SB546: Bill Text

SB546,26,10 2. Post the report on its Internet site.

SB546,26,14 3. Post on its Internet site the raw data collected in the previous calendar year for purposes of the annual report. The data shall be presented in a manner that does not disclose or enable the identification of any individual infant, mother, or birth attendant.

SB546,26,17 (3)   The department shall explore whether any of the costs of collecting the data and creating the report under sub. (2) may be funded by the Medical Assistance program.

SB546,37 Section 37. 253.18 of the statutes is created to read:

SB546,26,22 253.18 Neonatal intensive care unit report. (1) In this section, "neonatal intensive care unit" means a hospital unit on which special equipment and skilled medical personnel for the care of high-risk infants requiring immediate or continuous attention are concentrated.

SB546,26,24 (2) (a) Beginning on July 1, 2014, the department shall collect all of the following information from a hospital that has a neonatal intensive care unit:

SB546,26,25 1. The daily census of the neonatal intensive care unit.

SB546,27,1 2. The criteria for admission to the neonatal intensive care unit.

SB546,27,5 (b) On June 30, 2015, and on every June 30 after that, the department shall annually prepare a report that includes all of the information in par. (a) from the previous calendar year. The department shall make the report available to the public and post the report on the department's Internet site.

SB546,38 Section 38. 441.15 (1) (a) of the statutes is repealed.

SB546,39 Section 39. 441.15 (1) (am) of the statutes is created to read:

SB546,27,9 441.15 (1) (am) "Nurse-midwife" means a person licensed under this section to engage in the practice of nurse-midwifery.

SB546,40 Section 40. 441.15 (1) (c) of the statutes is created to read:

SB546,27,13 441.15 (1) (c) "Qualified health care professional" means a health care professional, as defined in s. 180.1901 (1m), who is performing services within his or her scope of practice.

SB546,41 Section 41. 441.15 (2) (b) of the statutes is amended to read:

SB546,27,17 441.15 (2) (b) The practice occurs in a health care facility approved by the board by rule under sub. (3) (c), in collaboration with a physician with postgraduate training in obstetrics, and pursuant to a written agreement with that physician.

SB546,42 Section 42. 441.15 (3) (c) of the statutes is amended to read:

SB546,27,24 441.15 (3) (c) The board shall promulgate rules necessary to administer this section, including the establishment of appropriate limitations on the scope of the practice of nurse-midwifery, the facilities in which such practice may occur, the definition of "elective" for purposes of the prohibition in sub. (4m), and the granting of temporary permits to practice nurse-midwifery pending qualification for certification.

SB546,43 Section 43. 441.15 (4) of the statutes is amended to read:

SB546,28,5 441.15 (4) A nurse-midwife who discovers evidence that any aspect of care involves any complication which jeopardizes the health or life of a newborn or mother shall consult with the collaborating physician under sub. (2) (b) or the physician's designee, or make a referral as specified in a written agreement under sub. (2) (b) a qualified health care professional or make a referral.

SB546,44 Section 44. 441.15 (4m) of the statutes is created to read:

SB546,28,13 441.15 (4m) No nurse-midwife may perform an elective procedure intended to induce labor in a pregnant woman before the completion of a gestational period of 39 weeks unless the nurse-midwife has first obtained the informed consent of the woman. A woman's consent is informed for purposes of this subsection only if she receives timely information orally and in person from the nurse-midwife regarding potential negative effects to the fetus of early delivery, including long-term learning and behavioral problems.

SB546,45 Section 45. 448.02 (3) (a) of the statutes is amended to read:

SB546,29,8 448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license, certificate , or limited permit granted by the board. An allegation that a physician has violated s. 253.10 (3), 448.30, 448.35, or 450.13 (2); or has failed to mail or present a medical certification required under s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate ; or that a physician has failed at least 6 times within a 6-month period to mail or present a medical certificate required under s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17, or 632.715, or under 42 CFR 1001.2005, shall be investigated by the board. Information contained in a report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license, certificate, or limited permit to undergo, and may consider the results of , one or more physical, mental, or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.

SB546,46 Section 46. 448.35 of the statutes is created to read:

SB546,29,17 448.35 Informed consent for certain elective procedures. No physician may perform an elective Caesarean section on a pregnant woman, or an elective procedure intended to induce labor in a pregnant woman, before the completion of a gestational period of 39 weeks unless the physician has first obtained the informed consent of the woman. A woman's consent is informed for purposes of this section only if she receives timely information orally and in person from the physician regarding potential negative effects to the fetus of early delivery, including long-term learning and behavioral problems.

SB546,47 Section 47. 448.40 (2) (am) of the statutes is created to read:

SB546,29,20 448.40 (2) (am) Defining "elective" for purposes of s. 448.35 and implementing s. 448.35.

SB546,48 Section 48. 619.04 (3) of the statutes is amended to read:

SB546,30,9 619.04 (3) The plan shall operate subject to the supervision and approval of a board of governors consisting of 3 representatives of the insurance industry appointed by and to serve at the pleasure of the commissioner, a person to be named by the State Bar Association, a person to be named by the Wisconsin Academy of Trial Lawyers, 2 persons to be named by the Wisconsin Medical Society, a person to be named by the Wisconsin Hospital Association, the commissioner or a designated representative employed by the office of the commissioner, and 4 public members at least one of whom is named by the Wisconsin Nurses Association and at least 2 of whom are not attorneys or physicians and are not professionally affiliated with any hospital or insurance company, appointed by the governor for staggered 3-year terms. The commissioner or the commissioner's representative shall be the chairperson of the board of governors. Board members shall be compensated at the rate of $50 per diem plus actual and necessary travel expenses.

SB546,49 Section 49. 655.001 (7t) of the statutes is renumbered 655.001 (7t) (a) and amended to read:

SB546,30,17 655.001 (7t) (a) "Health Except as provided in par. (b), "health care practitioner" means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist.

SB546,50 Section 50. 655.001 (7t) (a) of the statutes, as affected by 2013 Wisconsin Act .... (this act), is renumbered 655.001 (7t) and amended to read:

SB546,30,24 655.001 (7t) Except as provided in par. (b), "health "Health care practitioner" means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not under the direction and supervision of a physician or, nurse anesthetist, or nurse-midwife.

SB546,51 Section 51. 655.001 (7t) (b) of the statutes is created to read:

SB546,31,2 655.001 (7t) (b) "Health care practitioner" does not include a person licensed to practice nurse-midwifery under s. 441.15.

SB546,52 Section 52. 655.001 (7t) (b) of the statutes, as created by 2013 Wisconsin Act .... (this act), is repealed.

SB546,53 Section 53. 655.001 (9c) of the statutes is created to read:

SB546,31,7 655.001 (9c) "Nurse-midwife" means a person who is licensed to practice nurse-midwifery under s. 441.15.

SB546,54 Section 54. 655.002 (1) (a) of the statutes is amended to read:

SB546,31,11 655.002 (1) (a) A physician or, a nurse anesthetist, or a nurse-midwife for whom this state is a principal place of practice and who practices his or her profession in this state more than 240 hours in a fiscal year.

SB546,55 Section 55. 655.002 (1) (b) (intro.) of the statutes is amended to read:

SB546,31,14 655.002 (1) (b) (intro.) A physician or , a nurse anesthetist, or a nurse-midwife for whom Michigan is a principal place of practice, if all of the following apply:

SB546,56 Section 56. 655.002 (1) (b) 1. of the statutes is amended to read:

SB546,31,17 655.002 (1) (b) 1. The physician or, nurse anesthetist, or nurse-midwife is a resident of this state.

SB546,57 Section 57. 655.002 (1) (b) 2. of the statutes is amended to read:

SB546,31,21 655.002 (1) (b) 2. The physician or, nurse anesthetist, or nurse-midwife practices his or her profession in this state or in Michigan or a combination of both more than 240 hours in a fiscal year.

SB546,58 Section 58. 655.002 (1) (b) 3. of the statutes is amended to read:

SB546,32,2 655.002 (1) (b) 3. The physician or, nurse anesthetist, or nurse-midwife performs more procedures in a Michigan hospital than in any other hospital. In this subdivision, "Michigan hospital" means a hospital located in Michigan that is an affiliate of a corporation organized under the laws of this state that maintains its principal office and a hospital in this state.

SB546,59 Section 59. 655.002 (1) (c) of the statutes is amended to read:

SB546,32,11 655.002 (1) (c) A physician or, nurse anesthetist, or nurse-midwife who is exempt under s. 655.003 (1) or (3), or a nurse-midwife who is exempt under s. 655.003 (4), but who practices his or her profession outside the scope of the exemption and who fulfills the requirements under par. (a) in relation to that practice outside the scope of the exemption. For a physician or a, nurse anesthetist, or nurse-midwife who is subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is outside the scope of the exemption under s. 655.003 (1) or, (3), or (4).

SB546,60 Section 60. 655.002 (1) (d) of the statutes is amended to read:

SB546,32,16 655.002 (1) (d) A partnership comprised of physicians or, nurse anesthetists, or nurse-midwives and organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

SB546,61 Section 61. 655.002 (1) (e) of the statutes is amended to read:

SB546,32,20 655.002 (1) (e) A corporation organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

SB546,62 Section 62. 655.002 (1) (em) of the statutes is amended to read:

SB546,32,24 655.002 (1) (em) Any organization or enterprise not specified under par. (d) or (e) that is organized and operated in this state for the primary purpose of providing the medical services of physicians or, nurse anesthetists, or nurse-midwives.

SB546,63 Section 63. 655.002 (2) (a) of the statutes is amended to read:

SB546,33,4 655.002 (2) (a) A physician or , nurse anesthetist, or nurse-midwife for whom this state is a principal place of practice but who practices his or her profession fewer than 241 hours in a fiscal year, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession.

SB546,64 Section 64. 655.002 (2) (b) of the statutes is amended to read:

SB546,33,12 655.002 (2) (b) Except as provided in sub. (1) (b), a physician or, nurse anesthetist, or nurse-midwife for whom this state is not a principal place of practice, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession in this state. For a health care provider who elects to be subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is in this state and that is outside the scope of an exemption under s. 655.003 (1) or (3) or (4).

SB546,65 Section 65. 655.003 (1) of the statutes is amended to read:

SB546,33,17 655.003 (1) A physician or, a nurse anesthetist, or a nurse-midwife who is a state, county, or municipal employee, or federal employee or contractor covered under the federal tort claims act, as amended, and who is acting within the scope of his or her employment or contractual duties.

SB546,66 Section 66. 655.003 (3) of the statutes is amended to read:

SB546,33,23 655.003 (3) A physician or, a nurse anesthetist, or a nurse-midwife who provides professional services under the conditions described in s. 146.89 or 257.03 (1), with respect to those professional services provided by the physician or, nurse anesthetist, or nurse-midwife for which he or she is covered by s. 165.25 and considered an agent of the department, as provided in s. 165.25 (6) (b).

SB546,67 Section 67. 655.003 (4) of the statutes is created to read:

SB546,34,2 655.003 (4) A nurse-midwife who is considered to be an employee of the federal public health service under 42 USC 233 (g).

SB546,68 Section 68. 655.005 (2) (a) of the statutes is amended to read:

SB546,34,7 655.005 (2) (a) An employee of a health care provider if the employee is a physician or a nurse anesthetist or is a health care practitioner who is providing health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist.

SB546,69 Section 69 . 655.005 (2) (a) of the statutes, as affected by 2013 Wisconsin Act .... (this act), is amended to read:

SB546,34,13 655.005 (2) (a) An employee of a health care provider if the employee is a physician or a, nurse anesthetist, or nurse-midwife or is a health care practitioner who is providing health care services that are not under the direction and supervision of a physician or, nurse anesthetist, or nurse-midwife.

SB546,70 Section 70. 655.005 (2) (b) of the statutes is amended to read:

SB546,34,23 655.005 (2) (b) A service corporation organized under s. 180.1903 by health care professionals, as defined under s. 180.1901 (1m), if the board of governors determines that it is not the primary purpose of the service corporation to provide the medical services of physicians or, nurse anesthetists, or nurse-midwives. The board of governors may not determine under this paragraph that it is not the primary purpose of a service corporation to provide the medical services of physicians or, nurse anesthetists, or nurse-midwives unless more than 50% of the shareholders of the service corporation are neither not physicians nor, nurse anesthetists, or nurse-midwives.

SB546,71 Section 71. 655.23 (5m) of the statutes is amended to read:

SB546,35,3 655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of a physician or, nurse anesthetist, or nurse-midwife and his or her corporation, partnership, or other organization or enterprise under s. 655.002 (1) (d), (e), or (em).

SB546,72 Section 72. 655.27 (3) (a) 4. of the statutes is amended to read:

SB546,35,8 655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e), (em), or (f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or, nurse anesthetist , or nurse-midwife.

SB546,73 Section 73. 655.27 (3) (b) 2f. of the statutes is created to read:

SB546,35,14 655.27 (3) (b) 2f. With respect to fees paid by nurse-midwives, the rule may provide for a separate payment classification or for a payment classification that is combined with one or more other categories of health care providers, as the commissioner, after approval by the board of governors, determines is appropriate for pooling risks under the fund.

SB546,74 Section 74. 655.27 (3) (b) 2m. of the statutes is amended to read:

SB546,35,22 655.27 (3) (b) 2m. In addition to the fees and payment classifications described under subds. 1. and 2. to 2f., the commissioner, after approval by the board of governors, may by rule establish a separate payment classification for physicians satisfying s. 655.002 (1) (b) and, a separate fee for nurse anesthetists satisfying s. 655.002 (1) (b), and a separate fee for nurse-midwives satisfying s. 655.002 (1) (b) which take into account the loss experience of health care providers for whom Michigan is a principal place of practice.

SB546,75 Section 75. 655.275 (5) (b) 3. of the statutes is created to read:

SB546,35,25 655.275 (5) (b) 3. If a claim was paid for damages arising out of the rendering of care by a nurse-midwife, with at least one nurse-midwife.

SB546,76 Section 76 . Nonstatutory provisions.

SB546,36,6 (1) Expiration of term of member on board of governors. Notwithstanding the length of terms specified for the members of the board of governors under section 619.04 (3) of the statutes, as affected by this act, the initial public member named by the Wisconsin Nurses Association shall be appointed for a term expiring on May 1, 2015.

SB546,36,12 (2 ) Notice of effective date of rule for fees. The commissioner of insurance shall promulgate a rule under section 655.27 (3) (b) of the statutes, as affected by this act, that takes into account participation in the injured patients and families compensation fund by nurse-midwives. When the rule has been promulgated and is in effect, the commissioner of insurance shall publish a notice in the Wisconsin Administrative Register that specifies the effective date of the rule.

SB546,77 Section 77. Initial applicability.

SB546,36,18 (1) The treatment of section 71.07 (9e) (h) of the statutes first applies to taxable years beginning on January 1 of the year in which this subsection takes effect, except that if this subsection takes effect on or after August 1 the treatment of section 71.07 (9e) (h) of the statutes first applies to taxable years beginning on January 1 of the year following the year in which this subsection takes effect.

SB546,78 Section 78. Effective dates. This act takes effect on the day after publication, except as follows: