Amendment AA1-AB675

AB675-AA1,1,1 At the locations indicated, amend the bill as follows:

AB675-AA1,1,2 1. Page 3, line 23: after that line insert:

AB675-AA1,1,3 " Section 5m. 619.04 (3) of the statutes is amended to read:

AB675-AA1,2,3 619.04 (3) The plan shall operate subject to the supervision and approval of a board of governors consisting of 3 representatives of the insurance industry appointed by and to serve at the pleasure of the commissioner, a person to be named by the State Bar Association, a person to be named by the Wisconsin Academy of Trial Lawyers, 2 persons to be named by the Wisconsin Medical Society, a person to be named by the Wisconsin Hospital Association, a person to be named by the Wisconsin Nurses Association, the commissioner or a designated representative employed by the office of the commissioner, and 4 public members at least 2 of whom are not attorneys or physicians and are not professionally affiliated with any hospital or insurance company, appointed by the governor for staggered 3-year terms. The commissioner or the commissioner's representative shall be the chairperson of the board of governors. Board members shall be compensated at the rate of $50 per diem plus actual and necessary travel expenses.".

AB675-AA1,2,4 2. Page 4, line 6: after that line insert:

AB675-AA1,2,6 " Section 6m. 655.001 (7t) (a) of the statutes, as affected by 2009 Wisconsin Act .... (this act), is renumbered 655.001 (7t) and amended to read:

AB675-AA1,2,11 655.001 (7t) Except as provided in par. (b), "health "Heath care practitioner" means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not under the direction and supervision of a physician or, nurse anesthetist, or nurse-midwife.".

AB675-AA1,2,13 3. Page 4, line 8: delete the material beginning with "person" and ending with "s. 441.15" on line 9 and substitute "nurse-midwife".

AB675-AA1,2,14 4. Page 4, line 9: after that line insert:

AB675-AA1,2,16 " Section 7b. 655.001 (7t) (b) of the statutes, as created by 2009 Wisconsin Act .... (this act), is repealed.

AB675-AA1, s. 7d Section 7d. 655.001 (9c) of the statutes is created to read:

AB675-AA1,2,19 655.001 (9c) "Nurse-midwife" means a person who is licensed to practice nurse-midwifery under s. 441.15.

AB675-AA1, s. 7f Section 7f. 655.002 (1) (a) of the statutes is amended to read:

AB675-AA1,2,23 655.002 (1) (a) A physician or, a nurse anesthetist, or a nurse-midwife for whom this state is a principal place of practice and who practices his or her profession in this state more than 240 hours in a fiscal year.

AB675-AA1, s. 7h Section 7h. 655.002 (1) (b) (intro.) of the statutes is amended to read:

AB675-AA1,3,2 655.002 (1) (b) (intro.) A physician or, a nurse anesthetist, or a nurse-midwife for whom Michigan is a principal place of practice, if all of the following apply:

AB675-AA1, s. 7i Section 7i. 655.002 (1) (b) 1. of the statutes is amended to read:

AB675-AA1,3,5 655.002 (1) (b) 1. The physician or, nurse anesthetist, or nurse-midwife is a resident of this state.

AB675-AA1, s. 7j Section 7j. 655.002 (1) (b) 2. of the statutes is amended to read:

AB675-AA1,3,9 655.002 (1) (b) 2. The physician or, nurse anesthetist, or nurse-midwife practices his or her profession in this state or in Michigan or a combination of both more than 240 hours in a fiscal year.

AB675-AA1, s. 7k Section 7k. 655.002 (1) (b) 3. of the statutes is amended to read:

AB675-AA1,3,15 655.002 (1) (b) 3. The physician or, nurse anesthetist, or nurse-midwife performs more procedures in a Michigan hospital than in any other hospital. In this subdivision, "Michigan hospital" means a hospital located in Michigan that is an affiliate of a corporation organized under the laws of this state that maintains its principal office and a hospital in this state.

AB675-AA1, s. 7m Section 7m. 655.002 (1) (c) of the statutes is amended to read:

AB675-AA1,3,24 655.002 (1) (c) A physician or, nurse anesthetist, or nurse-midwife who is exempt under s. 655.003 (1) or (3), or a nurse-midwife who is exempt under s. 655.03 (4), but who practices his or her profession outside the scope of the exemption and who fulfills the requirements under par. (a) in relation to that practice outside the scope of the exemption. For a physician or a, nurse anesthetist, or nurse-midwife who is subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is outside the scope of the exemption under s. 655.003 (1) or (3) or (4).

AB675-AA1, s. 7p Section 7p. 655.002 (1) (d) of the statutes is amended to read:

AB675-AA1,4,4 655.002 (1) (d) A partnership comprised of physicians or, nurse anesthetists, or nurse-midwives and organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

AB675-AA1, s. 7q Section 7q. 655.002 (1) (e) of the statutes is amended to read:

AB675-AA1,4,8 655.002 (1) (e) A corporation organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

AB675-AA1, s. 7r Section 7r. 655.002 (1) (em) of the statutes is amended to read:

AB675-AA1,4,12 655.002 (1) (em) Any organization or enterprise not specified under par. (d) or (e) that is organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

AB675-AA1, s. 7t Section 7t. 655.002 (2) (a) of the statutes is amended to read:

AB675-AA1,4,17 655.002 (2) (a) A physician or, nurse anesthetist, or nurse-midwife for whom this state is a principal place of practice but who practices his or her profession fewer than 241 hours in a fiscal year, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession.

AB675-AA1, s. 7v Section 7v. 655.002 (2) (b) of the statutes is amended to read:

AB675-AA1,4,25 655.002 (2) (b) Except as provided in sub. (1) (b), a physician or, nurse anesthetist, or nurse-midwife for whom this state is not a principal place of practice, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession in this state. For a health care provider who elects to be subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is in this state and that is outside the scope of an exemption under s. 655.003 (1) or (3) or (4).".

AB675-AA1,4,26 5. Page 4, line 10: delete lines 10 and 11.

AB675-AA1,5,2 6. Page 4, line 11: after that line insert:

AB675-AA1,5,3 " Section 8f. 655.003 (1) of the statutes is amended to read:

AB675-AA1,5,7 655.003 (1) A physician or, a nurse anesthetist, or a nurse-midwife who is a state, county, or municipal employee, or federal employee or contractor covered under the federal tort claims act, as amended, and who is acting within the scope of his or her employment or contractual duties.

AB675-AA1, s. 8h Section 8h. 655.003 (3) of the statutes is amended to read:

AB675-AA1,5,13 655.003 (3) A physician or, a nurse anesthetist, or a nurse-midwife who provides professional services under the conditions described in s. 146.89 or 250.042 (4) (b), with respect to those professional services provided by the physician or, nurse anesthetist, or nurse-midwife for which he or she is covered by s. 165.25 and considered an agent of the department, as provided in s. 165.25 (6) (b).

AB675-AA1, s. 8j Section 8j. 655.003 (4) of the statutes is created to read:

AB675-AA1,5,16 655.003 (4) A nurse-midwife who is considered to be an employee of the federal public health service under 42 USC 233 (g).".

AB675-AA1,5,17 7. Page 4, line 16: after that line insert:

AB675-AA1,5,19 " Section 10. 655.005 (2) (a) of the statutes, as affected by 2009 Wisconsin Act .... (this act), is amended to read:

AB675-AA1,5,23 655.005 (2) (a) An employee of a health care provider if the employee is a physician or a, nurse anesthetist, or nurse-midwife or is a health care practitioner who is providing health care services that are not under the direction and supervision of a physician or, nurse anesthetist, or nurse-midwife.

AB675-AA1, s. 11 Section 11. 655.005 (2) (b) of the statutes is amended to read:

AB675-AA1,6,9 655.005 (2) (b) A service corporation organized under s. 180.1903 by health care professionals, as defined under s. 180.1901 (1m), if the board of governors determines that it is not the primary purpose of the service corporation to provide the medical services of physicians or, nurse anesthetists, or nurse-midwives. The board of governors may not determine under this paragraph that it is not the primary purpose of a service corporation to provide the medical services of physicians or, nurse anesthetists, or nurse-midwives unless more than 50% of the shareholders of the service corporation are neither not physicians nor, nurse anesthetists, or nurse-midwives.

AB675-AA1, s. 12 Section 12. 655.23 (5m) of the statutes is amended to read:

AB675-AA1,6,13 655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of a physician or, nurse anesthetist, or nurse-midwife and his or her corporation, partnership, or other organization or enterprise under s. 655.002 (1) (d), (e), or (em).

AB675-AA1, s. 13 Section 13. 655.27 (3) (a) 4. of the statutes is amended to read:

AB675-AA1,6,18 655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e), (em), or (f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or, nurse anesthetist , or nurse-midwife.

AB675-AA1, s. 14 Section 14. 655.27 (3) (b) 2f. of the statutes is created to read:

AB675-AA1,6,24 655.27 (3) (b) 2f. With respect to fees paid by nurse-midwives, the rule may provide for a separate payment classification or for a payment classification that is combined with one or more other categories of health care providers, as the commissioner, after approval by the board of governors, determines is appropriate for pooling risks under the fund.

AB675-AA1, s. 15 Section 15. 655.27 (3) (b) 2m. of the statutes is amended to read:

AB675-AA1,7,7 655.27 (3) (b) 2m. In addition to the fees and payment classifications described under subds. 1. and 2. to 2f., the commissioner, after approval by the board of governors, may by rule establish a separate payment classification for physicians satisfying s. 655.002 (1) (b) and, a separate fee for nurse anesthetists satisfying s. 655.002 (1) (b), and a separate fee for nurse-midwives satisfying s. 655.002 (1) (b) which take into account the loss experience of health care providers for whom Michigan is a principal place of practice.

AB675-AA1, s. 16 Section 16. 655.275 (5) (b) 3. of the statutes is created to read:

AB675-AA1,7,10 655.275 (5) (b) 3. If a claim was paid for damages arising out of the rendering of care by a nurse-midwife, with at least one nurse-midwife.

AB675-AA1, s. 17 Section 17. Nonstatutory provisions.

AB675-AA1,7,15 (1) Expiration of term of member on board of governors. Notwithstanding the length of terms specified for the members of the board of governors under section 619.04 (3) of the statutes, as affected by this act, the initial member named by the Wisconsin Nurses Association shall be appointed for a term expiring on May 1, 2013.

AB675-AA1,7,25 (2) Notice of effective date of rule for fees. The commissioner of insurance shall promulgate a rule under section 655.27 (3) (b) of the statutes, as affected by this act, that takes into account participation in the injured patients and families compensation fund by nurse-midwives. The rule may provide for a separate payment classification or for a payment classification that is combined with one or more other categories of health care providers, as the commissioner, after approval by the board of governors, determines is appropriate for pooling risks under the fund. When the rule has been promulgated and is in effect, the commissioner of insurance shall publish a notice in the Wisconsin Administrative Register that specifies the effective date of the rule.

AB675-AA1, s. 18 Section 18. Effective dates. This act takes effect on the first day of the 3rd month beginning after the date published by the commissioner of insurance in the Wisconsin Administrative Register under 2009 Wisconsin Act .... (this act), section 17 (2), except as follows:

AB675-AA1,8,9 (1) The treatment of sections 50.36 (3i), 441.51 (1) (a) and (c), (2) (b), and (4), 619.04 (3), 655.001 (9c), and 655.005 (2) (a) (by Section 9) of the statutes, the renumbering and amendment of section 655.001 (7t) of the statutes, the creation of section 655.001 (7t) (b) of the statutes, and Section 17 of this act take effect on the day after publication.".

AB675-AA1,8,10 (End)