AB925: Bill Text

AB925,31,9 (d) The applicant has sufficient cash reserves and cash flow to pay operating and capital costs.

AB925,31,15 (e) Increases in operating and capital costs that will result from the activity are reasonable, including the direct charge to the consumer, the applicant's projected request for rate increases under ss. 150.61 to 150.67, and the charges to be paid by medical assistance and disability insurers. In considering whether the increases are reasonable, the department shall consider the analysis provided by the commission under sub. (2).

AB925,31,16 (f) Financing for the activity is available at market rates.

AB925,31,18 (g) Health care personnel needed to provide the proposed services are available and will be effectively used.

AB925,31,19 (h) Proposed construction costs are consistent with industry averages.

AB925,31,21 (i) Any proposed expansion and construction or renovation alternatives are cost-effective.

AB925,31,22 (j) The activity is consistent with efficiency standards and criteria.

AB925,32,3 (k) The applicant is participating in a utilization review program that is applicable to a statistical sampling of all hospital patients regardless of payment source, that requires public disclosure of all review data in a form useful to the department but protects the identities of individual patients and health care professionals, and that is conducted by persons who are free of any substantial conflict of interest.

AB925,32,5 (L) The applicant has prepared a plan to provide health care to low-income individuals, and the department has approved the plan.

AB925,32,8 (2) The commission shall determine the effect of any rate change the applicant has requested on the applicant's activity and provide a report to the department no later than 45 days after the department receives a completed application.

AB925,32,13 150.723 Review process. (1) Upon the request of an affected party, the department shall hold a public meeting to review activities for which an application for review has been received. All affected parties may present testimony at the public meeting. The department shall keep minutes or other record of testimony presented at the public meeting.

AB925,32,21 (2) (a) The department shall issue an initial finding to approve or reject the application no later than 75 days after the date on which the notice under s. 150.719 (1) is published unless the applicant consents to an extension of this period. The department may not require substantial modifications of any project as a condition of approval without the applicant's consent. The department shall submit the initial finding to the applicant. Unless the applicant makes a timely request for a hearing under sub. (3), an initial finding issued under this subsection shall be considered a final action.

AB925,32,25 (b) Notwithstanding par. (a), the department may extend the review period of all projects being reviewed concurrently for 60 days if the department finds that completing the review within the 75-day time period under par. (a) is not practical due to the number of applications under review.

AB925,33,7 (3) (a) If an applicant's application is rejected, the applicant may request a public hearing to review the department's initial finding if the applicant submits a request for the hearing in writing no later than 10 days after the department issues the initial finding or the applicant may initiate a hearing under s. 227.42. The department shall commence the hearing no later than 30 days after the date on which a timely request for the hearing is received unless all parties consent to an extension of the period.

AB925,33,10 (b) Except as provided in s. 227.42, ss. 227.43 to 227.50 do not apply to hearings under this subsection. The department shall promulgate rules specifying all of the following:

AB925,33,11 1. Procedures for scheduling hearings under this subsection.

AB925,33,14 2. Procedures for conducting hearings under this subsection, including methods of presenting arguments, cross-examination of witnesses, and submission of exhibits.

AB925,33,16 3. Procedures following the completion of a hearing under this subsection, including the establishment of time limits for issuance of a decision.

AB925,33,18 4. Standards relating to ex parte communication in hearings under this subsection.

AB925,33,19 5. Procedures for reconsideration and rehearing.

AB925,33,20 (c) The department shall issue all decisions in writing.

AB925,33,23 (d) Each applicant has the burden of proving, by clear and convincing evidence, that the department's initial finding was arbitrary and capricious, contrary to law, or contrary to the weight of the evidence on the record when considered as a whole.

AB925,34,2 150.725 Judicial review. An applicant adversely affected by a decision of the department under s. 150.723 (3) may petition for judicial review of the decision under s. 227.52. The scope of judicial review shall be as provided in s. 227.57, and the record before the reviewing court shall consist of all of the following:

AB925,34,4 (1) The application and all supporting material received prior to the department's initial finding issued under s. 150.723 (2)

AB925,34,5 (2) The record of the public meeting held under s. 150.723 (1).

AB925,34,7 (3) The department's analysis of the activity and the activity's compliance with the criteria specified in s. 150.72 (1).

AB925,34,8 (4) The record of the hearing held under s. 150.723 (3).

AB925,34,9 (5) The department's decisions and analysis issued under s. 150.723 (2) or (3).

AB925,34,12 150.727 Validity and contents of an approval. (1) An approval is valid for one year from the date of issuance. The department may grant one extension of up to 6 months for each approval.

AB925,34,14 (2) Each approval shall specify the maximum capital expenditure that may be obligated for an activity.

AB925,34,19 (3) Each approval shall include the proposed timetable for implementing and completing the project and, for the 3-year period following completion of the activity, the activity's depreciation and interest schedule, any required staff, the proposed per diem rate needed to pay capital costs, and the proposed per diem rate needed to pay operating costs.

AB925,34,25 150.73 Capital budget reporting. Beginning January 1, 2003, each hospital shall annually, by January 1, submit to the department a proposed capital budget for the 5-year period that begins on July 1 of the year in which the proposed budget is submitted. The budget shall specify all anticipated capital expenditures for activities specified in s. 150.71 (1) (a) to (c) and (e) and all anticipated application dates.

AB925,35,6 150.733 State medical facilities plan. (1) The department shall adopt a state medical facilities plan at least once every 3 years that includes a description of the state hospital system and identifies any needed or surplus hospital beds. Each plan, except the initial plan adopted under this subsection, shall also include a description of needed and surplus health services and any other comments the department determines are useful.

AB925,35,11 (2) The department may not approve an application for any activity that requires the addition of hospital beds that would exceed the number of beds authorized by the state medical facilities plan for the acute care service area where the project would be located. The department shall promulgate rules to define an acute care service.

AB925, s. 10 Section 10. 153.08 of the statutes is repealed.

AB925, s. 11 Section 11. 153.75 (1) (g) of the statutes is repealed.

AB925, s. 12 Section 12. 165.40 of the statutes is repealed.

AB925, s. 13 Section 13. 230.08 (2) (mp) of the statutes is created to read:

AB925,35,17 230.08 (2) (mp) One staff director of the hospital rate-setting commission, created under s. 15.105 (27).

AB925, s. 14 Section 14. 632.75 (5) of the statutes is amended to read:

AB925,35,22 632.75 (5) Payments for hospital services. No insurer may reimburse a hospital for patient health care costs at a rate exceeding the rate established under ch. 54, 1985 stats., or s. 146.60, 1983 stats., for care provided prior to July 1, 1987 ss. 150.61 to 150.67.

AB925, s. 15 Section 15. Nonstatutory provisions.

AB925,36,2 (1) Initial appointment of members of the hospital rate-setting commission. Notwithstanding the length of terms specified for the members of the hospital rate-setting commission under section 15.105 (27) of the statutes, as created by this act, the initial members shall be appointed for the following terms:

AB925,36,3 (a) One member for a term expiring on March 1, 2005.

AB925,36,4 (b) One member for a term expiring on March 1, 2007.

AB925,36,5 (c) One member for a term expiring on March 1, 2009.

AB925,36,9 (2) Initial appointment of members of the hospital rate-setting council. Notwithstanding the length of terms specified for the members of the hospital rate-setting council under section 15.107 (18) of the statutes, as created by this act, the initial members shall be appointed for the following terms:

AB925,36,11 (a) The members specified under section 15.107 (18) (a) of the statutes, as created by this act, for terms expiring on July 1, 2003.

AB925,36,14 (b) The members specified under section 15.107 (18) (b) and (d) of the statutes, as created by this act, and the members not specified in section 15.107 (18) (a) to (e) of the statutes, as created by this act, for terms expiring on July 1, 2005.

AB925,36,16 (c) The members specified under section 15.107 (18) (c) and (e) of the statutes, as created by this act, for terms expiring on July 1, 2007.

AB925,36,22 (3) Request to supplement appropriation. By April 1, 2002, the hospital rate-setting commission shall submit to the secretary of administration a request to supplement the appropriation under section 20.438 (1) (g) of the statutes, as created by this act, as specified under section 16.515 of the statutes. The request shall include a proposed budget for activities of the hospital rate-setting commission under subchapter III of chapter 150 of the statutes, as created by this act.

AB925,36,23 (4) Hospital rate-setting commission rules.

AB925,37,2 (a) The hospital rate-setting commission shall submit proposed rules required under section 150.615 of the statutes, as created by this act, to the legislative council staff for review under section 227.15 (1) of the statutes no later than May 1, 2002. These rules may not take effect before July 1, 2002.

AB925,37,10 (b) Using the procedure under section 227.24 of the statutes, the hospital rate-setting commission shall promulgate rules required under section 150.68 of the statutes, as created by this act, for the period prior to the effective date of the rules submitted under paragraph (a), but not to exceed the period authorized under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24 (1) (a) and (2) (b) of the statutes, the hospital rate-setting commission need not provide evidence of the necessity of preservation of the public peace, health, safety, or welfare in promulgating the rules under this subsection.

AB925, s. 16 Section 16. Effective date.

AB925,37,13 (1) This act takes effect on January 1, 2003, or on the day after publication, whichever is later.

AB925,37,14 (End)