SB640,7,22 19(6) The health care entity to which the referral is made is a joint venture in
20which the health care provider's group practice has invested for the purpose of pro
21viding health care services, an ambulatory surgery center or a hospital, if all of the
22following conditions are met:
SB640,7,2423 (a) The health care provider has an employment or service agreement with the
24entity for specified services.
SB640,8,4
1(b) The compensation the health care provider receives from the entity is con
2sistent with the fair market value of the services provided, is not determined on the
3basis of the value or volume of referrals, and is reasonable even if no referrals are
4made to the entity.
SB640,8,8 5150.886 Community need referrals. (1) A health care provider may refer
6a patient to a health care entity that is outside his or her office practice or group prac
7tice and in which he or she has a financial interest if all of the following conditions
8are met:
SB640,8,119 (a) The community in which the entity is located has a demonstrated need for
10the entity. A community has a demonstrated need for an entity in any one of the fol
11lowing situations:
SB640,8,1312 1. There is no other health care entity or facility of reasonable quality that pro
13vides medically appropriate service.
SB640,8,1514 2. Requiring a patient to use another entity or facility creates a hardship for
15the patient.
SB640,8,1816 3. The entity has been formed to own or lease medical equipment that replaces
17obsolete or inadequate equipment in or under the control of a hospital located in a
18health manpower shortage area.
SB640,8,2019 4. The community meets any other demonstrated need established by rule by
20the commission.
SB640,8,2121 (b) The structure of the entity meets all of the following requirements:
SB640,8,2322 1. A person who is not in a position to refer a patient to the entity is able to in
23vest in the entity on the same terms as those offered to a health care provider.
SB640,9,3
12. No health care provider who invests is required or encouraged to make refer
2rals to the entity or otherwise generate business for the entity as a condition of be
3coming or remaining an investor.
SB640,9,64 3. The entity markets or furnishes its services on equal terms to referring
5health care provider investors, other investors and health care providers who are not
6investors.
SB640,9,87 4. The entity does not loan funds or guarantee any loans for health care provid
8ers who are in a position to refer patients to an entity.
SB640,9,119 5. The income on the health care provider's investment is based on the health
10care provider's equity in the entity rather than on the volume of the referrals the
11health care provider makes to the entity.
SB640,9,1312 6. The investment contract between the entity and the health care provider
13does not prohibit a health care provider from investing in other entities.
SB640,9,24 14(2) Before obtaining a financial interest in a health care entity, a health care
15provider may request the commission to determine whether the entity satisfies the
16requirements under sub. (1). A request by a health care provider under this subsec
17tion shall be in writing and shall contain sufficient information for the commission
18to make a determination. The commission shall provide the determination in writ
19ing, stating the reasons for its determination, no later than 90 days after receiving
20the health care provider's written request. If the commission does not provide a de
21termination in the 90-day period, the entity shall be considered to satisfy the re
22quirements under sub. (1) based on the information contained in the health care pro
23vider's written request and the health care provider may make referrals to the entity
24under this section.
SB640,10,13
1(3) If a health care provider has not received a determination under sub. (2)
2that permits the health care provider to make referrals to an entity in which the
3health care provider has a financial interest, the health care provider shall, before
4making a referral under this section, request the commission to determine whether
5the entity satisfies the requirements under sub. (1). A request by a health care pro
6vider under this subsection shall be in writing and shall contain sufficient informa
7tion for the commission to make a determination. The commission shall provide the
8determination in writing, stating the reasons for its determination, no later than 90
9days after receiving the health care provider's written request. If the commission
10does not provide a determination in the 90-day period, the entity shall be considered
11to satisfy the requirements under sub. (1) based on the information contained in the
12health care provider's written request and the health care provider may make the
13referral to the entity under this section.
SB640,10,22 14(4) When making a referral under this section, a health care provider shall dis
15close his or her financial interest in the entity to which the patient is being referred
16to the patient and, if it requests information regarding the health care provider's fi
17nancial interest, to a 3rd-party payor. If alternative facilities are reasonably avail
18able, the health care provider shall provide the patient with a list of the alternative
19facilities and shall inform the patient that he or she may use the alternative facility
20other than the one in which the health care worker has a financial interest. A health
21care provider may not treat a patient differently if the patient chooses to use an alter
22native facility.
SB640,10,25 23(5) No entity may receive referrals under this section unless the entity esta
24blishes a referral review program to ensure that referrals from health care providers
25who have a financial interest in the entity are appropriate or necessary referrals.
SB640,11,6
1(6) If compliance with the provisions of this section are not practical, as defined
2by rule by the commission, the health care provider may refer the patient to an entity
3in which he or she has a financial interest without submitting a written request un
4der sub. (3). A health care provider making a referral under this subsection shall pro
5vide the patient with information concerning all reasonably available alternative fa
6cilities.
SB640,11,9 7150.888 Evasion. No health care provider may enter into an agreement or ar
8rangement with another person that provides for the other person to make a referral
9that the health care provider is prohibited by this subchapter to make directly.
SB640,11,16 10150.89 Advisory opinions. A health care provider may request in writing
11that the commission provide an advisory opinion concerning whether a referral to an
12entity violates this subchapter. The opinion of the commission requested under this
13section shall be presumptively correct. If the commission does not provide the opin
14ion within 90 days after receiving the written request the health care provider may
15make the referral and the referral shall not be considered to be a violation of this sub
16chapter.
SB640,11,18 17150.892 Rule-making authority. The commission shall promulgate rules
18that it determines are necessary to administer this subchapter.
SB640,11,20 19150.894 Penalties. Any person violating this subchapter or a rule promul
20gated under this subchapter shall forfeit $20,000 for each violation.
SB640, s. 2 21Section 2. 441.07 (1) (f) of the statutes is created to read:
SB640,11,2322 441.07 (1) (f) Any act that violates subch. V of ch. 150 or a rule promulgated
23under subch. V of ch. 150.
SB640, s. 3 24Section 3. 446.04 (4m) of the statutes is created to read:
SB640,12,2
1446.04 (4m) Violating subch. V of ch. 150 or a rule promulgated under subch.
2V of ch. 150; and
SB640, s. 4 3Section 4. 447.07 (3) (km) of the statutes is created to read:
SB640,12,54 447.07 (3) (km) Violated subch. V of ch. 150 or a rule promulgated under subch.
5V of ch. 150.
SB640, s. 5 6Section 5. 448.01 (11) of the statutes is renumbered 448.01 (11) (intro.) and
7amended to read:
SB640,12,88 448.01 (11) (intro.) "Unprofessional conduct" means those any of the following:
SB640,12,11 9(a) Those acts or attempted acts of commission or omission defined as unprofes
10sional conduct by the board under the authority delegated to the board by s. 15.08
11(5) (b) and any.
SB640,12,12 12(b) Any act by a physician or podiatrist in violation of ch. 161 or 450.
SB640, s. 6 13Section 6. 448.01 (11) (c) of the statutes is created to read:
SB640,12,1614 448.01 (11) (c) Any act in violation of subch. V of ch. 150 or a rule promulgated
15under subch. V of ch. 150 by a person holding a license, certificate or limited permit
16granted by the board.
SB640, s. 7 17Section 7. 448.57 (2) (gm) of the statutes is created to read:
SB640,12,1918 448.57 (2) (gm) Violated subch. V of ch. 150 or a rule promulgated under subch.
19V of ch. 150.
SB640, s. 8 20Section 8. 448.90 (2) (gm) of the statutes is created to read:
SB640,12,2221 448.90 (2) (gm) Violated subch. V of ch. 150 or a rule promulgated under subch.
22V of ch. 150.
SB640, s. 9 23Section 9. 449.07 (1) (fc) of the statutes is created to read:
SB640,12,2524 449.07 (1) (fc) Violates subch. V. of ch. 150 or a rule promulgated under subch.
25V of ch. 150;
SB640, s. 10
1Section 10. 449.19 of the statutes is amended to read:
SB640,13,7 2449.19 Referral to other specialists. If, during the course of examining a
3person, an optometrist determines the existence of a pathological condition requiring
4treatment outside the scope of the practice of optometry, the optometrist shall so ad
5vise the person and shall refer the person to an appropriate medical specialist for fur
6ther evaluation. No referral under this section may violate subch. V of ch. 150 or a
7rule promulgated under subch. V of ch. 150.
SB640, s. 11 8Section 11. 450.10 (1) (a) 3m. of the statutes is created to read:
SB640,13,109 450.10 (1) (a) 3m. Violating subch. V of ch. 150 or a rule promulgated under
10subch. V of ch. 150.
SB640, s. 12 11Section 12. 455.09 (1) (em) of the statutes is created to read:
SB640,13,1312 455.09 (1) (em) Violates subch. V of ch. 150 or a rule promulgated under subch.
13V of ch. 150.
SB640, s. 13 14Section 13. 457.26 (2) (gm) of the statutes is created to read:
SB640,13,1615 457.26 (2) (gm) Violated subch. V of ch. 150 or a rule promulgated under subch.
16V of ch. 150.
SB640, s. 14 17Section 14. 459.34 (2) (fm) of the statutes is created to read:
SB640,13,1918 459.34 (2) (fm) Violated subch. V of ch. 150 or a rule promulgated under subch.
19V of ch. 150.
SB640, s. 15 20Section 15. 459.46 (5) (b) 6m. of the statutes is created to read:
SB640,13,2221 459.46 (5) (b) 6m. Violated subch. V of ch. 150 or a rule promulgated under
22subch. V of ch. 150.
SB640, s. 16 23Section 16. Initial applicability.
SB640,13,25 24(1)  This act first applies to referrals made on the effective date of this subsec
25tion.
SB640, s. 17
1Section 17. Effective date.
SB640,14,3 2(1) This act takes effect on the first day of the 7th month beginning after publi
3cation.
SB640,14,44 (End)
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