Amendment SA1-SSA1-SB45

SB45-SSA1-SA1,286,6 (3) Notice of termination or change in relationship. (a) 1. Except as provided in subds. 2. and 3., a supplier shall provide a wholesaler at least 90 days' prior written notice of termination, cancellation, nonrenewal or substantial change in the relationship or a substantial change in the competitive circumstances of the wholesaler's business. The notice shall be given by certified mail or personal service to the wholesaler and to the secretary of the department. The notice shall state all of the supplier's reasons for terminating, canceling, not renewing or substantially changing the relationship or substantially changing in the competitive circumstances of the wholesaler's business. The wholesaler shall have 60 days after receiving the notice in which to correct any claimed deficiency. If the wholesaler corrects the deficiency within 60 days after receiving the notice, the notice is void.

SB45-SSA1-SA1,286,8 2. If the reason is nonpayment of sums owed, the wholesaler shall have only 10 days to correct the deficiency.

SB45-SSA1-SA1,286,11 3. No notice is required under this subsection for the termination, cancellation, nonrenewal or substantial change of a relationship caused by an assignment for the benefit of creditors or bankruptcy.

SB45-SSA1-SA1,286,20 (b) 1. Within the time period for remedying any claimed deficiency, the wholesaler may file a written request with the division of hearings and appeals in the department of administration for a hearing and serve the supplier and the secretary of revenue by certified mail or in person, with a notice of the contested action. Service of notice stays any action proposed by the supplier in the notice provided under par. (a) 1. If the supplier files a motion with the division of hearings and appeals to allow the action to proceed, the division of hearings and appeals shall, within 20 days after receiving that notice, hold a hearing to determine whether the action should proceed.

SB45-SSA1-SA1,286,24 2. The division of hearings and appeals shall conduct a contested case hearing on the matter, as provided in ch. 227, within 180 days after the filing of a notice of contest and shall determine whether the supplier has met the requirements of this subsection and sub. (2).

SB45-SSA1-SA1,287,12 3. If the division of hearings and appeals, after a hearing, determines the supplier has failed to comply with this subsection or sub. (2), the relationship between the supplier and the wholesaler is still in effect. The department may revoke or refuse to renew the out-of-state shippers' permit of a supplier that fails to comply with the terms of the relationship or may refuse to grant an out-of-state shippers' permit to such a supplier. If the division of hearings and appeals, after a hearing, determines that a transferee has failed to comply with this subsection or sub. (2), the transferee shall comply with the terms of the relationship between the supplier and the wholesaler. The department may revoke or refuse to renew the out-of-state shippers' permit of a transferee that fails to comply with the terms of the relationship, or may refuse to grant an out-of-state shippers' permit to such a transferee.

SB45-SSA1-SA1,287,16 3m. If the wholesaler prevails at the hearing, the wholesaler shall be awarded its actual costs incurred in the hearing, including reasonable attorney fees. The losing party shall pay to the division of hearings and appeals the costs of the hearing, as determined under s. 227.43 (3) (f).

SB45-SSA1-SA1,287,19 4. Any person aggrieved by a decision of the division of hearings and appeals may seek judicial review under ss. 227.53 to 227.58 in the circuit court in the county in which the wholesaler's premises is located.

SB45-SSA1-SA1,287,21 (4) Liability of transferee. A transferee of a supplier's business shall comply with the requirements under subs. (2) and (3).

SB45-SSA1-SA1,287,25 (5) Action for damages and injunctive relief. A wholesaler may bring an action to enjoin any violation of sub. (2), (3) or (4) to compel compliance with those subsections, and in the same action may recover the damages, together with costs including reasonable, actual attorney fees, notwithstanding s. 814.04 (1).

SB45-SSA1-SA1,288,2 (6) Other rights, remedies. This section does not limit any other right or remedy provided by law.".

SB45-SSA1-SA1,288,3 935. Page 1140, line 6: after that line insert:

SB45-SSA1-SA1,288,4 " Section 2171p. 139.32 (5) of the statutes is amended to read:

SB45-SSA1-SA1,288,6 139.32 (5) Manufacturers and distributors having a permit from the secretary shall receive a discount of 1.6% 2% of the tax.".

SB45-SSA1-SA1,288,7 936. Page 1140, line 7: delete lines 7 to 24.

SB45-SSA1-SA1,288,8 937. Page 1143, line 13: delete "a portion" and substitute "70%".

SB45-SSA1-SA1,288,9 938. Page 1144, line 1: delete lines 1 and 2.

SB45-SSA1-SA1,288,11 939. Page 1144, line 6: delete lines 6 to 9 and substitute "tax imposed under s. 139.76 (1)".

SB45-SSA1-SA1,288,13 940. Page 1144, line 24: delete the material beginning with that line and ending with page 1145, line 15.

SB45-SSA1-SA1,288,14 941. Page 1146, line 1: delete lines 1 to 9.

SB45-SSA1-SA1,288,16 942. Page 1146, line 19: delete the material beginning with that line and ending with page 1147, line 9.

SB45-SSA1-SA1,288,17 943. Page 1148, line 13: delete lines 13 to 19.

SB45-SSA1-SA1,288,19 944. Page 1149, line 9: delete the material beginning with that line and ending with page 1150, line 5.

SB45-SSA1-SA1,288,20 945. Page 1155, line 13: after that line insert:

SB45-SSA1-SA1,288,21 " Section 2246m. 146.37 (1g) of the statutes is amended to read:

SB45-SSA1-SA1,289,14 146.37 (1g) Except as provided in s. 153.85, no person acting in good faith who participates in the review or evaluation of the services of health care providers or facilities or the charges for such services conducted in connection with any program organized and operated to help improve the quality of health care, to avoid improper utilization of the services of health care providers or facilities or to determine the reasonable charges for such services, or who participates in the obtaining of health care information under ch. 153, or who participates in hospital rate price cap activities under subch. II of ch. 196, is liable for any civil damages as a result of any act or omission by such person in the course of such review or evaluation. Acts and omissions to which this subsection applies include, but are not limited to, acts or omissions by peer review committees or hospital governing bodies in censuring, reprimanding, limiting or revoking hospital staff privileges or notifying the medical examining board or podiatrists affiliated credentialing board under s. 50.36 or taking any other disciplinary action against a health care provider or facility and acts or omissions by a medical director, as defined in s. 146.50 (1) (j), in reviewing the performance of emergency medical technicians or ambulance service providers.".

SB45-SSA1-SA1,289,15 946. Page 1158, line 11: after that line insert:

SB45-SSA1-SA1,289,16 " Section 2251gm. 146.82 (1) of the statutes is amended to read:

SB45-SSA1-SA1,289,22 146.82 (1) Confidentiality. All patient health care records shall remain confidential. Patient health care records may be released only to the persons designated in this section or to other persons with the informed consent of the patient or of a person authorized by the patient. This subsection does not prohibit reports made in compliance with s. 146.995, 253.12 (2) or 979.01 or testimony authorized under s. 905.04 (4) (h).".

SB45-SSA1-SA1,289,23 947. Page 1158, line 11: after that line insert:

SB45-SSA1-SA1,289,24 " Section 2251r. 146.84 (3) of the statutes is amended to read:

SB45-SSA1-SA1,290,4 146.84 (3) Discipline of employes. Any person employed by the state, or any political subdivision of the state who violates s. 146.82 or 146.83 , except a health care provider that negligently violates s. 153.50 (6) (c), may be discharged or suspended without pay.".

SB45-SSA1-SA1,290,5 948. Page 1158, line 11: after that line insert:

SB45-SSA1-SA1,290,6 " Section 2252g. 146.83 (1) (b) of the statutes is amended to read:

SB45-SSA1-SA1,290,10 146.83 (1) (b) Receive a copy of the patient's health care records, whether certified or not, upon payment of reasonable an approximation of actual costs. In this paragraph, "approximation of actual costs" means, at a maximum, the fees that are prescribed by the department by rule under s. 908.03 (6m) (d).

SB45-SSA1-SA1, s. 2252h Section 2252h. 146.83 (3m) of the statutes is created to read:

SB45-SSA1-SA1,290,16 146.83 (3m) If a health care provider provides a copy of a patient health care record after 30 days after receipt of a statement of informed consent for the release of the copy, the health care provider, notwithstanding sub. (1) (b) and s. 908.03 (6m) (d), may collect as payment no more than 25% of the approximation of actual costs, as specified under sub. (1) (b).".

SB45-SSA1-SA1,290,18 949. Page 1163, line 15: delete the material beginning with that line and ending with page 1165, line 8 and substitute:

SB45-SSA1-SA1,290,19 " Section 2262e. 149.143 (1) (b) (intro.) of the statutes is repealed.

SB45-SSA1-SA1, s. 2262m Section 2262m. 149.143 (1) (b) 1. (intro.) of the statutes is repealed.

SB45-SSA1-SA1, s. 2262r Section 2262r. 149.143 (1) (b) 1. a. of the statutes is renumbered 149.143 (1) (b) and amended to read:

SB45-SSA1-SA1,291,6 149.143 (1) (b) First, Next from premiums from eligible persons with coverage under s. 149.14 set, except as reduced under sub. (2m), at 150% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as are provided under the plan, including amounts received for premium and deductible subsidies under s. 149.144 and under the transfer to the fund from the appropriation account under ss. s. 20.435 (5) (4) (ah) and 149.144, and from premiums collected from eligible persons with coverage under s. 149.146 set in accordance with s. 149.146 (2) (b).

SB45-SSA1-SA1, s. 2263b Section 2263b. 149.143 (1) (b) 1. b. of the statutes is repealed.

SB45-SSA1-SA1, s. 2263e Section 2263e. 149.143 (1) (b) 1. c. of the statutes is repealed.

SB45-SSA1-SA1, s. 2263m Section 2263m. 149.143 (1) (b) 1. d. of the statutes is repealed.

SB45-SSA1-SA1, s. 2263r Section 2263r. 149.143 (1) (b) 2. of the statutes is renumbered 149.143 (1) (c) and 149.143 (1) (c) (intro.) and 2., as renumbered, are amended to read:

SB45-SSA1-SA1,291,12 149.143 (1) (c) (intro.) A total of 40% The remainder as follows:

SB45-SSA1-SA1,291,14 2. Fifty percent from adjustments to provider payment rates, excluding adjustments to those rates under ss. s. 149.144 and 149.15 (3) (e).

SB45-SSA1-SA1, s. 2264b Section 2264b. 149.143 (2) (a) 1. of the statutes is repealed.

SB45-SSA1-SA1, s. 2264e Section 2264e. 149.143 (2) (a) 2. of the statutes is amended to read:

SB45-SSA1-SA1,291,22 149.143 (2) (a) 2. After making the determinations under subd. 1., by By rule set premium rates for the new plan year, including the rates under s. 149.146 (2) (b), in the manner specified in sub. (1) (b) 1. a. and c. and such that a rate for coverage under s. 149.14 is not less than 150% nor more than 200% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as are provided under the plan.

SB45-SSA1-SA1, s. 2264m Section 2264m. 149.143 (2) (a) 3. of the statutes is amended to read:

SB45-SSA1-SA1,292,2 149.143 (2) (a) 3. By rule set the total insurer assessments under s. 149.13 for the new plan year by estimating and setting the assessments at the amount necessary to equal the amounts specified in sub. (1) (b) 1. d. and 2. a. (c) 1. and notify the commissioner of the amount.

SB45-SSA1-SA1, s. 2264r Section 2264r. 149.143 (2) (a) 4. of the statutes is amended to read:

SB45-SSA1-SA1,292,7 149.143 (2) (a) 4. By the same rule as under subd. 3. adjust the provider payment rate for the new plan year by estimating and setting the rate at the level necessary to equal the amounts specified in sub. (1) (b) 1. d. and 2. b. (c) 2. and as provided in s. 149.145.

SB45-SSA1-SA1, s. 2265b Section 2265b. 149.143 (2) (b) of the statutes is amended to read:

SB45-SSA1-SA1,292,15 149.143 (2) (b) In setting the premium rates under par. (a) 2., the insurer assessment amount under par. (a) 3. and the provider payment rate under par. (a) 4. for the new plan year, the department shall include any increase or decrease necessary to reflect the amount, if any, by which the rates and amount and rate set under par. (a) for the current plan year differed from the rates and amount and rate which would have equaled the amounts specified in sub. (1) (b) (c) in the current plan year.".

SB45-SSA1-SA1,292,16 950. Page 1165, line 15: delete "60% of".

SB45-SSA1-SA1,292,17 951. Page 1165, line 20: delete "(1) (b) 1." and substitute "(1) (b).".

SB45-SSA1-SA1,292,18 952. Page 1165, line 21: delete lines 21 to 24.

SB45-SSA1-SA1,292,19 953. Page 1166, line 1: delete lines 1 to 8 and substitute:

SB45-SSA1-SA1,292,21 " Section 2267c. 149.143 (3) (a) of the statutes is renumbered 149.143 (3) and amended to read:

SB45-SSA1-SA1,293,7 149.143 (3) If, during a plan year, the department determines that the amounts estimated to be received as a result of the rates and amount set under sub. (2) (a) 2. to 4. and any adjustments in insurer assessments and the provider payment rate under s. 149.144 will not be sufficient to cover plan costs, the department may by rule increase the premium rates set under sub. (2) (a) 2. for the remainder of the plan year, subject to s. 149.146 (2) (b) and the maximum specified in sub. (2) (a) 2., by rule increase the assessments set under sub. (2) (a) 3. for the remainder of the plan year, subject to sub. (1) (b) 2. a. (c) 1., and by the same rule under which assessments are increased adjust the provider payment rate set under sub. (2) (a) 4. for the remainder of the plan year, subject to sub. (1) (b) 2. b (c) 2.

SB45-SSA1-SA1, s. 2267g Section 2267g. 149.143 (3) (b) of the statutes is repealed.".

SB45-SSA1-SA1,293,9 954. Page 1166, line 15: delete "sub." and substitute "subs.".

SB45-SSA1-SA1,293,10 955. Page 1166, line 16: after "(b)" insert "and (2m) (b) 1".

SB45-SSA1-SA1,293,11 956. Page 1167, line 19: delete "(a) and (b)" and substitute "(a) and (b)".

SB45-SSA1-SA1,293,12 957. Page 1170, line 11: after that line insert:

SB45-SSA1-SA1,293,13 " Section 2279m. 153.05 (4n) of the statutes is created to read:

SB45-SSA1-SA1,293,17 153.05 (4n) The office shall provide the public service commission with information necessary for performance of duties of the public service commission under subch. II of ch. 196 and as requested of the office by the public service commission.".

SB45-SSA1-SA1,293,18 958. Page 1170, line 18: after that line insert:

SB45-SSA1-SA1,293,20 " Section 2280b. 153.45 (1) (b) of the statutes is renumbered 153.45 (1) (b) 1. and amended to read:

SB45-SSA1-SA1,294,3 153.45 (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.

SB45-SSA1-SA1, s. 2280c Section 2280c. 153.45 (1) (b) 2. of the statutes is created to read:

SB45-SSA1-SA1,294,16 153.45 (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:

SB45-SSA1-SA1,294,17 a. The patient's county of residence.

SB45-SSA1-SA1,294,18 b. The payment source, by type.

SB45-SSA1-SA1,294,20 c. The patient's age category, by 5-year intervals up to age 80 and a category of 80 years or older.

SB45-SSA1-SA1,294,21 d. The patient's procedure code.

SB45-SSA1-SA1,294,22 e. The patient's diagnosis code.

SB45-SSA1-SA1,294,23 f. Charges assessed with respect to the procedure code.

SB45-SSA1-SA1,294,25 g. The name and address of the facility in which the patient's services were rendered.

SB45-SSA1-SA1,295,1 h. The patient's sex.

SB45-SSA1-SA1,295,6 i. Information that contains the name of a health care provider that is not a hospital or ambulatory surgery center, if the independent review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the independent review board need not review and approve the release.

SB45-SSA1-SA1,295,9 j. Calendar quarters 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.

SB45-SSA1-SA1,295,11 k. Information other than patient-identifiable data, as defined in s. 153.50 (1) (b), as approved by the independent review board.

SB45-SSA1-SA1, s. 2280e Section 2280e. 153.45 (1) (c) of the statutes is renumbered 153.45 (1) (c) (intro.) and amended to read:

SB45-SSA1-SA1,295,25 153.45 (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 independent 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 independent review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the independent 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:

SB45-SSA1-SA1, s. 2280f Section 2280f. 153.45 (1) (c) 1. to 4. of the statutes are created to read: