, cultural, or athletic programs and services. The school board may collect fees to cover all or part of the costs of such community programs and services. Current law excludes such costs from the school district's shared cost. The property taxes levied for community programs and services are outside the district's revenue limit.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact report

It is unknown how many existing school district expenditures on community programs and services will remain eligible costs under this rule. To the extent that school district expenditures change based on the definition of eligible costs defined as a result of this rule, school district revenue limits and local property taxes may change. In 2013-14, school districts levied $79,560,060 for community service fund programs.

Anticipated Costs Incurred by Private Sector

There is not expected to be a cost to the private sector.

Effect on Small Business

The proposed rules will have no economic impact on small businesses, as defined in s. 227.114 (1), Stats.

Agency Contact Person

Katie Schumacher

Budget and Policy Analyst

Wisconsin Department of Public Instruction

[e-mail]

[phone]

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA 2049 (R 07/2011) ADMINISTRATIVE RULES FISCAL ESTIMATE AND ECONOMIC IMPACT ANALYSIS
Type of Estimate and Analysis
X Original ⍽ Updated ⍽ Corrected
Administrative Rule Chapter, Title and Number
PI 80, Community Programs and Services
Subject
Defining Ineligible Costs
Fund Sources Affected			Chapter 20, Stats. Appropriations Affected
⍽ GPR ⍽ FED ⍽ PRO ⍽ PRS ⍽ SEG ⍽ SEG-S
Fiscal Effect of Implementing the Rule
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues		⍽ Increase Costs ⍽ Could Absorb Within Agency's Budget ⍽ Decrease Costs
The Rule Will Impact the Following (Check All That Apply)
⍽ State's Economy X Local Government Units		⍽ Specific Businesses/Sectors ⍽ Public Utility Rate Payers
Would Implementation and Compliance Costs Be Greater Than $20 million? ⍽ Yes X No
Policy Problem Addressed by the Rule
Under 2013 Wisconsin Act 306, the Department must define ineligible costs related to community programs and services. The proposed rule change will create PI 80, which defines the costs that cannot be included by school districts in Fund 80 (the revenue source for community programs and services).
Summary of Rule's Economic and Fiscal Impact on Specific Businesses, Business Sectors, Public Utility Rate Payers, Local Governmental Units and the State's Economy as a Whole (Include Implementation and Compliance Costs Expected to be Incurred)
Local: It is unknown how many existing school district expenditures on community programs and services will remain eligible costs under this rule. To the extent that school district expenditures change based on the definition of eligible costs defined as a result of this rule, school district revenue limits and local property taxes may change. In 2013-14, school districts levied $79,560,060 for community service fund programs. State: None.
Benefits of Implementing the Rule and Alternative(s) to Implementing the Rule
The rule change gives the Department legal authority to prevent ineligible costs from being allocated to a school district's community programs and services fund. Without a rule, the Department provided guidance on what constituted ineligible costs but it was only advisory.
Long Range Implications of Implementing the Rule
It is unknown how many existing school district expenditures on community programs and services will remain eligible costs under this rule change.
Compare With Approaches Being Used by Federal Government
No information.
Compare With Approaches Being Used by Neighboring States (Illinois, Iowa, Michigan and Minnesota)
No information.
Name and Phone Number of Contact Person
Katie Schumacher, Department of Public Instruction Administrative Rules Coordinator, [phone].