Amendment AA2-ASA1-AB133

AB133-ASA1-AA2,353,6 " Section 2278rm. 150.84 (2) of the statutes is amended to read:

AB133-ASA1-AA2,353,12 150.84 (2) "Health care facility" means a facility, as defined in s. 647.01 (4), or any hospital, nursing home, community-based residential facility, county home, county infirmary, county hospital, county mental health center, tuberculosis sanatorium or other place licensed or approved by the department under s. 49.70, 49.71, 49.72, 50.02, 50.03, 50.35, 51.08, or 51.09, 58.06, 252.073 or 252.076 or a facility under s. 45.365, 51.05, 51.06, 233.40, 233.41, 233.42 or 252.10.".

AB133-ASA1-AA2,353,13 865. Page 1170, line 18: after that line insert:

AB133-ASA1-AA2,353,15 " Section 2280b. 153.45 (1) (b) of the statutes is renumbered 153.45 (1) (b) 1. and amended to read:

AB133-ASA1-AA2,353,22 153.45 (1) (b) 1. Public For information that is submitted by hospitals or ambulatory surgery centers, public use data files which that do not permit the identification of specific patients, employers or health care providers, as defined by rules promulgated by the department. The identification of these groups patients, employers or health care providers shall be protected by all necessary means, including the deletion of patient identifiers and the use of calculated variables and aggregated variables.

AB133-ASA1-AA2, s. 2280c Section 2280c. 153.45 (1) (b) 2. of the statutes is created to read:

AB133-ASA1-AA2,354,12 153.45 (1) (b) 2. For information that is submitted by health care providers other than hospitals or ambulatory surgery centers, public use data files that do not permit the identification of specific patients, employers or health care providers, as defined by rules promulgated by the department. The identification of patients, employers or health care providers shall be protected by all necessary means, including the deletion of patient identifiers; the use of calculated variables and aggregated variables; the specification of counties as to residence, rather than zip codes; the use of 5-year categories for age, rather than exact age; not releasing information concerning a patient's race or ethnicity or dates of admission, discharge, procedures or visits; and masking sensitive diagnoses and procedures by use of larger diagnostic and procedure categories. Public use data files under this subdivision may include only the following:

AB133-ASA1-AA2,354,13 a. The patient's county of residence.

AB133-ASA1-AA2,354,14 b. The payment source, by type.

AB133-ASA1-AA2,354,16 c. The patient's age category, by 5-year intervals up to age 80 and a category of 80 years or older.

AB133-ASA1-AA2,354,17 d. The patient's procedure code.

AB133-ASA1-AA2,354,18 e. The patient's diagnosis code.

AB133-ASA1-AA2,354,19 f. Charges assessed with respect to the procedure code.

AB133-ASA1-AA2,354,21 g. The name and address of the facility in which the patient's services were rendered.

AB133-ASA1-AA2,354,22 h. The patient's sex.

AB133-ASA1-AA2,355,2 i. Information that contains the name of a health care provider that is not a hospital or ambulatory surgery center, if the privacy institutional review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the privacy institutional review board need not review and approve the release.

AB133-ASA1-AA2,355,3 j. Calendar quarters of service.

AB133-ASA1-AA2,355,5 k. Information other than patient-identifiable data, as defined in s. 153.50 (1) (b), as approved by the privacy institutional review board.

AB133-ASA1-AA2, s. 2280d Section 2280d. 153.45 (1) (b) 3. of the statutes is created to read:

AB133-ASA1-AA2,355,10 153.45 (1) (b) 3. Public use data files that specify calendar quarters of service, rather than date of service, except if the department specifies by rule that the number of data elements included in the public use data file is too small to enable protection of patient confidentiality.

AB133-ASA1-AA2, s. 2280e Section 2280e. 153.45 (1) (c) of the statutes is renumbered 153.45 (1) (c) (intro.) and amended to read:

AB133-ASA1-AA2,355,24 153.45 (1) (c) (intro.) Custom-designed reports containing portions of the data under par. (b). Of information submitted by health care providers that are not hospitals or ambulatory surgery centers, requests under this paragraph for data elements other than those available for public use data files under par. (b) 2., including the patient's month and year of birth, require review and approval by the privacy institutional review board before the data elements may be released. Information that contains the name of a health care provider that is not a hospital or ambulatory surgery center may be released only if the privacy institutional review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the privacy institutional review board need not review and approve the release. Reports under this paragraph may include the patient's zip code only if at least one of the following applies:

AB133-ASA1-AA2, s. 2280f Section 2280f. 153.45 (1) (c) 1. to 4. of the statutes are created to read:

AB133-ASA1-AA2,356,1 153.45 (1) (c) 1. Other potentially identifying data elements are not released.

AB133-ASA1-AA2,356,2 2. Population density is sufficient to mask patient identity.

AB133-ASA1-AA2,356,4 3. Other potentially identifying data elements are grouped to provide population density sufficient to protect identity.

AB133-ASA1-AA2,356,5 4. Multiple years of data elements are added to protect identity.

AB133-ASA1-AA2, s. 2280g Section 2280g. 153.45 (6) of the statutes is created to read:

AB133-ASA1-AA2,356,10 153.45 (6) The department may not sell or distribute data bases of information, from health care providers who are not hospitals or ambulatory surgery centers, that are able to be linked with public use data files, unless first approved by the privacy institutional review board.

AB133-ASA1-AA2, s. 2280ge Section 2280ge. 153.50 (1) (a) of the statutes is renumbered 153.01 (2m).

AB133-ASA1-AA2, s. 2280gg Section 2280gg. 153.50 (1) (b) of the statutes is renumbered 153.50 (1) (b) 1., and 153.50 (1) (b) 1. (intro.), b., c., i. and j., as renumbered, are amended to read:

AB133-ASA1-AA2,356,16 153.50 (1) (b) 1. (intro.) "Patient-identifiable data", for information submitted by hospitals and ambulatory surgery centers, means all of the following data elements:

AB133-ASA1-AA2,356,17 b. Patient control or account number.

AB133-ASA1-AA2,356,18 c. Patient date of birth age category.

AB133-ASA1-AA2,356,19 i. Patient's employer's name or school name.

AB133-ASA1-AA2,356,20 j. Insured's sex and date of birth.

AB133-ASA1-AA2, s. 2280gm Section 2280gm. 153.50 (1) (b) 2. of the statutes is created to read:

AB133-ASA1-AA2,356,24 153.50 (1) (b) 2. "Patient-identifiable data", for information submitted by health care providers who are not hospitals or ambulatory surgery centers, means all of the following data elements:

AB133-ASA1-AA2,356,25 a. Data elements specified in subd. 1. a. to g.

AB133-ASA1-AA2,357,2 b. Whether the patient's condition is related to employment, and occurrence and place of an auto accident or other accident.

AB133-ASA1-AA2,357,4 c. Date of first symptom of current illness, of current injury or of current pregnancy.

AB133-ASA1-AA2,357,5 d. First date of patient's same or similar illness, if any.

AB133-ASA1-AA2,357,7 e. Dates that the patient has been unable to work in his or her current occupation.

AB133-ASA1-AA2,357,8 f. Dates of receipt by patient of medical service.

AB133-ASA1-AA2,357,9 g. The patient's city, town or village.

AB133-ASA1-AA2, s. 2280h Section 2280h. 153.50 (2) of the statutes is repealed.

AB133-ASA1-AA2, s. 2280i Section 2280i. 153.50 (3) (b) 7. of the statutes is created to read:

AB133-ASA1-AA2,357,13 153.50 (3) (b) 7. The patient's account number, after use only as verification of data by the department.

AB133-ASA1-AA2, s. 2280j Section 2280j. 153.50 (3) (c) of the statutes is created to read:

AB133-ASA1-AA2,357,18 153.50 (3) (c) Develop, for use by purchasers of data under this chapter, a data use agreement that specifies data use restrictions, appropriate uses of data and penalties for misuse of data, and notify prospective and current purchasers of data of the appropriate uses.

AB133-ASA1-AA2, s. 2280k Section 2280k. 153.50 (3) (d) of the statutes is created to read:

AB133-ASA1-AA2,357,21 153.50 (3) (d) Require that a purchaser of data under this chapter sign and have notarized the data use agreement of the department specified in par. (c).

AB133-ASA1-AA2, s. 2280km Section 2280km. 153.50 (3m) of the statutes is created to read:

AB133-ASA1-AA2,358,2 153.50 (3m) Healthcare provider measures to ensure patient identity protection. A health care provider that is not a hospital or ambulatory surgery center shall, before submitting information required by the department under this chapter, convert to a payer category code as specified by the department any names of an insured's payer or other insured's payer.

AB133-ASA1-AA2, s. 2280kp Section 2280kp. 153.50 (4) (intro.) of the statutes is renumbered 153.50 (4) (a) (intro.) and amended to read:

AB133-ASA1-AA2,358,7 153.50 (4) (a) (intro.) Under Except as specified in par. (b), under the procedures specified in sub. (5), release of patient-identifiable data may be made only to any of the following:

AB133-ASA1-AA2, s. 2280kq Section 2280kq. 153.50 (4) (a) of the statutes is repealed.

AB133-ASA1-AA2, s. 2280kr Section 2280kr. 153.50 (4) (b) to (e) of the statutes are renumbered 153.50 (4) (a) 1. to 4.

AB133-ASA1-AA2, s. 2280ks Section 2280ks. 153.50 (4) (b) of the statutes is created to read:

AB133-ASA1-AA2,358,15 153.50 (4) (b) Of information submitted by health care providers that are not hospitals or ambulatory surgery centers, patient-identifiable data that contains a patient's date of birth may be released under this subsection only under circumstances as specified by rule by the department.

AB133-ASA1-AA2, s. 2280ku Section 2280ku. 153.50 (5) (a) (intro.) of the statutes is amended to read:

AB133-ASA1-AA2,358,20 153.50 (5) (a) (intro.) 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:

AB133-ASA1-AA2, s. 2280kv Section 2280kv. 153.50 (5) (a) 3. of the statutes is amended to read:

AB133-ASA1-AA2,358,24 153.50 (5) (a) 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.

AB133-ASA1-AA2, s. 2280kw Section 2280kw. 153.50 (5) (a) 4. (intro.) of the statutes is amended to read:

AB133-ASA1-AA2,359,3 153.50 (5) (a) 4. (intro.) For an entity that is authorized under sub. (4) (e) (a) 4. to receive or have access to patient-identifiable data, evidence, in writing, of all of the following:

AB133-ASA1-AA2, s. 2280kx Section 2280kx. 153.50 (5) (b) 3. of the statutes is amended to read:

AB133-ASA1-AA2,359,6 153.50 (5) (b) 3. For a person who believes that he or she is authorized under sub. (4) (a), the action provided under s. 19.37.".

AB133-ASA1-AA2,359,7 866. Page 1170, line 22: after that line insert:

AB133-ASA1-AA2,359,8 " Section 2280p. 153.50 (6) of the statutes is renumbered 153.50 (6) (a).

AB133-ASA1-AA2, s. 2280q Section 2280q. 153.50 (6) (b), (c), (d) and (e) of the statutes are created to read:

AB133-ASA1-AA2,359,12 153.50 (6) (b) The department may not require under this chapter a health care provider that is a hospital or ambulatory surgery center to submit uniform patient billing forms.

AB133-ASA1-AA2,359,15 (c) A health care provider that is not a hospital or ambulatory surgery center may not submit any of the following to the department under the requirements of this chapter:

AB133-ASA1-AA2,359,16 1. The data elements specified under sub. (3) (b).

AB133-ASA1-AA2,359,17 2. The patient's telephone number.

AB133-ASA1-AA2,359,18 3. The insured's employer's name or school name.

AB133-ASA1-AA2,359,20 4. Data regarding insureds other than the patient, other than the name of the insured's payer or other insured's payer.

AB133-ASA1-AA2,359,21 5. The patient's employer's name or school name.

AB133-ASA1-AA2,359,22 6. The patient's relationship to the insured.

AB133-ASA1-AA2,359,23 7. The insured's identification number.

AB133-ASA1-AA2,359,24 8. The insured's policy or group number.

AB133-ASA1-AA2,360,1 9. The insured's date of birth or sex.

AB133-ASA1-AA2,360,2 10. The patient's marital, employment or student status.

AB133-ASA1-AA2,360,6 (d) If a health care provider that is not a hospital or ambulatory surgery center submits a data element that is specified in par. (c) 1. to 10., the department shall immediately return this information to the health care provider or, if discovered later, shall remove and destroy the information.

AB133-ASA1-AA2,360,8 (e) A health care provider may not submit information that uses any of the following as a patient account number:

AB133-ASA1-AA2,360,10 1. The patient's social security number or any substantial portion of the patient's social security number.

AB133-ASA1-AA2,360,11 2. A number that is related to another patient identifying number.

AB133-ASA1-AA2, s. 2280r Section 2280r. 153.55 of the statutes is amended to read:

AB133-ASA1-AA2,360,15 153.55 Protection of health care provider confidentiality. Health care provider-identifiable data Data obtained under this chapter is not subject to inspection, copying or receipt under s. 19.35 (1).".