Amendment ASA1-AB100

AB100-ASA1, s. 2250 Section 2250. 149.16 (title) of the statutes is created to read:

AB100-ASA1,1359,8 149.16 (title) Plan administrator.

AB100-ASA1, s. 2251 Section 2251. 149.16 (1) of the statutes is created to read:

AB100-ASA1,1359,11 149.16 (1) The department shall contract with an organization or other person to administer the plan.

AB100-ASA1, s. 2252 Section 2252. 150.21 (1) of the statutes is amended to read:

AB100-ASA1,1359,13 150.21 (1) The construction or total replacement of a new nursing home.

AB100-ASA1, s. 2253 Section 2253. 150.21 (3) of the statutes is amended to read:

AB100-ASA1,1359,16 150.21 (3) A capital expenditure, other than a renovation or replacement, that exceeds $1,000,000 by or on behalf of a nursing home.

AB100-ASA1, s. 2254 Section 2254. 150.21 (4) of the statutes is amended to read:

AB100-ASA1,1359,19 150.21 (4) An expenditure, other than a renovation or replacement, that exceeds $600,000 for clinical equipment by or on behalf of a nursing home.

AB100-ASA1, s. 3035v Section 3035v. 150.31 (4) of the statutes is amended to read:

AB100-ASA1,1359,24 150.31 (4) The department may decrease the statewide bed limit in facilities primarily serving the developmentally disabled in order to account for any decreased use of beds at the a state centers center for the developmentally disabled due to the community integration program under s. 46.275.

AB100-ASA1, s. 2255 Section 2255. 150.31 (5t) of the statutes is created to read:

AB100-ASA1,1360,3 150.31 (5t) The department shall decrease the statewide bed limits specified in sub. (1) to account for any reduction in the licensed bed capacity of a nursing home that has relinquished use of a bed, as specified in s. 49.45 (6m) (ap) 4.

AB100-ASA1, s. 2256 Section 2256. 150.35 (3m) (a) 3. of the statutes is amended to read:

AB100-ASA1,1360,8 150.35 (3m) (a) 3. All applications for activities that are specified in s. 150.21 (3), that are renovations with capital expenditures which do not exceed $1,500,000 and that do not include additions, the replacement of a nursing home or an increase in the bed capacity of a nursing home.

AB100-ASA1, s. 2257 Section 2257. 150.39 (2) of the statutes is amended to read:

AB100-ASA1,1360,13 150.39 (2) The cost of renovating or providing an equal number of nursing home beds or of an equal expansion would be consistent with the cost at similar nursing homes, and the applicant's per diem rates would be consistent with those of similar nursing homes.

AB100-ASA1, s. 2258 Section 2258. 153.01 (4) of the statutes is created to read:

AB100-ASA1,1360,15 153.01 (4) "Department" means the department of health and family services.

AB100-ASA1, s. 2259 Section 2259. 153.01 (4m) of the statutes is repealed.

AB100-ASA1, s. 2260 Section 2260. 153.01 (6) of the statutes is repealed.

AB100-ASA1, s. 2261 Section 2261. 153.05 (1) (c) 1. of the statutes is amended to read:

AB100-ASA1,1360,23 153.05 (1) (c) 1. Identification of charges in each hospital's most recent entire fiscal year for up to 100 charge elements, as selected by the office department, and identification of the increase or decrease in charges for each of these charge elements from amounts charged during the hospital's entire fiscal year that is nearest in time to the hospital's most recent entire fiscal year.

AB100-ASA1, s. 2262 Section 2262. 153.05 (1) (e) of the statutes is amended to read:

AB100-ASA1,1361,4 153.05 (1) (e) Final audited financial statements of hospitals that include, for a hospital's most recent entire fiscal year, as dollar amounts, the amounts of revenue and expenditures for the hospital, in categories specified in rules promulgated by the commissioner department.

AB100-ASA1, s. 2263 Section 2263. 153.05 (2) of the statutes is amended to read:

AB100-ASA1,1361,12 153.05 (2) The office department shall provide copies of reports published under ss. 153.10 to 153.35 at no charge to hospitals assessed under s. 153.60 (1) and, if assessed, at no charge to ambulatory surgery centers assessed under s. 153.60 (2). The office department shall provide copies of the reports to any person, upon the person's request, and the board shall advise the office department as to whether the copies shall be provided at no charge or at a charge not to exceed the cost of printing, copying and mailing the report to the person.

AB100-ASA1, s. 2264 Section 2264. 153.05 (3) of the statutes is amended to read:

AB100-ASA1,1361,16 153.05 (3) Upon request of the office department, state agencies shall provide health care information to the office department for use in preparing reports under ss. 153.10 to 153.35.

AB100-ASA1, s. 2265 Section 2265. 153.05 (4) of the statutes is amended to read:

AB100-ASA1,1361,24 153.05 (4) (a) The office department, under rules promulgated by the commissioner department, shall require hospitals to use, and private-pay patients and payers who are insurers to accept, uniform patient billing forms, shall require hospitals to submit to the office department the information provided on the billing forms, including, for an injury, the external cause of the event, and may require payers who are insurers to use a standard set of definitions for base data reporting under a uniform patient billing form.

AB100-ASA1,1362,6 (b) The office department, under rules promulgated by the commissioner department, may require ambulatory surgery centers to use uniform patient billing forms and other information, and, if so requiring, shall require ambulatory surgery centers to submit to the office department the information provided on the billing forms, including, for an injury, the external cause of the event, using a standard set of definitions for base data reporting.

AB100-ASA1, s. 2266 Section 2266. 153.05 (5) of the statutes is amended to read:

AB100-ASA1,1362,8 153.05 (5) The office department:

AB100-ASA1,1362,11 (a) Shall require hospitals to submit information regarding medical malpractice, staffing levels and patient case-mix, and expenditures related to labor relations consultants, as specified by the office department.

AB100-ASA1,1362,16 (b) May require hospitals to submit to the office department information from sources identified under sub. (1) (a) to (e) that the office department deems necessary for the preparation of reports, plans and recommendations under ss. 153.10 to 153.35 and any other reports required of the office department in the form specified by the office department.

AB100-ASA1,1362,20 (bm) Shall require a hospital to submit to the office department information from sources identified under sub. (1) (e) by the date that is 4 months following the close of the hospital's fiscal year unless the office department grants an extension of time to file the information.

AB100-ASA1, s. 2267 Section 2267. 153.05 (6) of the statutes is amended to read:

AB100-ASA1,1363,2 153.05 (6) If the requirements of s. 153.07 (2) are first met, the office department may contract with a public or private entity that is not a major purchaser, payer or provider of health care services in this state for the provision of data processing services for the collection, analysis and dissemination of health care information under sub. (1) or the department of health and family services shall provide the services under s. 153.07 (2).

AB100-ASA1, s. 2268 Section 2268. 153.05 (6m) of the statutes is amended to read:

AB100-ASA1,1363,11 153.05 (6m) If the requirements of s. 153.07 (2) are first met, the office department may contract with the group insurance board for the provision of data collection and analysis services related to health maintenance organizations and insurance companies that provide health insurance for state employes or the commissioner department shall provide the services under s. 153.07 (2). The office department shall establish contract fees for the provision of the services. All moneys collected under this subsection shall be credited to the appropriation under s. 20.145 (8) 20.435 (1) (kx).

AB100-ASA1, s. 2269 Section 2269. 153.05 (7) of the statutes is amended to read:

AB100-ASA1,1363,16 153.05 (7) The office department may require each insurer authorized to write disability insurance to submit to the office department information obtained on uniform patient billing forms regarding reported claims for health care services which insureds who are residents of this state obtain in another state.

AB100-ASA1, s. 2270 Section 2270. 153.05 (8) of the statutes is amended to read:

AB100-ASA1,1364,2 153.05 (8) Beginning April 1, 1992, the office department shall collect, analyze and disseminate, in language that is understandable to lay persons, health care information under the provisions of this chapter, as determined by rules promulgated by the commissioner department, from health care providers, as defined by rules promulgated by the commissioner department, other than hospitals and ambulatory surgery centers. Data from physicians shall be obtained through sampling techniques in lieu of collection of data on all patient encounters and data collection procedures shall minimize unnecessary duplication and administrative burdens.

AB100-ASA1, s. 2271 Section 2271. 153.05 (9) of the statutes is amended to read:

AB100-ASA1,1364,7 153.05 (9) The office department shall provide orientation and training to physicians, hospital personnel and other health care providers to explain the process of data collection and analysis and the procedures for data verification, interpretation and release.

AB100-ASA1, s. 2272 Section 2272. 153.05 (11) of the statutes is amended to read:

AB100-ASA1,1364,12 153.05 (11) In order to elicit public comment concerning the reports required under ss. 153.10 to 153.35, the office department shall, following the release of the reports and by a date that is determined by the board, provide notice of and hold public hearings.

AB100-ASA1, s. 2273 Section 2273. 153.05 (12) of the statutes is amended to read:

AB100-ASA1,1364,16 153.05 (12) The office department shall, to the extent possible and upon request, assist members of the public in interpreting data in health care information disseminated by the office department.

AB100-ASA1, s. 2274 Section 2274. 153.07 (1) of the statutes is amended to read:

AB100-ASA1,1364,20 153.07 (1) The board shall advise the director of the office department with regard to the collection, analysis and dissemination of health care information required by this chapter.

AB100-ASA1, s. 2275 Section 2275. 153.07 (2) of the statutes is amended to read:

AB100-ASA1,1365,8 153.07 (2) The board, upon advice of the office department, shall first determine whether to contract for services pursuant to s. 153.05 (6) or (6m). If the board determines to contract for such services, it shall approve specifications for a contract including the length of the contract and the standards for determining potential contractor conflicts with the purposes of the office department as specified under s. 153.05 (1). In the alternative, the board may direct the office to have the department of health and family services department to provide the services under s. 153.05 (6) or (6m). The board may subsequently determine to contract for these services in subsequent years. If the board decides to bid the contract for services under s. 153.05 (6) or (6m), the department of health and family services may offer a bid as would any other potential contractor. The board shall evaluate a contractor's performance 6 months prior to the close of each existing contract.

AB100-ASA1, s. 2276 Section 2276. 153.07 (3) of the statutes is amended to read:

AB100-ASA1,1365,11 153.07 (3) The board shall approve all rules which are proposed by the commissioner department for promulgation to implement this chapter.

AB100-ASA1, s. 2277 Section 2277. 153.08 (2) (b) of the statutes is amended to read:

AB100-ASA1,1365,24 153.08 (2) (b) No sooner than 15 days after a notice is published under par. (a) and no later than 15 days before the date of the proposed rate change, conducts a public hearing on the proposed rate change. The hearing shall be on the expected impact of the proposed rate change on health care costs, the expected improvement, if any, in the local health care delivery system, and any other issue related to the proposed rate change. Management staff, if any, of the hospital proposing the rate change and, if possible, at least 3 members of the governing board of any not-for-profit hospital proposing the rate change shall attend the public hearing to review public testimony. The hospital shall record accurate minutes of the meeting and shall provide copies of the minutes and any written testimony presented at the hearing to the office of health care information in the office of the commissioner of insurance department within 10 days after the date of the public hearing.

AB100-ASA1, s. 2278 Section 2278. 153.10 (1) of the statutes is amended to read:

AB100-ASA1,1366,5 153.10 (1) Beginning in 1990 and quarterly thereafter, the office 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:

AB100-ASA1,1366,7 (a) The charges for up to 100 health care services or diagnostic-related groups selected by the office department.

AB100-ASA1,1366,9 (b) The utilization and charge information for ambulatory surgery and other outpatient health care services selected by the office department.

AB100-ASA1, s. 2279 Section 2279. 153.15 of the statutes is amended to read:

AB100-ASA1,1366,16 153.15 Small area analysis reports. Beginning in 1990 and annually thereafter, the office 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) reports identifying health care services or procedures provided by one or more hospitals in specific areas of the state for which the rate of utilization of the service or procedure is significantly different than the state or area average.

AB100-ASA1, s. 2280 Section 2280. 153.20 of the statutes is amended to read:

AB100-ASA1,1366,25 153.20 Uncompensated health care services report. (1) Beginning in 1990 and annually thereafter, the office 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 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).

AB100-ASA1,1367,5 (2) Beginning in 1990 and annually thereafter, every hospital shall file with the office department a 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.

AB100-ASA1, s. 2281 Section 2281. 153.25 of the statutes is amended to read:

AB100-ASA1,1367,13 153.25 Mortality and morbidity report. Beginning in 1990 and annually thereafter, the office 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) reports setting forth mortality and morbidity rates for every hospital. Before the release of a report under this section, the office department shall provide the physicians, hospitals or other health care providers identified in the report with the opportunity to review and comment under s. 153.40 (6).

AB100-ASA1, s. 2282 Section 2282. 153.30 of the statutes is amended to read:

AB100-ASA1,1367,20 153.30 Health care insurance report. Beginning in 1990 and annually thereafter, the office department and the office of the commissioner of insurance may jointly prepare and submit to the governor, and to the legislature under s. 13.172 (2), a report specifying, to the extent possible, on a regional basis, the number, nature of coverage and costs of health care coverage plans covering residents of this state during the preceding year.

AB100-ASA1, s. 2283 Section 2283. 153.35 (intro.) of the statutes is amended to read:

AB100-ASA1,1368,2 153.35 (title) Report by the office department. (intro.) The office department shall annually, by October 1, under rules promulgated by the commissioner department, submit under s. 13.172 (3) a report to the legislature for distribution to standing committees with jurisdiction over health matters, that shall include all of the following:

AB100-ASA1, s. 2284 Section 2284. 153.35 (1) of the statutes is amended to read:

AB100-ASA1,1368,6 153.35 (1) The range, median and mean of charges and increases or decreases in specific charges by hospitals for up to 100 charge elements, as selected by the office department, as reported to the office department under s. 153.05 (1) (c) 1.

AB100-ASA1, s. 2285 Section 2285. 153.40 (1) of the statutes is amended to read:

AB100-ASA1,1368,14 153.40 (1) Prior to data submission, hospitals, ambulatory surgery centers or other health care providers shall review discharge data for accuracy and shall obtain verification by the physician of the principal and secondary diagnoses and primary and secondary procedures. The verification shall occur within the time specified by rules promulgated by the commissioner department for data submission to the office department. If the verification is not made on a timely basis, the hospital or other health care provider shall submit the data noting the lack of verification.

AB100-ASA1, s. 2286 Section 2286. 153.40 (2) of the statutes is amended to read:

AB100-ASA1,1368,23 153.40 (2) The office department shall be responsible for assuring that appropriate editing is conducted for all submitted data to identify systematic errors, missing data, values beyond an allowed range, illegal codes within a range, illogical sequence of dates, diagnoses and procedures inconsistent with age and sex, other data failing internal consistency checks and other patterns inconsistent with what would be expected. The office department shall notify hospitals, ambulatory surgery centers or, beginning April 1, 1992, other health care providers of missing or incorrect information under this subsection.

AB100-ASA1, s. 2287 Section 2287. 153.40 (3) of the statutes is amended to read:

AB100-ASA1,1369,4 153.40 (3) Hospitals, ambulatory surgery centers or, beginning April 1, 1992, other health care providers shall be responsible for resolving the errors found by the editing under sub. (2) and shall resubmit corrected data within 10 working days after receiving written notification from the office department of the errors.

AB100-ASA1, s. 2288 Section 2288. 153.40 (4) of the statutes is amended to read:

AB100-ASA1,1369,8 153.40 (4) The office department shall send edited and corrected data to hospitals, ambulatory surgery centers or, beginning April 1, 1992, other health care providers for a 10-working-day review period before the data are released.

AB100-ASA1, s. 2289 Section 2289. 153.40 (5) of the statutes is amended to read:

AB100-ASA1,1369,13 153.40 (5) The office department may, by rules promulgated by the commissioner department, require that other forms of data verification, including reabstracting studies and comparisons with information collected from other data systems, be conducted prior to the release of physician-specific data.

AB100-ASA1, s. 2290 Section 2290. 153.40 (6) of the statutes is amended to read:

AB100-ASA1,1369,23 153.40 (6) At least 30 calendar days prior to the release of a report under s. 153.25, the office department shall notify a physician, hospital or other health care provider identified in the report of the office's department's intent to release the report. The notification shall include a copy of the draft report and a statement that those identified may submit comments on the report to the office department. If the office department receives comments prior to the release of the report, the office department shall append the comments to the report. If the office department receives comments after the report is released, the office department shall make the comments available to anyone requesting the comments.