Amendment SSA2-SB369

LRBs0371/1

DAK:skg:jlb

1995 - 1996 LEGISLATURE

SENATE SUBSTITUTE AMENDMENT 2, To 1995 SENATE BILL 369

March 7, 1996 - Offered by Senator Risser.

SB369-SSA2,1,9 An Act to repeal 15.735 (2); to renumber 153.07 (3); to amend 15.07 (2) (b), 15.07 (3) (bm) 1., 20.145 (8) (hg), 20.145 (8) (mr) and 153.01 (2); and to create 15.735 (3), 153.01 (4r), 153.01 (8m) and 153.07 (3) to (7) of the statutes; relating to: eliminating the board on health care information, creating a health insurance plan oversight board, requiring development of health insurance plan performance measures and models, development of a health insurance plan data collection and dissemination systems improvement plan and the study of consolidating certain functions in a single state agency and requiring submittal of certain reports.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB369-SSA2, s. 1 Section 1. 15.07 (2) (b) of the statutes is amended to read:

SB369-SSA2,1,12 15.07 (2) (b) The chairperson of the board on health care information insurance plan oversight board shall be designated biennially by the governor.

SB369-SSA2, s. 2 Section 2. 15.07 (3) (bm) 1. of the statutes is amended to read:

SB369-SSA2,2,3 15.07 (3) (bm) 1. The board on health care information insurance plan oversight board shall meet 4 times each year and may meet at other times on the call of the chairperson or a majority of the board's members.

SB369-SSA2, s. 3 Section 3. 15.735 (2) of the statutes is repealed.

SB369-SSA2, s. 4 Section 4. 15.735 (3) of the statutes is created to read:

SB369-SSA2,2,9 15.735 (3) Health insurance plan oversight board. There is created a health insurance plan oversight board which is attached to the office of the commissioner of insurance under s. 15.03. The board shall consist of all of the following members, appointed for 4-year terms:

SB369-SSA2,2,10 (a) The following 7 providers of health care services:

SB369-SSA2,2,12 1. One representative of hospitals, who is nominated by the Wisconsin Hospital Association, Inc.

SB369-SSA2,2,14 2. One representative of clinics, who is nominated by the Wisconsin Medical Group Management Association.

SB369-SSA2,2,15 3. One physician, who is nominated by the State Medical Society of Wisconsin.

SB369-SSA2,2,18 4. One nurse who holds a certificate of registration under s. 441.06 (1) or a license under s. 441.10 (3) and who is nominated by the Wisconsin Nurses Association Incorporated.

SB369-SSA2,2,19 5. One representative of home health agencies.

SB369-SSA2,2,21 6. One pharmacist, who is nominated by the Wisconsin Pharmacists Association, Inc.

SB369-SSA2,2,22 7. One provider of mental health services.

SB369-SSA2,3,2 (b) Three members of the insurance industry, one of whom is nominated by the Association of Wisconsin HMOs, one of whom is nominated by Blue Cross and Blue Shield United of Wisconsin and one of whom is nominated by an insurer that is authorized to do business in this state in one or more lines of insurance that includes health insurance.

SB369-SSA2,3,3 (c) The following 7 health care consumers:

SB369-SSA2,3,5 1. One representative of labor, who is nominated by the American Federation of State, County and Municipal Employees, Council 24.

SB369-SSA2,3,6 2. One mother, who is nominated by the Maternal and Child Health Coalition.

SB369-SSA2,3,8 3. One representative of elderly persons, who is nominated by the Coalition of Wisconsin Aging Groups Incorporated.

SB369-SSA2,3,10 4. One representative of persons who have developmental disabilities, who is nominated by the council on developmental disabilities.

SB369-SSA2,3,12 5. One representative of persons who have mental illness, who is nominated by the Wisconsin Coalition for Advocacy, Inc.

SB369-SSA2,3,14 6. One representative of black consumers of health care, who is nominated by the Black Health Coalition of Wisconsin.

SB369-SSA2,3,16 7. One American Indian, who is nominated by the Great Lakes Inter-Tribal Council, Inc.

SB369-SSA2,3,18 (d) The following 6 purchasers of health care or health care coverage on behalf of a group:

SB369-SSA2,3,22 1. Two purchasers who are nominated by the Wisconsin Association of Manufacturers and Commerce, Inc., one of whom purchases on behalf of a group that is located in an urban area and one of whom purchases on behalf of a group that is located in a rural area.

SB369-SSA2,3,23 2. One purchaser who is nominated by a self-insured health plan.

SB369-SSA2,3,25 3. One purchaser who is nominated by the National Federation of Independent Business, Wisconsin chapter.

SB369-SSA2,4,3 4. A representative of the department of health and social services who assists in administering the medical assistance program and who is designated by the secretary of health and social services.

SB369-SSA2,4,5 5. A representative of the department of employe trust funds who is designated by the secretary of employe trust funds.

SB369-SSA2,4,9 (e) Two persons who have expertise in health care data, one of whom is a member of the faculty of the Medical College of Wisconsin, Inc., and one of whom is a member of the faculty of the University of Wisconsin-Madison who is nominated by the chancellor of the University of Wisconsin-Madison.

SB369-SSA2, s. 5 Section 5. 20.145 (8) (hg) of the statutes is amended to read:

SB369-SSA2,4,15 20.145 (8) (hg) General program operations; office of health care information. The amounts in the schedule to fund the activities of the office of health care information and the board on health care information insurance plan oversight board under ch. 153. The assessments paid under s. 153.60 shall be credited to this appropriation account.

SB369-SSA2, s. 6 Section 6. 20.145 (8) (mr) of the statutes is amended to read:

SB369-SSA2,4,20 20.145 (8) (mr) Federal funds; office of health care information. All moneys received from the federal government, as authorized by the governor under s. 16.54, for the purposes of the office of health care information and the board on health care information insurance plan oversight board under ch. 153.

SB369-SSA2, s. 7 Section 7. 153.01 (2) of the statutes is amended to read:

SB369-SSA2,4,23 153.01 (2) "Board" means the board on health care information insurance plan oversight board.

SB369-SSA2, s. 8 Section 8. 153.01 (4r) of the statutes is created to read:

SB369-SSA2,5,2 153.01 (4r) "Health plan performance measures" means the relationship of features of health insurance plans to the health of individual patients or insureds.

SB369-SSA2, s. 9 Section 9. 153.01 (8m) of the statutes is created to read:

SB369-SSA2,5,4 153.01 (8m) "State agency" has the meaning given in s. 16.004 (12) (a).

SB369-SSA2, s. 10 Section 10. 153.07 (3) of the statutes is renumbered 153.07 (8).

SB369-SSA2, s. 11 Section 11. 153.07 (3) to (7) of the statutes are created to read:

SB369-SSA2,5,7 153.07 (3) The board shall work to accomplish all of the following:

SB369-SSA2,5,8 (a) Increased accessibility to and usefulness of health insurance plan data.

SB369-SSA2,5,12 (b) Development of a detailed plan of procedure for the release of health insurance plan data that distinguishes health insurance plan data intended to be available for public use from health insurance plan data intended to be restricted for research and other nonpublic use.

SB369-SSA2,5,15 (c) Consideration of the feasibility of developing a health insurance plan institute for public and private use or instituting a publicly sponsored program for private health insurance plan data collection.

SB369-SSA2,5,17 (4) The board shall seek advice from the committees specified under 1995 Wisconsin Act .... (this act), section 12 (2), on all of the following:

SB369-SSA2,5,19 (a) The identification of health insurance plan data policy issues that require extensive research.

SB369-SSA2,5,21 (b) Recommended health insurance plan data collection, analysis and dissemination techniques for meeting the needs of policy makers and the public.

SB369-SSA2,5,23 (c) Any recommended adjustments to the health insurance plan data collection and dissemination systems improvement plan under sub. (5).

SB369-SSA2,5,25 (5) Beginning on January 1, 1996, the health insurance plan data oversight board shall do all of the following:

SB369-SSA2,6,2 (a) Develop recommendations on the use of health insurance plan performance measures, including recommendations on standardizing measures.

SB369-SSA2,6,4 (b) Develop a health insurance plan data collection and dissemination systems improvement plan for this state that addresses the following areas:

SB369-SSA2,6,6 1. Identification of health insurance plan data collection needs of the state, with priority given to data collection necessary to support public policy decisions.

SB369-SSA2,6,8 2. Identification of existing data that can be obtained from the public or the private sector and the cost of obtaining the data.

SB369-SSA2,6,10 3. An analysis of the costs and benefits of linking data from existing public and private data systems to obtain needed health insurance plan data.

SB369-SSA2,6,13 4. Identification of data in addition to that under subds. 2. and 3., that should be collected on an ongoing basis and data that should be collected on a one-time or periodic basis and the costs of collecting the data.

SB369-SSA2,6,14 5. Recommendations on the collection and dissemination of all of the following:

SB369-SSA2,6,15 a. Comparisons of costs, including costs of health insurance plan premiums.

SB369-SSA2,6,17 b. Information on costs of various health care services that is available through existing data collection mechanisms.

SB369-SSA2,6,19 c. Information not currently available that addresses overall costs and charges for care for selected high-cost or high-volume conditions and episodes of care.

SB369-SSA2,6,24 (c) In developing the plan under par. (b), the board shall give consideration to the administrative costs imposed on health care providers and insurers as a result of state data collection requirements and shall seek to minimize those costs, consistent with providing necessary information about the performance of health insurance plans.

SB369-SSA2,7,2 (d) 1. Review existing health insurance plan data collection undertaken by state agencies, and where appropriate, recommend any of the following:

SB369-SSA2,7,3 a. Elimination of unnecessary data collection.

SB369-SSA2,7,5 b. Modifications to existing data collection that will improve the utility of the data or reduce the administrative costs to the public and private sectors.

SB369-SSA2,7,7 c. Steps that would improve linkages between data systems if the linkages would assist policymakers in evaluating policy issues and alternatives.

SB369-SSA2,7,10 2. As part of the review and recommendations under subd. 1., study issues associated with consolidating all health insurance plan data collection and dissemination that is performed by state agencies into a single state agency.

SB369-SSA2,7,15 (6) (a) Beginning on January 1, 1997, the board shall direct the office, except as provided under par. (b), to apply the health insurance plan data collection and dissemination systems improvement plan under sub. (5) to the collection and dissemination of health insurance plan performance measures from all of the following:

SB369-SSA2,7,16 1. Health care providers under s. 153.05 (8).