SB191: Bill Text

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2009 - 2010 LEGISLATURE

2009 Senate BILL 191

May 7, 2009 - Introduced by Senators Lehman, Taylor, Plale, Schultz, Wirch and Holperin, cosponsored by Representatives Barca, Zigmunt, Benedict, Turner, Kerkman, Steinbrink, Friske, Mason, Townsend, Zepnick, Ballweg, Berceau and Petrowski. Referred to Committee on Health, Health Insurance, Privacy, Property Tax Relief, and Revenue.

SB191,2,4 An Act to renumber 45.40 (1); to amend 15.085 (1m) (b), 15.406 (3) (intro.), 25.36 (1), 29.193 (2) (b) 2., 29.193 (2) (c) 3., 29.193 (2) (e), 45.40 (2m) (a), 45.40 (2m) (b), 45.40 (3m), 49.45 (9), 49.855 (4m) (b), 50.36 (3) (b), 50.36 (3) (c), 50.39 (3), 146.37 (1g), 180.1901 (1m) (bk), 185.981 (1), 185.981 (2), 185.981 (3), 185.981 (4), 185.982 (1), 343.62 (4) (a) 4., subchapter IV (title) of chapter 448 [precedes 448.60], 448.60 (1), 450.11 (8) (bm), 632.64, 632.99, 655.45 (1), 812.30 (9), 814.29 (1) (d) 1., 895.48 (1m) (a) (intro.) and 2., 905.04 (title), 905.04 (1) (b), 905.04 (1) (c), 905.04 (2) and 905.04 (3); and to create 45.40 (1g), 45.40 (1t) and 905.04 (1) (dg) of the statutes; relating to: podiatrist-patient privilege, immunity exemption for podiatrists providing emergency care at athletic events, allowing podiatrists to determine an illness or injury and complete forms for the purpose of granting assistance to needy veterans, allowing podiatrists to determine disability for the purpose of issuing certain hunting permits, cooperatives organized to provide sickness care, the Podiatrists Affiliated Credentialing Board, allowing podiatrists to certify driver school instructors' physical fitness, allowing Medical Assistance recipients to freely choose among podiatrists, and giving equal weight to certifications of disability by podiatrists for insurance purposes.

Analysis by the Legislative Reference Bureau

Under current law, certain health care providers, including physicians, first responders, and dentists, who render voluntary health care to a participant in an athletic event or contest at a school are immune from civil liability for their acts or omissions. The immunity applies only if certain conditions are met, including that the health care is rendered at the site of event or contest and that there is no compensation paid to the health care provider. This bill adds podiatrists to those who are immune from civil liability for their acts or omissions while rendering voluntary health care to a participant in an athletic event or contest at a school.

Currently, a communication by a patient to certain health care professionals, including physicians, chiropractors, and psychologists, is privileged. The patient may refuse to disclose, and can prevent the health care provider from disclosing, a communication made for the purpose of diagnosis or treatment of the patient. This bill adds podiatrists to those whose communication regarding diagnosis or treatment may be prevented from being disclosed by the patient.

Under current law, the Department of Transportation (DOT) issues driver school instructors' licenses. DOT may not issue an instructor's license to an applicant unless the applicant submits a statement completed by a physician or another specified medical care provider certifying that the applicant is physically fit to teach driving. This bill adds podiatrists to the list of medical care providers that may certify to DOT that an applicant is physically fit to teach driving.

Under current law, the Department of Veterans Affairs (DVA) may grant assistance to needy veterans who have suffered a loss of income due to illness, injury, or natural disaster. By rule, DVA has defined an illness or injury as a physical or mental health problem that is diagnosed by a physician, dentist, optometrist, or audiologist. This bill expands the health care providers who can diagnose an illness or injury for DVA purposes to include podiatrists.

Under current law, the Department of Natural Resources (DNR) is authorized to issue certain hunting permits that authorize hunting by persons who have a physical disability (specialized permits). Among the privileges granted by these specialized permits is the privilege of hunting with assistance rendered by another person. In order to obtain a specialized permit from DNR, a person must submit an application furnished by DNR that includes a statement or report prepared and signed by a licensed physician or chiropractor verifying that the applicant is physically disabled. A person may also obtain a specialized permit even if the person would otherwise be ineligible for a specialized permit if DNR, based on the recommendation of a licensed physician or chiropractor, determines that the issuance of the permit complies with the intent of the law. This bill authorizes an applicant for a specialized permit to submit a statement, report, or recommendation from a licensed podiatrist, as well as from a physician or chiropractor, in support of a specialized permit application.

This bill changes the name of the Podiatrists Affiliated Credentialing Board to the Podiatry Affiliated Credentialing Board.

Current law permits the organization of a cooperative to provide sickness care through contracts with physicians, medical societies, chiropractors, optometrists, dentists, dental societies, hospitals, and others. This bill adds podiatrists to the list of enumerated providers of sickness care.

Under current law, life insurers, health insurers, and disability insurers are required to give equal weight to certifications of disability by physicians and by chiropractors, with respect to matters within the scope of the professional license of each. This bill requires those insurers also to give equal weight to certifications of disability by podiatrists with respect to matters within the scope of their professional licenses.

Current law provides that a person who is eligible for health care coverage under the Medical Assistance (MA) program may, unless limited by the Department of Health Services, which administers MA, use the provider of his or her choice, and lists the types of providers for which the person has free choice. The list includes physicians, chiropractors, dentists, and pharmacists. This bill adds podiatrists to the list of providers for which a person who is eligible for MA has free choice.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB191, s. 1 Section 1. 15.085 (1m) (b) of the statutes is amended to read:

SB191,3,6 15.085 (1m) (b) The public members of the physical therapists affiliated credentialing board, podiatrists podiatry affiliated credentialing board or occupational therapists affiliated credentialing board shall not be engaged in any profession or occupation concerned with the delivery of physical or mental health care.

SB191, s. 2 Section 2. 15.406 (3) (intro.) of the statutes is amended to read:

SB191,4,2 15.406 (3) (intro.) Podiatrists Podiatry affiliated credentialing board. There is created in the department of regulation and licensing, attached to the medical examining board, a podiatrists podiatry affiliated credentialing board consisting of the following members appointed for 4-year terms:

SB191, s. 3 Section 3. 25.36 (1) of the statutes is amended to read:

SB191,4,22 25.36 (1) Except as provided in sub. (2), all moneys appropriated or transferred by law shall constitute the veterans trust fund which shall be used for the lending of money to the mortgage loan repayment fund under s. 45.37 (5) (a) 12. and for the veterans programs under ss. 20.485 (2) (m), (mn), (tm), (u), (v), (vo), (vy), (w), (z), and (zm), 45.03 (19), 45.07, 45.20, 45.21, 45.40 (1) (1m), 45.41, 45.42, 45.43, and 45.82 and administered by the department of veterans affairs, including all moneys received from the federal government for the benefit of veterans or their dependents; all moneys paid as interest on and repayment of loans under the post-war rehabilitation fund; soldiers rehabilitation fund, veterans housing funds as they existed prior to July 1, 1961; all moneys paid as interest on and repayment of loans under this fund; all moneys paid as expenses for, interest on, and repayment of veterans trust fund stabilization loans under s. 45.356, 1995 stats.; all moneys paid as expenses for, interest on, and repayment of veterans personal loans; the net proceeds from the sale of mortgaged properties related to veterans personal loans; all mortgages issued with the proceeds of the 1981 veterans home loan revenue bond issuance purchased with moneys in the veterans trust fund; all moneys received from the state investment board under s. 45.42 (8) (b); all moneys received from the veterans mortgage loan repayment fund under s. 45.37 (7) (a) and (c); and all gifts of money received by the board of veterans affairs for the purposes of this fund.

SB191, s. 4 Section 4. 29.193 (2) (b) 2. of the statutes is amended to read:

SB191,5,3 29.193 (2) (b) 2. An applicant shall submit an application on a form prepared and furnished by the department, which shall include a written statement or report prepared and signed by a licensed physician or , a licensed chiropractor, or a licensed podiatrist prepared no more than 6 months preceding the application and verifying that the applicant is physically disabled.

SB191, s. 5 Section 5. 29.193 (2) (c) 3. of the statutes is amended to read:

SB191,5,13 29.193 (2) (c) 3. The department may issue a Class B permit to an applicant who is ineligible for a permit under subd. 1., 2. or 2m. or who is denied a permit under subd. 1., 2. or 2m. if, upon review and after considering the physical condition of the applicant and the recommendation of a licensed physician or , a licensed chiropractor, or a licensed podiatrist selected by the applicant from a list of licensed physicians and, licensed chiropractors, and licensed podiatrists compiled by the department, the department finds that issuance of a permit complies with the intent of this subsection. The use of this review procedure is discretionary with the department and all costs of the review procedure shall be paid by the applicant.

SB191, s. 6 Section 6. 29.193 (2) (e) of the statutes is amended to read:

SB191,5,23 29.193 (2) (e) Review of decisions. An applicant denied a permit under this subsection, except a permit under par. (c) 3., may obtain a review of that decision by a licensed physician or, a licensed chiropractor, or a licensed podiatrist designated by the department and with an office located in the department district in which the applicant resides. The department shall pay for the cost of a review under this paragraph unless the denied application on its face fails to meet the standards set forth in par. (c) 1. or 2. A review under this paragraph is the only method of review of a decision to deny a permit under this subsection and is not subject to further review under ch. 227.

SB191, s. 7 Section 7. 45.40 (1) of the statutes is renumbered 45.40 (1m).

SB191, s. 8 Section 8. 45.40 (1g) of the statutes is created to read:

SB191,6,1 45.40 (1g) Definitions. In this section:

SB191,6,2 (a) "Health care provider" includes a podiatrist licensed under s. 448.63.

SB191,6,5 (b) "Illness" or "injury" means a physical or mental health problem that has been diagnosed by a health care provider acting within the scope of the podiatrist's license.

SB191, s. 9 Section 9. 45.40 (1t) of the statutes is created to read:

SB191,6,9 45.40 (1t) Completion of health care forms. A health care provider may complete the medical forms necessary for the receipt of aid under this section if the provider has diagnosed the veteran and determined the veteran's medical condition.

SB191, s. 10 Section 10. 45.40 (2m) (a) of the statutes is amended to read:

SB191,6,16 45.40 (2m) (a) The unremarried spouse and dependent children of a veteran who died on active duty, or in the line of duty while on active or inactive duty for training purposes, in the U.S. armed forces or forces incorporated in the U.S. armed forces are eligible to receive payments under subs. (1) (1m) and (2) if the household income of those persons does not exceed the income limitations established under sub. (3m).

SB191, s. 11 Section 11. 45.40 (2m) (b) of the statutes is amended to read:

SB191,6,23 45.40 (2m) (b) The spouse and dependent children of a member of the U.S. armed forces or of the Wisconsin national guard who has been activated or deployed to serve in the U.S. armed forces who are residents of this state, who have suffered a loss of income due to that activation or deployment, and who experience an economic emergency during the member's activation or deployment are eligible to receive assistance under subs. (1) (1m) and (2).

SB191, s. 12 Section 12. 45.40 (3m) of the statutes is amended to read:

SB191,7,3 45.40 (3m) Rules. The department shall promulgate rules establishing eligibility criteria and household income limits for payments under subs. (1) (1m), (2), and (2m).

SB191, s. 13 Section 13. 49.45 (9) of the statutes is amended to read:

SB191,8,4 49.45 (9) Free choice. Any person eligible for medical assistance under s. 49.46, 49.468, 49.47, or 49.471 may use the physician, chiropractor, dentist, pharmacist, podiatrist, hospital, skilled nursing home, health maintenance organization, limited service health organization, preferred provider plan or other licensed, registered or certified provider of health care of his or her choice, except that free choice of a provider may be limited by the department if the department's alternate arrangements are economical and the recipient has reasonable access to health care of adequate quality. The department may also require a recipient to designate, in any or all categories of health care providers, a primary health care provider of his or her choice. After such a designation is made, the recipient may not receive services from other health care providers in the same category as the primary health care provider unless such service is rendered in an emergency or through written referral by the primary health care provider. Alternate designations by the recipient may be made in accordance with guidelines established by the department. Nothing in this subsection shall vitiate the legal responsibility of the physician, chiropractor, dentist, pharmacist, podiatrist, skilled nursing home, hospital, health maintenance organization, limited service health organization, preferred provider plan or other licensed, registered or certified provider of health care to patients. All contract and tort relationships with patients shall remain, notwithstanding a written referral under this section, as though dealings are direct between the physician, chiropractor, dentist, pharmacist, podiatrist, skilled nursing home, hospital, health maintenance organization, limited service health organization, preferred provider plan or other licensed, registered or certified provider of health care and the patient. No physician, chiropractor, pharmacist, podiatrist, or dentist may be required to practice exclusively in the medical assistance program.

SB191, s. 14 Section 14. 49.855 (4m) (b) of the statutes is amended to read:

SB191,9,9 49.855 (4m) (b) The department of revenue may provide a certification that it receives under sub. (1), (2m), (2p), or (2r) to the department of administration. Upon receipt of the certification, the department of administration shall determine whether the obligor is a vendor or is receiving any other payments from this state, except for wages, retirement benefits, or assistance under s. 45.352, 1971 stats., s. 45.40 (1) (1m), this chapter, or ch. 46, 108, or 301. If the department of administration determines that the obligor is a vendor or is receiving payments from this state, except for wages, retirement benefits, or assistance under s. 45.352, 1971 stats., s. 45.40 (1) (1m), this chapter, or ch. 46, 108, or 301, it shall begin to withhold the amount certified from those payments and shall notify the obligor that the state intends to reduce any payments due the obligor by the amount the obligor is delinquent under the support, maintenance, or receiving and disbursing fee order or obligation, by the outstanding amount for past support, medical expenses, or birth expenses under the court order, or by the amount due under s. 46.10 (4), 49.345 (4), or 301.12 (4). The notice shall provide that within 20 days after receipt of the notice the obligor may request a hearing before the circuit court rendering the order under which the obligation arose. An obligor may, within 20 days after receiving notice, request a hearing under this paragraph. Within 10 days after receiving a request for hearing under this paragraph, the court shall set the matter for hearing. A circuit court commissioner may conduct the hearing. Pending further order by the court or circuit court commissioner, the department of children and families or its designee, whichever is appropriate, may not disburse the payments withheld from the obligor. The sole issues at the hearing are whether the obligor owes the amount certified and, if not and it is a support or maintenance order, whether the money withheld shall be paid to the obligor or held for future support or maintenance, except that the obligor's ability to pay is also an issue at the hearing if the obligation relates to an order under s. 767.805 (4) (d) 1. or 767.89 (3) (e) 1. and the order specifies that the court found that the obligor's income was at or below the poverty line established under 42 USC 9902 (2).

SB191, s. 15 Section 15. 50.36 (3) (b) of the statutes is amended to read:

SB191,9,18 50.36 (3) (b) If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists podiatry affiliated credentialing board, for any reasons that include the quality of or ability to practice, loses his or her hospital staff privileges, has his or her hospital staff privileges reduced or resigns from the hospital staff, the hospital shall so notify the medical examining board or podiatrists podiatry affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.

SB191, s. 16 Section 16. 50.36 (3) (c) of the statutes is amended to read: