Prefatory note: This bill was prepared for the joint legislative council's special
committee on health care information.
Current law creates an office of health care information (OHCI) in the office of the
commissioner of insurance. OHCI is given specific powers and duties relating to the
collection, analysis and dissemination of health care information under ch. 153 of the
statutes. In addition, current law creates a board on health care information, which
advises the director of OHCI and approves all rules that the commissioner of insurance
promulgates with respect to OHCI and ch. 153. Current law also creates an interagency
coordinating council with members representing several state agencies that are involved
in collection, analysis and dissemination of health care information.
This bill eliminates OHCI and transfers many of its powers and duties to the
department of health and family services (DHFS). These functions would be undertaken
by a bureau of health care information in the division with primary responsibility for
health issues in DHFS. The bill requires the bureau to coordinate its activities with
persons in that division with responsibility for medical assistance administration and
collection and analysis of health statistics.
The bill also transfers the board on health care information to DHFS and adds a
requirement that appointees to the board are subject to confirmation by the senate. To
reflect the transfer of functions, the membership of the interagency coordinating council
is changed to add a representative from DHFS. In addition, the bill requires the
interagency coordinating council to establish methods and criteria for analyzing and
comparing complaints filed against health care plans and grievances filed with health
maintenance organizations.
The bill deletes from the statutes the specific sources of health care information
collected for purposes of ch. 153 and the specific reports OHCI is required to prepare
periodically, except the annual report on uncompensated health care services provided
by hospitals. These provisions are replaced by provisions requiring DHFS to specify by
rule the standard reports that it will issue and the uniform data set of health care
information to be collected and other details relating to collecting, using and
disseminating data. As with other rules under ch. 153, these rules would have to be
approved by the board on health care information.
In addition to the report on uncompensated health care services, which is retained
from current law, the bill requires DHFS to prepare an annual consumer guide to assist
consumers in selecting health care providers and health care plans. The bill also requires
DHFS to prepare a report on the feasibility of requiring annual reports and plans on
uncompensated health care services (i.e., charity care and bad debt services) from major
health care providers other than hospitals, which are already required to prepare these
reports and plans.

The bill also requires DHFS to study a voluntary system of health plan reporting
and allows DHFS, based on the results of the study, to develop and implement such a
system.
The bill modifies the current law on assessments on hospitals and ambulatory
surgery centers to fund activities under ch. 153 by instead allowing assessments on
health care providers who are in a class of health providers from whom DHFS collects
claims data and other health care data under ch. 153. The classes of health care providers
from whom claims data and other health care data is collected and the methods and
criteria for assessing those health care providers would be specified by DHFS by rule.
The bill repeals the required approval of the board on health care information for
contracts under ch. 153. In addition, the bill requires the board and DHFS to jointly: (1)
develop rules under ch. 153; (2) provide oversight on standard reports; (3) develop the
overall strategy and direction for implementation of ch. 153; and (4) provide information
on their activities to the interagency coordinating council.
In preparing this bill in final form, the legislative reference bureau deleted a
statement of legislative purpose and incorporated it, in large part, into a provision that
cross-references the statement. The statement adopted by the special committee was as
follows:
153.03 Legislative purpose. The availability of health care
information is critical in a competitive health care market. Consumers and
purchasers need information to make informed decisions in selecting health
care plans and health care providers. Health care providers need
information to provide health care that is both effective and economically
efficient. The purpose of this chapter is to grant the department the
authority and responsibility of collecting and disseminating health care
information in a manner to meet those needs.
Current law requires that before a hospital increases its rates by more than the
increase in the consumer price index, it must publish a notice and hold a public hearing.
The bill eliminates the requirement that a public hearing be held. In addition, the bill
requires that the notice be published in the area where the hospital is located and
eliminates the alternative of publishing the notice in the official state newspaper.
The bill prohibits DHFS from releasing any health care information that is subject
to the department's rules on review and verification until those rules have been complied
with. Whoever intentionally violates this prohibition may be fined not more than
$10,000, imprisoned for not more than 9 months, or both.
The bill creates a new crime in the criminal extortion statute, relating to using or
threatening to use patient health care records for purposes of extortion or to compel a
person to do an act against his or her will. A violator is subject to a Class D felony,
punishable by a fine not to exceed $10,000, imprisonment not to exceed 5 years, or both.
SB315, s. 1 1Section 1. 15.01 (6) of the statutes is amended to read:
SB315,4,52 15.01 (6) "Division," "bureau," "section" and "unit" means mean the subunits
3of a department or an independent agency, whether specifically created by law or
4created by the head of the department or the independent agency for the more
5economic and efficient administration and operation of the programs assigned to the
6department or independent agency. The office of justice assistance in the
7department of administration and the office of credit unions in the department of

1financial institutions have the meaning of "division" under this subsection. The
2office of health care information in the office of the commissioner of insurance, the
3office of the long-term care ombudsman under the board on aging and long-term
4care and the office of educational accountability in the department of education have
5the meaning of "bureau" under this subsection.
SB315, s. 2 6Section 2. 15.02 (3) (c) 2. of the statutes is amended to read:
SB315,4,127 15.02 (3) (c) 2. The principal subunit of the division is the "bureau". Each
8bureau shall be headed by a "director". The office of health care information in the
9office of the commissioner of insurance, the
office of the long-term care ombudsman
10under the board on aging and long-term care and the office of educational
11accountability in the department of education have the meaning of "bureau" under
12this subdivision.
SB315, s. 3 13Section 3. 15.07 (1) (b) 21. of the statutes is created to read:
SB315,4,1414 15.07 (1) (b) 21. Board on health care information.
SB315, s. 4 15Section 4. 15.107 (7) (b) to (d) of the statutes are amended to read:
SB315,4,1716 15.107 (7) (b) A representative of the unit in the department of health and
17social family services that deals with health statistics.
SB315,4,1918 (c) A representative of the unit in the department of health and social family
19services that deals with the medical assistance program.
SB315,4,2120 (d) A representative of the unit in the office of the commissioner of insurance
21that deals with health care information.
SB315, s. 5 22Section 5. 15.107 (7) (g) of the statutes is created to read:
SB315,4,2423 15.107 (7) (g) A representative of the bureau of health care information in the
24department of health and family services.
SB315, s. 6 25Section 6. 15.194 of the statutes is created to read:
SB315,5,3
115.194 Same; specified bureaus. (1) There is created in the division within
2the department of health and family services that has primary responsibility for
3health issues a bureau of health care information.
SB315, s. 7 4Section 7. 15.735 (2) of the statutes is renumbered 15.195 (6) and amended
5to read:
SB315,5,106 15.195 (6) Board on health care information. There is created a board on
7health care information which is attached to the office of the commissioner of
8insurance
department of health and family services under s. 15.03. The board shall
9consist of 9 members, a majority of whom may neither be nor represent health care
10providers, appointed for 4-year terms.
SB315, s. 8 11Section 8. 15.737 of the statutes is repealed.
SB315, s. 9 12Section 9. 16.03 (1) of the statutes is amended to read:
SB315,6,213 16.03 (1) General functions. The interagency coordinating council shall serve
14as a means of increasing the efficiency and utility and facilitating the effective
15functioning of state agencies in activities related to health care data collection. The
16interagency coordinating council shall advise and assist state agencies in the
17coordination of health care data collection programs and the exchange of information
18related to health care data collection and dissemination, including agency budgets
19for health care data collection programs, health care data monitoring and
20management, public information and education, health care data analysis and
21facilities, research activities and the appropriation and allocation of state funds for
22health care data collection. The interagency coordinating council shall establish
23methods and criteria for analyzing and comparing complaints filed against health
24care plans, as defined under s. 628.36 (2) (a) 1., and grievances filed with health
25maintenance organizations, as defined under s. 609.01 (2), without requiring the

1collection of information in addition to the information already collected by state
2agencies.
SB315, s. 10 3Section 10. 16.03 (3) of the statutes is amended to read:
SB315,6,74 16.03 (3) Report. The interagency coordinating council shall report at least
5twice annually to the board on health care information in the office of the
6commissioner of insurance
department of health and family services, concerning the
7council's activities under this section.
SB315, s. 11 8Section 11. 20.145 (1) (g) of the statutes is amended to read:
SB315,6,139 20.145 (1) (g) General program operations. The amounts in the schedule for
10general program operations and for funding the activities of the office of health care
11information under s. 153.05 (8)
the commissioner of insurance. Ninety percent of all
12moneys received under ss. 601.31, 601.32, 601.45 and 601.47 shall be credited to this
13appropriation.
SB315, s. 12 14Section 12. 20.145 (8) (title) of the statutes is repealed.
SB315, s. 13 15Section 13. 20.145 (8) (hg) of the statutes is renumbered 20.435 (1) (hg) and
16amended to read:
SB315,6,2117 20.435 (1) (hg) (title) General program operations; office of health care
18information.
The amounts in the schedule to fund the activities of the office of health
19care information
department of health and family services and the board on health
20care information under ch. 153. The contract fees paid under s. 153.05 (6m) and
21assessments paid under s. 153.60 shall be credited to this appropriation account.
SB315, s. 14 22Section 14. 20.145 (8) (hi) of the statutes is renumbered 20.435 (1) (hi), and
2320.435 (1) (hi) (title), as renumbered, is amended to read:
SB315,6,2524 20.435 (1) (hi) (title) Compilations and special reports; office of health care
25information.
SB315, s. 15
1Section 15. 20.145 (8) (hj), (kx) and (mr) of the statutes are repealed.
SB315, s. 16 2Section 16. 40.03 (6) (j) of the statutes is amended to read:
SB315,7,73 40.03 (6) (j) May contract with the office of health care information in the office
4of the commissioner of insurance
department of health and family services and may
5contract with other public or private entities for data collection and analysis services
6related to health maintenance organizations and insurance companies that provide
7health insurance to state employes.
SB315, s. 17 8Section 17. 153.01 (3), (4m), (6) and (9) of the statutes are repealed.
SB315, s. 18 9Section 18. 153.01 (4d), (4h), (4p) and (4t) of the statutes are created to read:
SB315,7,1010 153.01 (4d) "Department" means the department of health and family services.
SB315,7,12 11(4h) "Employer coalition" means an organization of employers formed for the
12purpose of purchasing health care coverage or services as a group.
SB315,7,14 13(4p) "Health care plan" means an insured or self-insured plan providing
14coverage of health care expenses or an employer coalition.
SB315,7,16 15(4t) "Health care provider" has the meaning given in s. 146.81 (1) and includes
16an ambulatory surgery center.
SB315, s. 19 17Section 19. 153.05 (1) (intro.) of the statutes is renumbered 153.05 (1) and
18amended to read:
SB315,8,419 153.05 (1)  In order to provide to hospitals, health care providers, insurers,
20consumers, governmental agencies and others information concerning hospital
21service utilization, charges, revenues, expenditures, mortality and morbidity rates

22health care providers and uncompensated health care services, and in order to
23provide information to assist in peer review for the purpose of quality assurance, the
24office department shall collect, analyze and disseminate health care information, in
25language that is understandable to lay persons, health care information obtained

1from the following data sources:
. This chapter shall be administered by a bureau of
2health care information. The bureau of health care information shall coordinate its
3activities with persons with responsibility for medical assistance administration and
4collection and analysis of health statistics.
SB315, s. 20 5Section 20. 153.05 (1) (a) to (e) of the statutes are repealed.
SB315, s. 21 6Section 21. 153.05 (2) of the statutes is repealed.
SB315, s. 22 7Section 22. 153.05 (3) of the statutes is amended to read:
SB315,8,108 153.05 (3) Upon request of the office department, state agencies shall provide
9health care information to the office department for use in preparing reports under
10ss. 153.10 to 153.35
this chapter.
SB315, s. 23 11Section 23. 153.05 (4) of the statutes is repealed.
SB315, s. 24 12Section 24. 153.05 (5) (intro.) and (b) of the statutes are consolidated,
13renumbered 153.05 (5) and amended to read:
SB315,8,1914 153.05 (5)  The office: (b) May department may require hospitals health care
15providers
to submit to the office department information from sources identified
16under sub. (1) (a) to (e)
that the office department deems necessary for the
17preparation of reports, plans and recommendations under ss. 153.10 to 153.35 and
18any other reports required of the office
in the form specified by the office department
19by rule
.
SB315, s. 25 20Section 25. 153.05 (5) (a) and (bm) of the statutes are repealed.
SB315, s. 26 21Section 26. 153.05 (6) of the statutes is amended to read:
SB315,9,222 153.05 (6) If the requirements of s. 153.07 (2) are first met, the office The
23department
may contract with a public or private entity that is not a major
24purchaser, payer or provider of health care services in this state for the provision of
25data processing services for the collection, analysis and dissemination of health care

1information under sub. (1) or the department of health and family services shall
2provide the services under s. 153.07 (2)
.
SB315, s. 27 3Section 27. 153.05 (6m) of the statutes is amended to read:
SB315,9,114 153.05 (6m) If the requirements of s. 153.07 (2) are first met, the office The
5department
may contract with the group insurance board for the provision of data
6collection and analysis services related to health maintenance organizations and
7insurance companies that provide health insurance for state employes or the
8commissioner shall provide the services under s. 153.07 (2)
. The office department
9shall establish contract fees for the provision of the services. All moneys collected
10under this subsection shall be credited to the appropriation under s. 20.145 (8) (kx)
1120.435 (1) (hg).
SB315, s. 28 12Section 28. 153.05 (6r) of the statutes is created to read:
SB315,9,2413 153.05 (6r) The department shall study and, based on the results of the study,
14may develop and implement a voluntary system of health care plan reporting that
15enables purchasers and consumers to assess the performance of health care plans
16and the health care providers that are employed or reimbursed by the health care
17plans. The department shall undertake the study and any development and
18implementation in cooperation with private health care purchasers, the board, the
19department of employe trust funds, the office of the commissioner of insurance, the
20interagency coordinating council created under s. 15.107 (7), major associations of
21health care providers, health care plans and consumers. If implemented, the
22department shall operate the system in a manner so as to enable purchasers,
23consumers, the public, the governor and legislators to assess the performance of
24health care plans and health care providers.
SB315, s. 29 25Section 29. 153.05 (7) of the statutes is repealed.
SB315, s. 30
1Section 30. 153.05 (8) of the statutes is amended to read:
SB315,10,132 153.05 (8) Beginning April 1, 1992, the office The department shall collect,
3analyze and disseminate, in language that is understandable to lay persons, health
4care
claims information and other health care information under the provisions of
5this chapter, as determined by rules promulgated by the commissioner department,
6from health care providers, as defined specified by rules promulgated by the
7commissioner, other than hospitals and ambulatory surgery centers department.
8Data from physicians shall health care providers may be obtained through sampling
9techniques in lieu of collection of data on all patient encounters and data collection
10procedures shall minimize unnecessary duplication and administrative burdens. If
11the department collects health care provider-specific data from health care plans,
12the department shall attempt to avoid collecting the same data from health care
13providers.
SB315, s. 31 14Section 31. 153.05 (9) of the statutes is amended to read:
SB315,10,1815 153.05 (9) The office department shall provide orientation and training to
16physicians, hospital personnel and other health care providers who submit data
17under this chapter
to explain the process of data collection and analysis and the
18procedures for data verification, interpretation and release.
SB315, s. 32 19Section 32. 153.05 (11) of the statutes is repealed.
SB315, s. 33 20Section 33. 153.05 (12) of the statutes is amended to read:
SB315,10,2321 153.05 (12) The office department shall, to the extent possible and upon
22request, assist members of the public in interpreting data in health care information
23disseminated by the office department.
SB315, s. 34 24Section 34. 153.07 (1) of the statutes is amended to read:
SB315,11,3
1153.07 (1) The board shall advise the director of the office department with
2regard to the collection, analysis and dissemination of health care information
3required by this chapter.
SB315, s. 35 4Section 35. 153.07 (2) of the statutes is repealed.
SB315, s. 36 5Section 36. 153.07 (3) of the statutes is amended to read:
SB315,11,76 153.07 (3) The board shall approve all rules which are proposed by the
7commissioner department for promulgation to implement this chapter.
SB315, s. 37 8Section 37. 153.07 (4) of the statutes is created to read:
SB315,11,99 153.07 (4) The board and the department shall jointly do all of the following:
SB315,11,1010 (a) Develop the rules that are required or authorized under this chapter.
SB315,11,1211 (b) Provide oversight on the standard reports under this chapter, including the
12reports under ss. 153.20 and 153.21.
SB315,11,1413 (c) Develop the overall strategy and direction for implementation of this
14chapter.
SB315,11,1615 (d) Provide information on their activities to the interagency coordinating
16council created under s. 15.107 (7).
SB315, s. 38 17Section 38. 153.08 (2) (intro.) and (a) of the statutes are consolidated,
18renumbered 153.08 (2) and amended to read:
SB315,12,219 153.08 (2) No hospital may increase its rates or charge any payer an amount
20exceeding its rates that are in effect on May 12, 1992, unless the hospital first does
21all of the following: (a) Causes
causes to be published a class 1 notice under ch. 985
22in the official newspaper designated under s. 985.04 or 985.05 or in a newspaper
23likely to give notice in the area where the hospital is located, no sooner than 45 days
24and no later than 30 days before the proposed rate change is to take effect. The notice

1shall describe the proposed rate change and the time and place for the public hearing
2required under sub. (2)
.
SB315, s. 39 3Section 39. 153.08 (2) (b) of the statutes is repealed.
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