1997 Wisconsin Act 231

231,23 Section 23 . 153.05 (9) of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:

153.05 (9) The department shall provide orientation and training to physicians, hospital personnel and other health care providers who submit data under this chapter to explain the process of data collection and analysis and the procedures for data verification, comment, interpretation and release.

231,24 Section 24 . 153.05 (11) of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,25 Section 25 . 153.05 (13) of the statutes is created to read:

153.05 (13) The department may waive the requirement under sub. (1), (5) or (8) for a health care provider, who requests the waiver and presents evidence to the department that the requirement under sub. (1), (5) or (8) is burdensome, under standards established by the department by rule. The department shall develop a form for use by a health care provider in submitting a request under this subsection.

231,26 Section 26 . 153.07 (1) of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:

153.07 (1) The board shall advise the director of the department with regard to the collection, analysis and dissemination of health care information required by this chapter.

231,27 Section 27 . 153.07 (2) of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,28 Section 28 . 153.07 (4) of the statutes is created to read:

153.07 (4) The board and the department shall jointly do all of the following:

(a) Develop the rules that are required or authorized under this chapter.

(b) Provide oversight on the standard reports under this chapter, including the reports under ss. 153.20 and 153.21.

(c) Develop the overall strategy and direction for implementation of this chapter.

(d) Provide information on their activities to the interagency coordinating council created under s. 15.107 (7).

231,28m Section 28m. 153.07 (5) of the statutes is created to read:

153.07 (5) The board shall approve the amounts of assessments that the department makes under s. 153.60 (1) for health care providers other than hospitals and ambulatory surgery centers.

231,29 Section 29 . 153.08 (2) (intro.) and (a) of the statutes are consolidated, renumbered 153.08 (2) and amended to read:

153.08 (2) No hospital may increase its rates or charge any payer an amount exceeding its rates that are in effect on May 12, 1992, unless the hospital first does all of the following: (a) Causes causes to be published a class 1 notice under ch. 985 in the official newspaper designated under s. 985.04 or 985.05 or in a newspaper likely to give notice in the area where the hospital is located, no sooner than 45 days and no later than 30 days before the proposed rate change is to take effect. The notice shall describe the proposed rate change and the time and place for the public hearing required under sub. (2).

231,30 Section 30 . 153.08 (2) (b) of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,31 Section 31 . 153.10 (1) (intro.) of the statutes, as affected by 1997 Wisconsin Act 27, is renumbered 153.10 and amended to read:

153.10 Health care data reports. Beginning in 1990 and quarterly thereafter, the The department shall prepare, and submit to the governor and the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2), in a manner that permits comparisons among hospitals, a report setting forth all of the following for every hospital for the preceding quarter: standard reports that the department prepares and shall collect information necessary for preparation of those reports.

231,32 Section 32 . 153.10 (1) (a) and (b) of the statutes, as affected by 1997 Wisconsin Act 27, are repealed.

231,33 Section 33 . 153.10 (2) of the statutes is repealed.

231,34 Section 34 . 153.15 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,35 Section 35 . 153.20 of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:

153.20 Uncompensated health care services report. (1) Beginning in 1990 and annually thereafter, the The department shall prepare, and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) a , an annual report setting forth the number of patients to whom uncompensated health care services were provided by each hospital and the total charges for the uncompensated health care services provided to the patients for the preceding year, together with the number of patients and the total charges that were projected by the hospital for that year in the plan filed under sub. (2).

(2) Beginning in 1990 and annually thereafter, every Every hospital shall file with the department a an annual plan setting forth the projected number of patients to whom uncompensated health care services will be provided by the hospital and the projected total charges for the uncompensated health care services to be provided to the patients for the ensuing year.

231,36 Section 36 . 153.21 of the statutes is created to read:

153.21 Consumer guide. The department shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) an annual guide to assist consumers in selecting health care providers and health care plans. The guide shall be written in language that is understandable to lay persons. The department shall widely publicize and distribute the guide to consumers.

231,37 Section 37 . 153.25 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,38 Section 38 . 153.30 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,39 Section 39 . 153.35 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,40 Section 40 . 153.40 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

231,41 Section 41 . 153.45 (1) (intro.) of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:

153.45 (1) (intro.) After completion of data verification, comment and review procedures under s. 153.40 specified by the department by rule, the department shall release data, together with comments, if any, in the following forms:

231,42 Section 42 . 153.45 (1) (a) of the statutes is amended to read:

153.45 (1) (a) Standard reports in accordance with ss. 153.10 to 153.35.

231,43 Section 43 . 153.45 (1) (b) of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:

153.45 (1) (b) Public use tapes data files which do not permit the identification of specific patients, physicians, employers or other health care providers , as defined by rules promulgated by the department. The identification of these groups shall be protected by all necessary means, including the deletion of patient identifiers and the use of calculated variables and aggregated variables.

231,44 Section 44 . 153.45 (1) (c) of the statutes is amended to read:

153.45 (1) (c) Custom-designed subfile tapes, other electronic media, special data compilations or reports containing portions of the public use tape data under par. (b).

231,44d Section 44d. 153.45 (1m) of the statutes is created to read:

153.45 (1m) After completion of data verification and review procedures specified by the department by rule, the department may, but is not required to, release special data compilations.

231,45 Section 45 . 153.45 (3) of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:

153.45 (3) The department shall may, but is not required to, release physician-specific health care provider-specific and employer-specific data, except in public use tapes data files as specified under sub. (1) (b), in a manner that is specified in rules promulgated by the department.

231,46 Section 46 . 153.45 (4) of the statutes is created to read:

153.45 (4) The department shall prohibit purchasers of data from rereleasing individual data elements of health care data files.

231,47 Section 47 . 153.45 (5) of the statutes is created to read:

153.45 (5) The department may not release any health care information that is subject to rules promulgated under s. 153.75 (1) (b) until the verification, comment and review procedures required under those rules have been complied with. Nothing in this subsection prohibits release of health care provider-specific information to the health care provider to whom the information relates.

231,48m Section 48m. 153.50 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed and recreated to read:

153.50 Protection of patient confidentiality. (1) Definitions. In this section:

(a) “Data element" means an item of information from a uniform patient billing form.

(b) “Patient-identifiable data" means all of the following data elements:

1. Patient medical record or chart number.

2. Patient control number.

3. Patient date of birth.

4. Date of patient admission.

5. Date of patient discharge.

6. Date of patient's principal procedure.

7. Encrypted case identifier.

8. Insured's policy number.

9. Patient's employer's name.

10. Insured's date of birth.

11. Insured's identification number.

12. Medicaid resubmission code.

13. Medicaid prior authorization number.

(c) “Small number" means a number that is insufficiently large to be statistically significant, as determined by the department.

(2) Prohibition on release. Patient-identifiable data obtained under this chapter is not subject to inspection, copying or receipt under s. 19.35 (1) and may not be released by the department except as provided in sub. (4).

(3) Departmental measures to ensure protection of patient identity. To ensure that the identity of patients is protected when information obtained by the department is disseminated, the department shall do all of the following:

(a) Aggregate any data element category containing small numbers, using procedures that are developed by the department and approved by the board and that follow commonly accepted statistical methodology.

(b) Remove and destroy all of the following data elements on the uniform patient billing forms that are received by the department under the requirements of this chapter:

1. The patient's name and street address.

2. The insured's name, address and telephone number.

3. Any other insured's name, employer name and date of birth.

4. The signature of the patient or other authorized signature.

5. The signature of the insured or other authorized signature.

6. The signature of the physician.

(4) Release of patient-identifiable data. Under the procedures specified in sub. (5), release of patient-identifiable data may be made to any of the following:

(a) The patient or a person granted permission in writing by the patient for release of the patient's patient-identifiable data.

(b) An agent of the department who is responsible for the patient-identifiable data in the department, in order to store the data and ensure the accuracy of the information in the data base of the department.

(c) A health care provider or the agent of a health care provider, to ensure the accuracy of the information in the data base of the department.

(d) The department, for purposes of epidemiological investigation or to eliminate the need for duplicative data bases.

(e) An entity that is required by federal or state statute to obtain patient-identifiable data for purposes of epidemiological investigation or to eliminate the need for duplicative data bases.

(5) Procedures for release of patient-identifiable data. (a) The department may not release or provide access to patient-identifiable data to a person authorized under sub. (4) (a), (c), (d) or (e) unless the authorized person requests the department, in writing, to release the patient-identifiable data. The request shall include all of the following:

1. The requester's name and address.

2. The reason for the request.

3. For a person who is authorized under sub. (4) (a), (c) or (d) to receive or have access to patient-identifiable data, evidence, in writing, that indicates that authorization.

4. For an entity that is authorized under sub. (4) (e) to receive or have access to patient-identifiable data, evidence, in writing, of all of the following:

a. The federal or state statutory requirement to obtain the patient-identifiable data.