LRBs0132/1
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2015 - 2016 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 366
October 21, 2015 - Offered by Representative Nygren.
AB366-ASA1,1,6 1An Act to repeal subchapter IV (title) of chapter 50 [precedes 50.90]; to amend
220.435 (6) (jm), 50.56 (3), 146.40 (1) (bo), 146.81 (1) (L) and 146.997 (1) (d) 18.;
3and to create subchapter V (title) of chapter 50 [precedes 50.60], 50.60, 50.65
4and subchapter VI (title) of chapter 50 [precedes 50.90] of the statutes; relating
5to:
pain clinic certification and requirements, granting rule-making authority,
6and providing a penalty.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB366-ASA1,1 7Section 1. 20.435 (6) (jm) of the statutes is amended to read:
AB366-ASA1,2,138 20.435 (6) (jm) Licensing and support services. The amounts in the schedule
9for the purposes specified in ss. 48.685 (2) (am) and (b) 1., (3) (a), (am), (b), and (bm),
10and (5) (a), 49.45 (47), 50.02 (2), 50.025, 50.065 (2) (am) and (b) 1., (3) (a) and (b), and
11(5), 50.13, 50.135, 50.36 (2), 50.49 (2) (b), 50.495, 50.52 (2) (a), 50.57, 50.981, and

1146.40 (4r) (b) and (er), and subch. IV VI of ch. 50 and to conduct health facilities plan
2and rule development activities, for accrediting nursing homes, convalescent homes,
3and homes for the aged, to conduct capital construction and remodeling plan reviews
4under ss. 50.02 (2) (b) and 50.36 (2), and for the costs of inspecting, licensing or
5certifying, and approving facilities, issuing permits, and providing technical
6assistance, that are not specified under any other paragraph in this subsection. All
7moneys received under ss. 48.685 (8), 49.45 (42) (c), 49.45 (47) (c), 50.02 (2), 50.025,
850.065 (8), 50.13, 50.36 (2), 50.49 (2) (b), 50.495, 50.52 (2) (a), 50.57, 50.93 (1) (c), and
950.981, all moneys received from fees for the costs of inspecting, licensing or
10certifying, and approving facilities, issuing permits, and providing technical
11assistance, that are not specified under any other paragraph in this subsection, and
12all moneys received under s. 50.135 (2) shall be credited to this appropriation
13account.
AB366-ASA1,2 14Section 2. 50.56 (3) of the statutes is amended to read:
AB366-ASA1,2,1815 50.56 (3) Notwithstanding sub. (2), insofar as a conflict exists between this
16subchapter, or the rules promulgated under this subchapter, and subch. I, II or IV
17VI, or the rules promulgated under subch. I, II or IV VI, the provisions of this
18subchapter and the rules promulgated under this subchapter control.
AB366-ASA1,3 19Section 3. Subchapter V (title) of chapter 50 [precedes 50.60] of the statutes
20is created to read:
AB366-ASA1,2,2121 Chapter 50
AB366-ASA1,2,2222 Subchapter V
AB366-ASA1,2,2323 Clinics
AB366-ASA1,4 24Section 4. 50.60 of the statutes is created to read:
AB366-ASA1,2,25 2550.60 Definitions; clinics. In this subchapter:
AB366-ASA1,3,1
1(1) "Health care provider" has the meaning given in s. 146.81 (1) (a) to (hp).
AB366-ASA1,3,4 2(2) "Interventional pain medicine" means the branch of medicine and surgery
3devoted to the diagnosis and treatment of pain syndromes through the use of
4invasive techniques.
AB366-ASA1,3,5 5(3) "Pain clinic" means any of the following:
AB366-ASA1,3,96 (a) A privately owned facility where a majority of the health care providers,
7practicing within the scope of their licenses, devotes a majority of their practices to
8the treatment of pain syndromes through the practice of pain medicine or
9interventional pain medicine.
AB366-ASA1,3,1310 (b) A privately owned facility that advertises or otherwise holds itself out as
11providing pain medicine or interventional pain medicine services and that has one
12or more employees or contractors who prescribe opioids or opiates, benzodiazepines,
13barbiturates, or carisoprodol as chronic therapy for pain syndromes.
AB366-ASA1,3,16 14(4) "Pain medicine" means the branch of medicine devoted to the diagnosis and
15treatment of pain syndromes through treatments, including prescription of a
16monitored prescription drug, as defined in s. 961.385 (1) (ag).
AB366-ASA1,3,17 17(5) "Pain syndrome" means any of the following:
AB366-ASA1,3,1918 (a) Pain that is reasonably anticipated to persist, or has persisted, beyond the
19time frame for normal healing.
AB366-ASA1,3,2120 (b) Pain that is reasonably anticipated to persist, or has persisted, for more
21than 3 months.
AB366-ASA1,5 22Section 5. 50.65 of the statutes is created to read:
AB366-ASA1,3,24 2350.65 Pain clinics. (1) Certification required. (a) No pain clinic may
24operate unless it holds a certificate to operate issued by the department.
AB366-ASA1,4,8
1(b) A pain clinic shall submit to the department an application, on a form
2prescribed by the department, for a certificate. A business entity that owns more
3than one pain clinic may apply for a single certificate for all pain clinics it owns, but
4the business entity assuming responsibility for the pain clinics shall submit with the
5application a listing of each pain clinic site, the number of days each week each pain
6clinic site operates, and the health care providers who are working on each day of
7operation at each site. The department may charge an applicant a fee for applying
8for a certificate.
AB366-ASA1,4,109 (c) A certified pain clinic that undergoes a change of majority ownership shall
10submit a new application for a certificate.
AB366-ASA1,4,1811 (d) A pain clinic shall have a medical director who is a physician that practices
12in this state. In the event that the medical director no longer meets the requirements
13of holding the position of medical director, the pain clinic shall notify the department
14within 10 business days of the identity of a physician who meets the requirements
15of medical director and who acts as medical director at that pain clinic. Failure to
16notify the department of an acting medical director within 10 days of the departure
17of the previous medical director may be a basis for the department to suspend the
18pain clinic's certification.
AB366-ASA1,4,2519 (e) The department shall issue a certificate of operation to a pain clinic if the
20department finds that the pain clinic meets the requirements of this section, has paid
21any application fee required by the department, and meets any requirements
22established by the department. The department may not issue a certificate of
23operation to a pain clinic if the owner has been convicted of a felony or found guilty
24of a misdemeanor related to the distribution of an illegal prescription drug or
25controlled substance.
AB366-ASA1,5,2
1(f) Subject to sub. (2), a certificate issued under this subsection is valid for 3
2years and may be renewed.
AB366-ASA1,5,6 3(2) Penalty for violation. (a) If the department finds that a pain clinic which
4was issued a certificate under this section no longer meets any requirement of this
5section or rules promulgated under this section or of requirements established by the
6department, the department may do any of the following:
AB366-ASA1,5,87 1. Suspend the certificate of the pain clinic until the department determines
8that the pain clinic demonstrates compliance.
AB366-ASA1,5,99 2. Revoke the certificate of the pain clinic.
AB366-ASA1,5,1010 3. Impose a forfeiture of up to $1,000 per day for each day of continued violation.
AB366-ASA1,5,1211 (b) A pain clinic subject to a penalty under par. (a) is entitled to an appeal and
12a hearing under ch. 227.
AB366-ASA1,5,18 13(3) Cash transactions. A pain clinic may not solicit or accept payment for
14services in cash from an individual seeking treatment at the pain clinic, except that
15an individual seeking treatment may pay an insurance copayment, coinsurance, or
16deductible with cash. A pain clinic may accept credit, a credit card, a check, or a draft
17from an individual who seeks treatment from a pain clinic but who does not have
18insurance.
AB366-ASA1,5,21 19(4) Direct dispensing. A pain clinic may not directly dispense, as defined in
20s. 450.01 (7), a monitored prescription drug, as defined in s. 961.385 (1) (ag), that is
21administered orally, unless any of the following are true:
AB366-ASA1,5,2222 (a) The pain clinic is licensed as a pharmacy under s. 450.06.
AB366-ASA1,5,2523 (b) The pain clinic is treating an individual under ch. 102 for a condition or
24complaint reasonably related to a condition for which the individual claims worker's
25compensation under ch. 102.
AB366-ASA1,6,1
1(5) Applicability. This section does not apply to any of the following:
AB366-ASA1,6,42 (a) A medical or dental school, nursing school, physician assistant training
3program, or outpatient clinic associated with any of the schools or training programs
4specified in this paragraph.
AB366-ASA1,6,55 (b) A hospital, as defined in s. 50.33 (2).
AB366-ASA1,6,66 (c) Hospice, as defined in s. 50.90 (1).
AB366-ASA1,6,77 (d) A nursing home, as defined in s. 50.01 (3).
AB366-ASA1,6,12 8(6) Rules. The department, after consulting with health care providers who
9provide pain medicine services in pain clinics, shall promulgate rules to govern the
10operation of pain clinics, including personnel, patient records, data collection and
11reporting, inspections, health and safety requirements, and billing. The department
12may promulgate other rules it determines are necessary to implement this section.
AB366-ASA1,6,17 13(7) Regulation of professions. Nothing in this section confers authority on the
14department of health services to regulate the profession or practice of a health care
15provider whose profession is regulated by the department of safety and professional
16services or an examining board attached to the department of safety and professional
17services.
AB366-ASA1,6 18Section 6. Subchapter VI (title) of chapter 50 [precedes 50.90] of the statutes
19is created to read:
AB366-ASA1,6,2020 Chapter 50
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