SB45: Bill Text

SB45, s. 2247 Section 2247. 146.50 (10) (b) of the statutes is created to read:

SB45,1050,15 146.50 (10) (b) The department shall credit all late fees assessed under par. (a) 3. to the appropriation account under s. 20.435 (1) (gm).

SB45, s. 2248 Section 2248. 146.50 (11m) of the statutes is created to read:

SB45,1050,23 146.50 (11m) Forfeitures; ambulance service providers. (a) Any ambulance service provider who violates this section or any rule promulgated under the authority of this section shall forfeit not more than the amount specified by rule by the department. Each day of violation constitutes a separate offense, except that no day in the period between the date on which a request for hearing is filed under s. 227.44 and the date of the conclusion of all administrative and judicial proceedings arising out of a decision under this subsection constitutes a violation.

SB45,1051,4 (b) The department may directly assess forfeitures under par. (a). If the department determines that a forfeiture should be assessed for a particular violation or for failure to correct the violation, the department shall send a notice of assessment to the alleged violator. The notice shall specify the alleged violation of the statute or rule and the amount of the forfeiture assessed and shall inform the alleged violator of the right to contest the assessment under s. 227.44.

SB45,1051,9 (c) All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested as specified in par. (b), within 10 days after receipt of the final decision, unless the final decision is appealed and the decision is in favor of the appellant. The department shall remit all forfeitures paid under this subsection to the state treasurer for deposit in the school fund.

SB45, s. 2249 Section 2249. 146.50 (13) (a) of the statutes is repealed.

SB45, s. 2250 Section 2250. 146.50 (13) (d) of the statutes is created to read:

SB45,1051,13 146.50 (13) (d) The department shall promulgate rules that prescribe all of the following:

SB45,1051,14 1. The amounts for license renewal fees to be assessed under sub. (10) (a) 2.

SB45,1051,16 2. The amounts for late fees to be assessed under sub. (10) (a) 3. against an applicant for untimely renewal of a license issued under sub. (5) or (7).

SB45,1051,18 3. The amounts for forfeitures to be assessed under sub. (11m) against an ambulance service provider.

SB45, s. 2251 Section 2251. 146.56 (1) of the statutes is amended to read:

SB45,1051,23 146.56 (1) Not later than July 1, 2001 2002, the department shall develop and implement a statewide trauma care system. The department shall seek the advice of the statewide trauma advisory council under s. 15.197 (25) in developing and implementing the system.

SB45, s. 2252 Section 2252. 146.819 (4) (e) of the statutes is repealed.

SB45, s. 2253 Section 2253. 146.82 (1) of the statutes is amended to read:

SB45,1052,6 146.82 (1) Confidentiality. All patient health care records shall remain confidential. Patient health care records may be released only to the persons designated in this section or to other persons with the informed consent of the patient or of a person authorized by the patient. This subsection does not prohibit reports made in compliance with s. 146.995, 253.12 (2) or 979.01 or testimony authorized under s. 905.04 (4) (h).

SB45, s. 2254 Section 2254. 146.93 (1) (a) of the statutes is amended to read:

SB45,1052,11 146.93 (1) (a) From the appropriation under s. 20.435 (1) (4) (gp), the department shall maintain a program for the provision of primary health care services based on the primary health care program in existence on June 30, 1987. The department may promulgate rules necessary to implement the program.

SB45, s. 2255 Section 2255. 146.99 of the statutes is amended to read:

SB45,1052,20 146.99 Assessments. The department shall, within 90 days after the commencement of each fiscal year, estimate the total amount of expenditures and the department shall assess the estimated total amount under s. 20.435 (1) (4) (gp) to hospitals, as defined in s. 50.33 (2), in proportion to each hospital's respective gross private-pay patient revenues during the hospital's most recently concluded entire fiscal year. Each hospital shall pay its assessment on or before December 1 for the fiscal year. All payments of assessments shall be deposited in the appropriation under s. 20.435 (1) (4) (gp).

SB45, s. 2256 Section 2256. 149.12 (2) (d) of the statutes is renumbered 149.12 (2) (d) 1. and amended to read:

SB45,1052,25 149.12 (2) (d) 1. Except for a person who is an eligible individual as provided in subd. 2., no person who is 65 years of age or older is eligible for coverage under the plan.

SB45, s. 2257 Section 2257. 149.12 (2) (d) 2. of the statutes is created to read:

SB45,1053,2 149.12 (2) (d) 2. Subdivision 1. does not apply to any of the following:

SB45,1053,3 a. A person who is an eligible individual.

SB45,1053,5 b. A person who has coverage under the plan on the date on which he or she attains the age of 65 years.

SB45, s. 2258 Section 2258. 149.12 (3) (b) of the statutes is amended to read:

SB45,1053,12 149.12 (3) (b) Persons for whom deductible or coinsurance amounts are paid or reimbursed under ch. 47 for vocational rehabilitation, under s. 49.68 for renal disease, under s. 49.685 (8) for hemophilia, under s. 49.683 for cystic fibrosis or, under s. 253.05 for maternal and child health services or under s. 49.686 for the cost of drugs for the treatment of HIV infection or AIDS are not ineligible for coverage under the plan by reason of such payments or reimbursements.

SB45, s. 2259 Section 2259. 149.14 (3) (intro.) of the statutes is amended to read:

SB45,1054,2 149.14 (3) Covered expenses. (intro.) Except as restricted by cost containment provisions under s. 149.17 (4) and except as reduced by the board under s. 149.15 (3) (e) or by the department under s. ss. 149.143 or, 149.144 and 149.15 (3) (e), covered expenses for the coverage under this section shall be the usual and customary charges for the services provided by persons licensed under ch. 446 and certified under s. 49.45 (2) (a) 11. Except as restricted by cost containment provisions under s. 149.17 (4) and except as reduced by the board under s. 149.15 (3) (e) or by the department under s. ss. 149.143 or, 149.144 and 149.15 (3) (e), covered expenses for the coverage under this section shall also be the usual and customary charges for the following services and articles if the service or article is prescribed by a physician who is licensed under ch. 448 or in another state and who is certified under s. 49.45 (2) (a) 11. and if the service or article is provided by a provider certified under s. 49.45 (2) (a) 11.:

SB45, s. 2260 Section 2260. 149.14 (4) (g) of the statutes is amended to read:

SB45,1054,4 149.14 (4) (g) Dental care except as provided in sub. (3) (m) and (q).

SB45, s. 2261 Section 2261. 149.14 (6) (title) of the statutes is created to read:

SB45,1054,6 149.14 (6) (title) Preexisting conditions.

SB45, s. 2262 Section 2262. 149.143 (1) (a) of the statutes is amended to read:

SB45,1054,8 149.143 (1) (a) First from the appropriation under s. 20.435 (5) (4) (af).

SB45, s. 2263 Section 2263. 149.143 (1) (b) 1. a. of the statutes is amended to read:

SB45,1054,16 149.143 (1) (b) 1. a. First, from premiums from eligible persons with coverage under s. 149.14 set at 150% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as are provided under the plan, including amounts received for premium and deductible subsidies under ss. 20.435 (5) (4) (ah) and 149.144, and from premiums collected from eligible persons with coverage under s. 149.146 set in accordance with s. 149.146 (2) (b).

SB45, s. 2264 Section 2264. 149.143 (1) (b) 1. b. of the statutes is amended to read:

SB45,1054,20 149.143 (1) (b) 1. b. Second, from the appropriation under s. 20.435 (5) (4) (gh), to the extent that the amounts under subd. 1. a. are insufficient to pay 60% of plan costs.

SB45, s. 2265 Section 2265. 149.143 (1) (b) 1. c. of the statutes is amended to read:

SB45,1055,4 149.143 (1) (b) 1. c. Third, by increasing premiums from eligible persons with coverage under s. 149.14 to more than 150% but not more than 200% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as are provided under the plan, including amounts received for premium and deductible subsidies under ss. 20.435 (5) (4) (ah) and 149.144, and by increasing premiums from eligible persons with coverage under s. 149.146 in accordance with s. 149.146 (2) (b), to the extent that the amounts under subd. 1. a. and b. are insufficient to pay 60% of plan costs.

SB45, s. 2266 Section 2266. 149.143 (2) (a) 1. a. of the statutes is amended to read:

SB45,1055,13 149.143 (2) (a) 1. a. Estimate the amount of enrollee premiums that would be received in the new plan year if the enrollee premiums were set at a level sufficient, when including amounts received for premium and deductible subsidies under ss. 20.435 (5) (4) (ah) and 149.144 and from premiums collected from eligible persons with coverage under s. 149.146 set in accordance with s. 149.146 (2) (b), to cover 60% of the estimated plan costs for the new plan year, after deducting from the estimated plan costs the amount available in the appropriation under s. 20.435 (5) (4) (af) for that plan year.

SB45, s. 2267 Section 2267. 149.143 (2) (a) 1. c. of the statutes is amended to read:

SB45,1055,20 149.143 (2) (a) 1. c. If the amount estimated to be received under subd. 1. a. is less than the amount estimated to be received under subd. 1. b., direct the plan administrator to provide to the department, prior to the beginning of the plan year and according to procedures specified by the department, the amount of the difference. The department shall deposit all amounts received under this subd. 1. c. in the appropriation account under s. 20.435 (5) (4) (gh).

SB45, s. 2268 Section 2268. 149.144 of the statutes is amended to read:

SB45,1056,9 149.144 Adjustments to insurer assessments and provider payment rates for premium and deductible reductions. If the moneys under s. 20.435 (5) (4) (ah) are insufficient to reimburse the plan for premium reductions under s. 149.165 and deductible reductions under s. 149.14 (5) (a), or the department determines that the moneys under s. 20.435 (5) (4) (ah) will be insufficient to reimburse the plan for premium reductions under s. 149.165 and deductible reductions under s. 149.14 (5) (a), the department shall, by rule, adjust in equal proportions the amount of the assessment set under s. 149.143 (2) (a) 3. and the provider payment rate set under s. 149.143 (2) (a) 4., subject to s. 149.143 (1) (b) 1., sufficient to reimburse the plan for premium reductions under s. 149.165 and deductible reductions under s. 149.14 (5) (a). The department shall notify the commissioner so that the commissioner may levy any increase in insurer assessments.

SB45, s. 2269 Section 2269. 149.146 (1) (a) of the statutes is amended to read:

SB45,1056,14 149.146 (1) (a) Beginning on January 1, 1998, in addition to the coverage required under s. 149.14, the plan shall offer to all eligible persons who are not eligible for medicare a choice of coverage, as described in section 2744 (a) (1) (C), P.L. 104-191. Any such choice of coverage shall be major medical expense coverage.

SB45, s. 2270 Section 2270. 149.146 (1) (b) 2. of the statutes is amended to read:

SB45,1056,24 149.146 (1) (b) 2. An eligible person under par. (a) may elect once each year, at the time and according to procedures established by the department, among the coverages offered under this section and s. 149.14. If an eligible person elects new coverage, any preexisting condition exclusion imposed under the new coverage is met to the extent that the eligible person has been previously and continuously covered under this chapter. No preexisting condition exclusion may be imposed on an eligible person who elects new coverage if the person was an eligible individual when first covered under this chapter and the person remained continuously covered under this chapter up to the time of electing the new coverage.

SB45, s. 2271 Section 2271. 149.146 (2) (am) of the statutes is created to read:

SB45,1057,4 149.146 (2) (am) 1. For all eligible persons with coverage under this section, the deductible shall be $2,500. Expenses used to satisfy the deductible during the last 90 days of a calendar year shall also be applied to satisfy the deductible for the following calendar year.

SB45,1057,8 2. Except as provided in subd. 3., if the covered costs incurred by the eligible person exceed the deductible for major medical expense coverage in a calendar year, the plan shall pay at least 80% of any additional covered costs incurred by the person during the calendar year.

SB45,1057,13 3. If the aggregate of the covered costs not paid by the plan under subd. 2. and the deductible exceeds $3,500 for any eligible person during a calendar year or $7,000 for all eligible persons in a family, the plan shall pay 100% of all covered costs incurred by the eligible person during the calendar year after the payment ceilings under this subdivision are exceeded.

SB45,1057,18 4. Notwithstanding subds. 1. to 3., the department may establish different deductible amounts, a different coinsurance percentage and different covered costs and deductible aggregate amounts from those specified in subds. 1. to 3. in accordance with cost containment provisions established by the department under s. 149.17 (4).

SB45, s. 2272 Section 2272. 149.15 (3) (intro.) of the statutes is amended to read:

SB45,1057,21 149.15 (3) (intro.) The board shall do advise the department on all of the following:

SB45, s. 2273 Section 2273. 149.15 (3) (a) of the statutes is amended to read:

SB45,1057,25 149.15 (3) (a) Establish Establishing procedures under which applicants and participants may have grievances reviewed by an impartial body and reported to the board.

SB45, s. 2274 Section 2274. 149.15 (3) (c) of the statutes is amended to read:

SB45,1058,8 149.15 (3) (c) Collect Determining assessments to be collected from all insurers to provide for claims paid under the plan and for administrative expenses incurred or estimated to be incurred during the period for which the assessment is made. The level of payments shall be established as provided under s. 149.143. Assessment of the insurers shall occur at the end of each calendar year or other fiscal year end established by the board. Assessments are due and payable within 30 days of receipt by the insurer of the assessment notice.

SB45, s. 2275 Section 2275. 149.15 (3) (d) of the statutes is amended to read:

SB45,1058,12 149.15 (3) (d) Develop and implement Developing and implementing a program to publicize the existence of the plan, the eligibility requirements and procedures for enrollment, and to maintain public awareness of the plan.

SB45, s. 2276 Section 2276. 149.15 (3) (e) of the statutes is amended to read:

SB45,1058,16 149.15 (3) (e) Establish Establishing for payment of covered expenses, a payment rate that is 10% less than the charges approved by the plan administrator for reimbursement of covered expenses under s. 149.14 (3).

SB45, s. 2277 Section 2277. 149.15 (3) (f) of the statutes is amended to read:

SB45,1058,19 149.15 (3) (f) Advise the department on the The choice of coverage under s. 149.146.

SB45, s. 2278 Section 2278. 149.165 (4) of the statutes is amended to read:

SB45,1058,23 149.165 (4) The department shall reimburse the plan for premium reductions under sub. (2) and deductible reductions under s. 149.14 (5) (a) with moneys from the appropriation under s. 20.435 (5) (4) (ah).

SB45, s. 2279 Section 2279. 150.84 (2) of the statutes is amended to read:

SB45,1059,6 150.84 (2) "Health care facility" means a facility, as defined in s. 647.01 (4), or any hospital, nursing home, community-based residential facility, county home, county infirmary, county hospital, county mental health center, tuberculosis sanatorium or other place licensed or approved by the department under s. 49.70, 49.71, 49.72, 50.02, 50.03, 50.35, 51.08, or 51.09, 58.06, 252.073 or 252.076 or a facility under s. 45.365, 51.05, 51.06, 233.40, 233.41, 233.42 or 252.10.

SB45, s. 2280 Section 2280. 153.05 (6m) of the statutes is amended to read:

SB45,1059,13 153.05 (6m) The 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. The 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. 20.435 (1) (4) (hg).

SB45, s. 2281 Section 2281. 153.60 (1) of the statutes is amended to read:

SB45,1060,10 153.60 (1) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures under this chapter for the department and the board for that fiscal year for data collection, data base development and maintenance, generation of data files and standard reports, orientation and training provided under s. 153.05 (9) and maintaining the board. The department shall assess the estimated total amount for that fiscal year less the estimated total amount to be received for purposes of administration of this chapter under s. 20.435 (1) (4) (hi) during the fiscal year, the unencumbered balance of the amount received for purposes of administration of this chapter under s. 20.435 (1) (4) (hi) from the prior fiscal year and the amount in the appropriation account under s. 20.435 (1) (dg) for the fiscal year, to health care providers who are in a class of health care providers from whom the department collects data under this chapter in a manner specified by the department by rule. The department shall obtain approval from the board for the amounts of assessments for health care providers other than hospitals and ambulatory surgery centers. The department shall work together with the department of regulation and licensing to develop a mechanism for collecting assessments from health care providers other than hospitals and ambulatory surgery centers. No health care provider that is not a facility may be assessed under this subsection an amount that exceeds $75 per fiscal year. Each hospital shall pay the assessment on or before December 1. All payments of assessments shall be deposited in the appropriation under s. 20.435 (1) (4) (hg).

SB45, s. 2282 Section 2282. 153.60 (3) of the statutes is amended to read:

SB45,1060,22 153.60 (3) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures required for the collection, database development and maintenance and generation of public data files and standard reports for health care plans that voluntarily agree to supply health care data under s. 153.05 (6r). The department shall assess the estimated total amount for that fiscal year to health care plans in a manner specified by the department by rule and may enter into an agreement with the office of the commissioner of insurance for collection of the assessments. Each health plan that voluntarily agrees to supply this information shall pay the assessments on or before December 1. All payments of assessments shall be deposited in the appropriation under s. 20.435 (1) (4) (hg) and may be used solely for the purposes of s. 153.05 (6r).

SB45, s. 2283 Section 2283. 153.65 of the statutes is amended to read:

SB45,1061,5 153.65 Provision of special information; user fees. The department may, but is not required to, provide, upon request from a person, a data compilation or a special report based on the information collected by the department. The department shall establish user fees for the provision of these compilations or reports, payable by the requester, which shall be sufficient to fund the actual necessary and direct cost of the compilation or report. All moneys collected under this section shall be credited to the appropriation under s. 20.435 (1) (4) (hi).

SB45, s. 2284 Section 2284. 155.01 (6) of the statutes is amended to read:

SB45,1061,12 155.01 (6) "Health care facility" means a facility, as defined in s. 647.01 (4), or any hospital, nursing home, community-based residential facility, county home, county infirmary, county hospital, county mental health center, tuberculosis sanatorium or other place licensed or approved by the department under s. 49.70, 49.71, 49.72, 50.02, 50.03, 50.35, 51.08, or 51.09, 58.06, 252.073 or 252.076 or a facility under s. 45.365, 51.05, 51.06, 233.40, 233.41, 233.42 or 252.10.

SB45, s. 2285 Section 2285. 160.255 of the statutes is amended to read:

SB45,1061,18 160.255 Exceptions for private certain sewage systems. (1) In this section, "private exempt sewage system" has the meaning given means a small sewage system, as defined in s. 145.01 (12) (14m), or a sewage system that is in existence on January 1, 2000, and that would be a small sewage system except that its design flow exceeds the maximum design flow specified under s. 145.02 (4) (c).

SB45,1061,22 (2) Notwithstanding s. 160.19 (1), (2) and (4) (b), a regulatory agency is not required to promulgate or amend rules that define design or management criteria for private exempt sewage systems to minimize the amount of nitrate in groundwater or to maintain compliance with the preventive action limit for nitrate.

SB45,1062,2 (3) Notwithstanding s. 160.19 (3), a regulatory agency may promulgate rules that define design or management criteria for private exempt sewage systems that permit the enforcement standard for nitrate to be attained or exceeded at the point of standards application.

SB45,1062,7 (4) Notwithstanding s. 160.21, a regulatory agency is not required to promulgate rules that set forth responses that the agency may take, or require to be taken, when the preventive action limit or enforcement standard for nitrate is attained or exceeded at the point of standards application if the source of the nitrate is a private an exempt sewage system.