LRBs0623/1
DAK:kmg:jlb
1995 - 1996 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
To 1995 ASSEMBLY BILL 1034
March 20, 1996 - Offered by Representatives Prosser, Urban and Underheim.
AB1034-ASA1,1,3 1An Act to amend 15.01 (4); and to create 15.107 (6) and 146.36 of the statutes;
2relating to: creating and specifying the powers and duties of the council on
3health care fraud and abuse.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB1034-ASA1, s. 1 4Section 1. 15.01 (4) of the statutes, as affected by 1995 Wisconsin Act 27, is
5amended to read:
AB1034-ASA1,1,146 15.01 (4) "Council" means a part-time body appointed to function on a
7continuing basis for the study, and recommendation of solutions and policy
8alternatives, of the problems arising in a specified functional area of state
9government, except the Milwaukee river revitalization council has the powers and
10duties specified in s. 23.18, the council on physical disabilities has the powers and
11duties specified in s. 46.29 (1) and (2) and, the state council on alcohol and other drug
12abuse has the powers and duties specified in s. 14.24 and, before January 1, 2001,
13the council on health care fraud and abuse has the powers and duties specified in s.
14146.36
.
AB1034-ASA1, s. 2
1Section 2. 15.107 (6) of the statutes is created to read:
AB1034-ASA1,2,102 15.107 (6) Council on health care fraud and abuse. (a) There is created a
3council on health care fraud and abuse which is attached to the department of
4administration under s. 15.03. The council consists of 15 members appointed for
53-year terms, at least one of whom shall have expertise in the medical assistance
6program and the remainder of whom shall include representatives of insurers, as
7defined in s. 146.36 (1) (d); employe benefit plan administrators; health maintenance
8organizations, as defined in s. 609.01 (2); physicians, as defined in s. 448.01 (5);
9health care providers, as defined in s. 146.81 (1), other than physicians; and law
10enforcement.
AB1034-ASA1,2,1211 (b) The governor shall designate one of the members to serve as chairperson
12of the council and shall establish the length of term for that office.
AB1034-ASA1,2,1313 (c) The council shall meet at least twice annually.
AB1034-ASA1,2,1414 (d) This subsection does not apply after December 30, 2000.
AB1034-ASA1, s. 3 15Section 3. 146.36 of the statutes is created to read:
AB1034-ASA1,2,16 16146.36 Council on health care fraud and abuse. (1) In this section:
AB1034-ASA1,2,1717 (a) "Agency" has the meaning given in s. 13.62 (2).
AB1034-ASA1,2,1818 (b) "Council" means the council on health care fraud and abuse.
AB1034-ASA1,2,1919 (c) "Health care provider" has the meaning given in s. 146.81 (1).
AB1034-ASA1,2,2220 (d) "Insurer" means an insurer, as defined in s. 600.03 (27), that is authorized
21to do business in this state in one or more lines of insurance that includes health
22insurance.
AB1034-ASA1,2,23 23(2) The council may do all of the following:
AB1034-ASA1,2,2424 (a) Study all aspects of health care fraud and abuse.
AB1034-ASA1,3,2
1(b) Develop strategies to combat health care fraud and abuse by health care
2consumers, health care providers and insurers.
AB1034-ASA1,3,33 (c) Examine problems that relate to electronic claims for payment.
AB1034-ASA1,3,44 (d) Survey efforts of other states to reduce health care fraud and abuse.
AB1034-ASA1,3,75 (e) Collect information relevant to preparation of the report specified under
6sub. (3), from health care providers, insurers, employe benefit plan administrators,
7law enforcement agencies and other sources.
AB1034-ASA1,3,88 (f) Conduct public hearings concerning health care fraud and abuse.
AB1034-ASA1,3,109 (g) Engage in public information programs concerning health care fraud and
10abuse.
AB1034-ASA1,3,1211 (h) Receive, for deposit in the council's account under s. 20.505 (4) (gm), gifts,
12grants or bequests to fund its operating expenses.
AB1034-ASA1,3,14 13(3) Annually, the council shall submit to the governor and, under s. 13.172 (2),
14to the legislature a report that does all of the following:
AB1034-ASA1,3,1515 (a) Identifies different types of fraud and abuse in health care.
AB1034-ASA1,3,1716 (b) Analyzes issues relating to health care fraud and abuse, such as
17self-interested referrals.
AB1034-ASA1,3,2018 (c) Lists successful prosecutions of health care fraud and activities to combat
19health care abuse that have been conducted in courts in this state or as contested
20cases under subch. III of ch. 227.
AB1034-ASA1,3,2221 (d) Specifies activities conducted by the council to combat health care fraud and
22abuse.
AB1034-ASA1,3,2423 (e) Recommends specific proposed changes to state statutes or administrative
24rules to define terms and to combat health care fraud and abuse.
AB1034-ASA1,4,3
1(4) A council member shall be immune from civil liability and criminal
2prosecution for any act or omission done in good faith within the scope of his or her
3powers and duties under this section.
AB1034-ASA1,4,4 4(5) This section does not apply after December 30, 2000.
AB1034-ASA1, s. 4 5Section 4. Nonstatutory provisions; administration.
AB1034-ASA1,4,96 (1) Initial appointments of members of the council on health care fraud and
7abuse.
Notwithstanding the length of terms specified in section 15.107 (6) (a) of the
8statutes, as created by this act, the initial members of the council on health care
9fraud and abuse shall be appointed for the following terms:
AB1034-ASA1,4,1010 (a) Five members, for terms expiring on July 1, 1997.
AB1034-ASA1,4,1111 (b) Five members, for terms expiring on July 1, 1998.
AB1034-ASA1,4,1212 (c) Five members, for terms expiring on July 1, 1999.
Loading...
Loading...