AB100: Bill Text

AB100,1269,18 149.14 (6) Timely payment. The department shall ensure timely payment of benefits under the plan according to the procedures established by the department for the payment of allowable charges under the medical assistance program under ss. 49.45 to 49.47.

AB100, s. 3029 Section 3029. 149.15 (3) (e) of the statutes is created to read:

AB100,1269,21 149.15 (3) (e) Under the direction of the department and in consultation with the office of the commissioner, develop an alternative plan for eligible persons.

AB100, s. 3030 Section 3030. 149.16 (title) of the statutes is created to read:

AB100,1269,23 149.16 (title) Plan administrator.

AB100, s. 3031 Section 3031. 149.16 (1) of the statutes is created to read:

AB100,1269,25 149.16 (1) The fiscal agent under s. 49.45 (2) (b) 2. shall administer the plan.

AB100, s. 3032 Section 3032. 149.168 of the statutes is created to read:

AB100,1270,8 149.168 Recovery of subsidies from estates. (1) (a) Unless already recovered by the department, the department shall file a claim against the estate of an eligible person who had coverage under the plan or against the estate of the surviving spouse of an eligible person who had coverage under the plan for the amount of any subsidies paid from the appropriation account under s. 20.435 (5) (ah) on behalf of the eligible person to reduce a deductible under s. 149.14 (5) (a), or to reduce a premium under s. 149.165.

AB100,1270,11 (b) The court shall reduce the amount of a claim under par. (a) by up to $3,000 if necessary to allow the eligible person's heirs or the beneficiaries of the eligible person's will to retain the following personal property:

AB100,1270,12 1. The decedent's wearing apparel and jewelry held for personal use.

AB100,1270,13 2. Household furniture, furnishings and appliances.

AB100,1270,15 3. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value.

AB100,1270,17 (2) A claim under par. (a) is not allowable if the decedent has a surviving child who is under 21 years of age or disabled or a surviving spouse.

AB100,1270,20 (3) The department may file a claim and recover amounts under this section only for subsidies paid on or after January 1, 1998, with respect to an eligible person who dies after March 15, 1998.

AB100,1270,23 (4) The department may waive the application of this section in a particular case if the department determines, according to standards established by rule, that the application of this section would work an undue hardship in that particular case.

AB100,1270,25 (5) The department shall deposit all moneys recovered under this section in the appropriation account under s. 20.435 (5) (g).

AB100, s. 3033 Section 3033. 150.21 (1) of the statutes is amended to read:

AB100,1271,2 150.21 (1) The construction or total replacement of a new nursing home.

AB100, s. 3034 Section 3034. 150.21 (3) of the statutes is amended to read:

AB100,1271,5 150.21 (3) A capital expenditure, other than a renovation or replacement, that exceeds $1,000,000 by or on behalf of a nursing home.

AB100, s. 3035 Section 3035. 150.21 (4) of the statutes is amended to read:

AB100,1271,8 150.21 (4) An expenditure, other than a renovation or replacement, that exceeds $600,000 for clinical equipment by or on behalf of a nursing home.

AB100, s. 3036 Section 3036. 150.31 (5t) of the statutes is created to read:

AB100,1271,12 150.31 (5t) The department shall decrease the statewide bed limits specified in sub. (1) to account for any reduction in the licensed bed capacity of a nursing home that has relinquished use of a bed, as specified in s. 49.45 (6m) (ap) 4.

AB100, s. 3037 Section 3037. 150.35 (3m) (a) 3. of the statutes is amended to read:

AB100,1271,17 150.35 (3m) (a) 3. All applications for activities that are specified in s. 150.21 (3), that are renovations with capital expenditures which do not exceed $1,500,000 and that do not include additions, the replacement of a nursing home or an increase in the bed capacity of a nursing home.

AB100, s. 3038 Section 3038. 150.39 (2) of the statutes is amended to read:

AB100,1271,22 150.39 (2) The cost of renovating or providing an equal number of nursing home beds or of an equal expansion would be consistent with the cost at similar nursing homes, and the applicant's per diem rates would be consistent with those of similar nursing homes.

AB100, s. 3039 Section 3039. Subchapter VI of chapter 150 [precedes 150.93] of the statutes is repealed.

AB100, s. 3040 Section 3040. Subchapter VII of chapter 150 [precedes 150.94] of the statutes is repealed.

AB100, s. 3041 Section 3041. 153.01 (4) of the statutes is created to read:

AB100,1272,4 153.01 (4) "Department" means the department of health and family services.

AB100, s. 3042 Section 3042. 153.01 (4m) of the statutes is repealed.

AB100, s. 3043 Section 3043. 153.01 (6) of the statutes is repealed.

AB100, s. 3044 Section 3044. 153.05 (1) (c) 1. of the statutes is amended to read:

AB100,1272,12 153.05 (1) (c) 1. Identification of charges in each hospital's most recent entire fiscal year for up to 100 charge elements, as selected by the office department, and identification of the increase or decrease in charges for each of these charge elements from amounts charged during the hospital's entire fiscal year that is nearest in time to the hospital's most recent entire fiscal year.

AB100, s. 3045 Section 3045. 153.05 (1) (e) of the statutes is amended to read:

AB100,1272,17 153.05 (1) (e) Final audited financial statements of hospitals that include, for a hospital's most recent entire fiscal year, as dollar amounts, the amounts of revenue and expenditures for the hospital, in categories specified in rules promulgated by the commissioner department.

AB100, s. 3046 Section 3046. 153.05 (2) of the statutes is amended to read:

AB100,1272,25 153.05 (2) The office department shall provide copies of reports published under ss. 153.10 to 153.35 at no charge to hospitals assessed under s. 153.60 (1) and, if assessed, at no charge to ambulatory surgery centers assessed under s. 153.60 (2). The office department shall provide copies of the reports to any person, upon the person's request, and the board shall advise the office department as to whether the copies shall be provided at no charge or at a charge not to exceed the cost of printing, copying and mailing the report to the person.

AB100, s. 3047 Section 3047. 153.05 (3) of the statutes is amended to read:

AB100,1273,4 153.05 (3) Upon request of the office department, state agencies shall provide health care information to the office department for use in preparing reports under ss. 153.10 to 153.35.

AB100, s. 3048 Section 3048. 153.05 (4) of the statutes is amended to read:

AB100,1273,12 153.05 (4) (a) The office department, under rules promulgated by the commissioner department, shall require hospitals to use, and private-pay patients and payers who are insurers to accept, uniform patient billing forms, shall require hospitals to submit to the office department the information provided on the billing forms, including, for an injury, the external cause of the event, and may require payers who are insurers to use a standard set of definitions for base data reporting under a uniform patient billing form.

AB100,1273,18 (b) The office department, under rules promulgated by the commissioner department, may require ambulatory surgery centers to use uniform patient billing forms and other information, and, if so requiring, shall require ambulatory surgery centers to submit to the office department the information provided on the billing forms, including, for an injury, the external cause of the event, using a standard set of definitions for base data reporting.

AB100, s. 3049 Section 3049. 153.05 (5) of the statutes is amended to read:

AB100,1273,20 153.05 (5) The office department:

AB100,1273,23 (a) Shall require hospitals to submit information regarding medical malpractice, staffing levels and patient case-mix, and expenditures related to labor relations consultants, as specified by the office department.

AB100,1274,3 (b) May require hospitals to submit to the office department information from sources identified under sub. (1) (a) to (e) that the office department deems necessary for the preparation of reports, plans and recommendations under ss. 153.10 to 153.35 and any other reports required of the office department in the form specified by the office department.

AB100,1274,7 (bm) Shall require a hospital to submit to the office department information from sources identified under sub. (1) (e) by the date that is 4 months following the close of the hospital's fiscal year unless the office department grants an extension of time to file the information.

AB100, s. 3050 Section 3050. 153.05 (6) of the statutes is amended to read:

AB100,1274,14 153.05 (6) If the requirements of s. 153.07 (2) are first met, the office department may contract with a public or private entity that is not a major purchaser, payer or provider of health care services in this state for the provision of data processing services for the collection, analysis and dissemination of health care information under sub. (1) or the department of health and family services shall provide the services under s. 153.07 (2).

AB100, s. 3051 Section 3051. 153.05 (6m) of the statutes is amended to read:

AB100,1274,23 153.05 (6m) If the requirements of s. 153.07 (2) are first met, the office department may contract with the group insurance board for the provision of data collection and analysis services related to health maintenance organizations and insurance companies that provide health insurance for state employes or the commissioner department shall provide the services under s. 153.07 (2). The office department shall establish contract fees for the provision of the services. All moneys collected under this subsection shall be credited to the appropriation under s. 20.145 (8) 20.435 (1) (kx).

AB100, s. 3052 Section 3052. 153.05 (7) of the statutes is amended to read:

AB100,1275,4 153.05 (7) The office department may require each insurer authorized to write disability insurance to submit to the office department information obtained on uniform patient billing forms regarding reported claims for health care services which insureds who are residents of this state obtain in another state.

AB100, s. 3053 Section 3053. 153.05 (8) of the statutes is amended to read:

AB100,1275,14 153.05 (8) Beginning April 1, 1992, the office department shall collect, analyze and disseminate, in language that is understandable to lay persons, health care information under the provisions of this chapter, as determined by rules promulgated by the commissioner department, from health care providers, as defined by rules promulgated by the commissioner department, other than hospitals and ambulatory surgery centers. Data from physicians shall be obtained through sampling techniques in lieu of collection of data on all patient encounters and data collection procedures shall minimize unnecessary duplication and administrative burdens.

AB100, s. 3054 Section 3054. 153.05 (9) of the statutes is amended to read:

AB100,1275,19 153.05 (9) The office department shall provide orientation and training to physicians, hospital personnel and other health care providers to explain the process of data collection and analysis and the procedures for data verification, interpretation and release.

AB100, s. 3055 Section 3055. 153.05 (11) of the statutes is amended to read:

AB100,1275,24 153.05 (11) In order to elicit public comment concerning the reports required under ss. 153.10 to 153.35, the office department shall, following the release of the reports and by a date that is determined by the board, provide notice of and hold public hearings.

AB100, s. 3056 Section 3056. 153.05 (12) of the statutes is amended to read:

AB100,1276,3 153.05 (12) The office department shall, to the extent possible and upon request, assist members of the public in interpreting data in health care information disseminated by the office department.

AB100, s. 3057 Section 3057. 153.07 (1) of the statutes is amended to read:

AB100,1276,7 153.07 (1) The board shall advise the director of the office department with regard to the collection, analysis and dissemination of health care information required by this chapter.

AB100, s. 3058 Section 3058. 153.07 (2) of the statutes is amended to read:

AB100,1276,20 153.07 (2) The board, upon advice of the office department, shall first determine whether to contract for services pursuant to s. 153.05 (6) or (6m). If the board determines to contract for such services, it shall approve specifications for a contract including the length of the contract and the standards for determining potential contractor conflicts with the purposes of the office department as specified under s. 153.05 (1). In the alternative, the board may direct the office to have the department of health and family services department to provide the services under s. 153.05 (6) or (6m). The board may subsequently determine to contract for these services in subsequent years. If the board decides to bid the contract for services under s. 153.05 (6) or (6m), the department of health and family services may offer a bid as would any other potential contractor. The board shall evaluate a contractor's performance 6 months prior to the close of each existing contract.

AB100, s. 3059 Section 3059. 153.07 (3) of the statutes is amended to read:

AB100,1276,23 153.07 (3) The board shall approve all rules which are proposed by the commissioner department for promulgation to implement this chapter.

AB100, s. 3060 Section 3060. 153.08 (2) (b) of the statutes is amended to read:

AB100,1277,12 153.08 (2) (b) No sooner than 15 days after a notice is published under par. (a) and no later than 15 days before the date of the proposed rate change, conducts a public hearing on the proposed rate change. The hearing shall be on the expected impact of the proposed rate change on health care costs, the expected improvement, if any, in the local health care delivery system, and any other issue related to the proposed rate change. Management staff, if any, of the hospital proposing the rate change and, if possible, at least 3 members of the governing board of any not-for-profit hospital proposing the rate change shall attend the public hearing to review public testimony. The hospital shall record accurate minutes of the meeting and shall provide copies of the minutes and any written testimony presented at the hearing to the office of health care information in the office of the commissioner of insurance department within 10 days after the date of the public hearing.

AB100, s. 3061 Section 3061. 153.10 (1) of the statutes is amended to read:

AB100,1277,18 153.10 (1) Beginning in 1990 and quarterly thereafter, the office department shall prepare and submit to the governor and the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2), in a manner that permits comparisons among hospitals, a report setting forth all of the following for every hospital for the preceding quarter:

AB100,1277,20 (a) The charges for up to 100 health care services or diagnostic-related groups selected by the office department.

AB100,1277,22 (b) The utilization and charge information for ambulatory surgery and other outpatient health care services selected by the office department.

AB100, s. 3062 Section 3062. 153.15 of the statutes is amended to read:

AB100,1278,4 153.15 Small area analysis reports. Beginning in 1990 and annually thereafter, the office department shall prepare and submit to the governor and the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) reports identifying health care services or procedures provided by one or more hospitals in specific areas of the state for which the rate of utilization of the service or procedure is significantly different than the state or area average.

AB100, s. 3063 Section 3063. 153.20 of the statutes is amended to read:

AB100,1278,13 153.20 Uncompensated health care services report. (1) Beginning in 1990 and annually thereafter, the office department shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) a report setting forth the number of patients to whom uncompensated health care services were provided by each hospital and the total charges for the uncompensated health care services provided to the patients for the preceding year, together with the number of patients and the total charges that were projected by the hospital for that year in the plan filed under sub. (2).

AB100,1278,18 (2) Beginning in 1990 and annually thereafter, every hospital shall file with the office department a plan setting forth the projected number of patients to whom uncompensated health care services will be provided by the hospital and the projected total charges for the uncompensated health care services to be provided to the patients for the ensuing year.

AB100, s. 3064 Section 3064. 153.25 of the statutes is amended to read:

AB100,1279,2 153.25 Mortality and morbidity report. Beginning in 1990 and annually thereafter, the office department shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) reports setting forth mortality and morbidity rates for every hospital. Before the release of a report under this section, the office department shall provide the physicians, hospitals or other health care providers identified in the report with the opportunity to review and comment under s. 153.40 (6).

AB100, s. 3065 Section 3065. 153.30 of the statutes is amended to read:

AB100,1279,9 153.30 Health care insurance report. Beginning in 1990 and annually thereafter, the office department and the office of the commissioner of insurance may jointly prepare and submit to the governor, and to the legislature under s. 13.172 (2), a report specifying, to the extent possible, on a regional basis, the number, nature of coverage and costs of health care coverage plans covering residents of this state during the preceding year.

AB100, s. 3066 Section 3066. 153.35 (intro.) of the statutes is amended to read:

AB100,1279,15 153.35 (title) Report by the office department. (intro.) The office department shall annually, by October 1, under rules promulgated by the commissioner department, submit under s. 13.172 (3) a report to the legislature for distribution to standing committees with jurisdiction over health matters, that shall include all of the following:

AB100, s. 3067 Section 3067. 153.35 (1) of the statutes is amended to read: