SB21: Bill Text

SB21,2744 Section 2744. 102.07 (8) (c) of the statutes is amended to read:

SB21,1081,16 102.07 (8) (c) The department office may not admit in evidence any state or federal laws, regulations, documents law, regulation, or document granting operating authority, or licenses license when determining whether an independent contractor meets the conditions specified in par. (b) 1. or 3.

SB21,2745 Section 2745. 102.07 (11) of the statutes is amended to read:

SB21,1082,2 102.07 (11) The department office may by rule prescribe classes of volunteer workers who may, at the election of the person for whom the service is being performed, be deemed considered to be employees for the purposes of this chapter. Election shall be by endorsement upon the that person's worker's compensation insurance policy with written notice to the department office. In the case of an employer that is exempt from insuring liability, election shall be by written notice to the department office. The department office shall by rule prescribe the means and manner in which notice of election by the employer is to be provided to the volunteer workers.

SB21,2746 Section 2746. 102.07 (12m) of the statutes is renumbered 102.07 (12m) (b) and amended to read:

SB21,1082,13 102.07 (12m) (b) A student of a public school, as described in s. 115.01 (1), or a private school, as defined in s. 115.001 (3r), or an institution of higher education, while he or she is engaged in performing services as part of a school work training, work experience, or work study program, and who is not on the payroll of an employer that is providing the work training or work experience or who is not otherwise receiving compensation on which a worker's compensation carrier could assess premiums on that employer, is an employee of a school district or, private school, or institution of higher education that elects under s. 102.077 to name the student as its employee.

SB21,2747 Section 2747. 102.07 (12m) (a) of the statutes is created to read:

SB21,1082,15 102.07 (12m) (a) In this subsection:

SB21,1082,20 1. "Institution of higher education" means an institution within the University of Wisconsin System, a technical college, a tribally controlled college controlled by an Indian tribe that has elected under s. 102.05 (2) to become subject to this chapter, a school approved under s. 38.50, or a private, nonprofit institution of higher education located in this state.

SB21,1082,21 2. "Private school" has the meaning given in s. 115.001 (3r).

SB21,1082,22 3. "Public school" means a school described in s. 115.01 (1).

SB21,2748 Section 2748. 102.076 (2) of the statutes is amended to read:

SB21,1083,5 102.076 (2) If a corporation has not more than 10 stockholders, not more than 2 officers, and no other employees and is not otherwise required under this chapter to have a policy of worker's compensation insurance, an officer of that corporation who elects not to be subject to this chapter shall file a notice of that election with the department office on a form approved by the department office. The election is effective until the officer rescinds it the election by notifying the department office in writing.

SB21,2749 Section 2749. 102.077 (1) of the statutes is amended to read:

SB21,1083,18 102.077 (1) A school district or a , private school, as defined in s. 115.001 (3r), or institution of higher education may elect to name as its employee for purposes of this chapter a student described in s. 102.07 (12m) (b) by an endorsement on its policy of worker's compensation insurance or, if the school district or, private school, or institution of higher education is exempt from the duty to insure under s. 102.28 (2) (a), by filing a declaration with the department in the manner provided in s. 102.31 (2) (a) naming the student as an employee of the school district or, private school, or institution of higher education for purposes of this chapter. A declaration under this subsection shall list the name of the student to be covered under this chapter, the name and address of the employer that is providing the work training or work experience for that student, and the title, if any, of the work training, work experience, or work study program in which the student is participating.

SB21,2750 Section 2750 . 102.077 (1) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,1084,7 102.077 (1) A school district, private school, or institution of higher education may elect to name as its employee for purposes of this chapter a student described in s. 102.07 (12m) (b) by an endorsement on its policy of worker's compensation insurance or, if the school district, private school, or institution of higher education is exempt from the duty to insure under s. 102.28 (2) (a), by filing a declaration with the department office in the manner provided in s. 102.31 (2) (a) naming the student as an employee of the school district, private school, or institution of higher education for purposes of this chapter. A declaration under this subsection shall list the name of the student to be covered under this chapter, the name and address of the employer that is providing the work training or work experience for that student, and the title, if any, of the work training, work experience, or work study program in which the student is participating.

SB21,2751 Section 2751. 102.077 (2) of the statutes is amended to read:

SB21,1084,14 102.077 (2) A school district or, private school, or institution of higher education may revoke a declaration under sub. (1) by providing written notice to the department in the manner provided in s. 102.31 (2) (a), the student , and the employer who is providing the work training or work experience for that student. A revocation under this subsection is effective 30 days after the department receives notice of that revocation.

SB21,2752 Section 2752 . 102.077 (2) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,1084,22 102.077 (2) A school district, private school, or institution of higher education may revoke a declaration under sub. (1) by providing written notice to the department office in the manner provided in s. 102.31 (2) (a), the student, and the employer who is providing the work training or work experience for that student. A revocation under this subsection is effective 30 days after the department office receives notice of that revocation.

SB21,2753 Section 2753. 102.08 of the statutes is amended to read:

SB21,1085,11 102.08 Administration for state employees. The department of administration has responsibility for the timely delivery of benefits payable under this chapter to employees of the state and their dependents and other functions of the state as an employer under this chapter. The department of administration may delegate this authority that responsibility to employing departments and agencies and require such reports as it deems considers necessary to accomplish this purpose. The department of administration or its delegated authorities shall file with the department of workforce development office the reports that are required of all employers. The department of workforce development office shall monitor the delivery of benefits payable under this chapter to state employees and their dependents and shall consult with and advise the department of administration in the manner and at the times necessary to ensure prompt and proper delivery of those benefits.

SB21,2754 Section 2754. 102.11 (1) (am) 1. of the statutes is amended to read:

SB21,1085,19 102.11 (1) (am) 1. The employee is a member of a class of employees that does the same type of work at the same location and, in the case of an employee in the service of the state, is employed in the same office, department, independent agency, authority, institution, association, society, or other body in state government or, if the department office determines appropriate, in the same subunit of an office, department, independent agency, authority, institution, association, society, or other body in state government.

SB21,2755 Section 2755. 102.12 of the statutes is amended to read:

SB21,1086,15 102.12 Notice of injury, exception, laches. No claim for compensation may be maintained unless, within 30 days after the occurrence of the injury or within 30 days after the employee knew or ought to have known the nature of his or her disability and its relation to the employment, actual notice was received by the employer or by an officer, manager, or designated representative of an employer. If no representative has been designated by posters placed in one or more conspicuous places where notices to employees are customarily posted, then notice received by any superior is sufficient. Absence of notice does not bar recovery if it is found that the employer was not misled thereby by that absence. Regardless of whether notice was received, if no payment of compensation, other than medical treatment or burial expense, is made, and and if no application is filed with the department office within 2 years from after the date of the injury or death, or from or the date the employee or his or her dependent knew or ought to have known the nature of the disability and its relation to the employment, the right to compensation therefor for the injury or death is barred, except that the right to compensation is not barred if the employer knew or should have known, within the 2-year period, that the employee had sustained the injury on which the claim is based. Issuance of notice of a hearing on the department's division's own motion has the same effect for the purposes of this section as the filing of an application. This section does not affect any claim barred under s. 102.17 (4).

SB21,2756 Section 2756. 102.125 of the statutes is amended to read:

SB21,1087,5 102.125 Fraudulent claims reporting and investigation. If an insurer or self-insured employer has evidence that a claim is false or fraudulent in violation of s. 943.395 and if the insurer or self-insured employer is satisfied that reporting the claim to the department office will not impede its ability to defend the claim, the insurer or self-insured employer shall report the claim to the department office. The department office may require an insurer or self-insured employer to investigate an allegedly false or fraudulent claim and may provide the insurer or self-insured employer with any records of the department office relating to that claim. An insurer or self-insured employer that investigates a claim under this section shall report on the results of that investigation to the department office. If based on the investigation the department office has a reasonable basis to believe that a violation of s. 943.395 has occurred, the department office shall refer the results of the investigation to the district attorney of the county in which the alleged violation occurred for prosecution.

SB21,2757 Section 2757. 102.13 (1) (c) of the statutes is amended to read:

SB21,1087,14 102.13 (1) (c) So long as the employee, after a written request of the employer or insurer which that complies with par. (b), refuses to submit to or in any way obstructs the examination, the employee's right to begin or maintain any proceeding for the collection of compensation is suspended, except as provided in sub. (4). If the employee refuses to submit to the examination after direction by the department division or an examiner, or in any way obstructs the examination, the employee's right to the weekly indemnity which that accrues and becomes payable during the period of that refusal or obstruction, is barred, except as provided in sub. (4).

SB21,2758 Section 2758. 102.13 (1) (d) 2. of the statutes is amended to read:

SB21,1087,20 102.13 (1) (d) 2. Any physician, chiropractor, psychologist, dentist, physician assistant, advanced practice nurse prescriber, or podiatrist who attended a worker's compensation claimant for any condition or complaint reasonably related to the condition for which the claimant claims compensation may be required to testify before the department division when the department division so directs.

SB21,2759 Section 2759. 102.13 (1) (d) 3. of the statutes is amended to read:

SB21,1088,3 102.13 (1) (d) 3. Notwithstanding any statutory provisions except par. (e), any physician, chiropractor, psychologist, dentist, physician assistant, advanced practice nurse prescriber, or podiatrist attending a worker's compensation claimant for any condition or complaint reasonably related to the condition for which the claimant claims compensation may furnish to the employee, employer, worker's compensation insurer, or the department the office, or the division information and reports relative to a compensation claim.

SB21,2760 Section 2760. 102.13 (1) (f) of the statutes is amended to read:

SB21,1088,7 102.13 (1) (f) If an employee claims compensation under s. 102.81 (1), the department office may require the employee to submit to physical or vocational examinations under this subsection.

SB21,2761 Section 2761. 102.13 (2) (a) of the statutes is amended to read:

SB21,1088,19 102.13 (2) (a) An employee who reports an injury alleged to be work-related or who files an application for hearing waives any physician-patient, psychologist-patient or chiropractor-patient privilege with respect to any condition or complaint reasonably related to the condition for which the employee claims compensation. Notwithstanding ss. 51.30 and 146.82 and any other law, any physician, chiropractor, psychologist, dentist, podiatrist, physician assistant, advanced practice nurse prescriber, hospital, or health care provider shall, within a reasonable time after written request by the employee, employer, worker's compensation insurer, or department office, or division, or its representative, provide that person with any information or written material reasonably related to any injury for which the employee claims compensation.

SB21,2762 Section 2762. 102.13 (2) (c) of the statutes is amended to read:

SB21,1089,10 102.13 (2) (c) Except as provided in this paragraph, if an injured employee has a period of temporary disability that exceeds 3 weeks or a permanent disability, if the injured employee has undergone surgery to treat his or her injury, other than surgery to correct a hernia, or if the injured employee sustained an eye injury requiring medical treatment on 3 or more occasions off the employer's premises, the department office may by rule require the insurer or self-insured employer to submit to the department office a final report of the employee's treating practitioner. The department office may not require an insurer or self-insured employer to submit to the department office a final report of an employee's treating practitioner when the insurer or self-insured employer denies the employee's claim for compensation and the employee does not contest that denial. A treating practitioner may charge a reasonable fee for the completion of the final report, but may not require prepayment of that fee. An insurer or self-insured employer that disputes the reasonableness of a fee charged for the completion of a treatment practitioner's final report may submit that dispute to the department office for resolution under s. 102.16 (2).

SB21,2763 Section 2763. 102.13 (3) of the statutes is amended to read:

SB21,1089,24 102.13 (3) If 2 or more physicians, chiropractors, psychologists, dentists or podiatrists disagree as to the extent of an injured employee's temporary disability, the end of an employee's healing period, an employee's ability to return to work at suitable available employment, or the necessity for further treatment or for a particular type of treatment, the department division may appoint another physician, chiropractor, psychologist, dentist or podiatrist to examine the employee and render an opinion as soon as possible. The department division shall promptly notify the parties of this appointment. If the employee has not returned to work, payment for temporary disability shall continue until the department division receives the opinion. The employer or its insurance carrier or both shall pay for the examination and opinion. The employer or insurance carrier or both shall receive appropriate credit for any overpayment to the employee determined by the department division after receipt of the opinion.

SB21,2764 Section 2764. 102.13 (4) of the statutes is amended to read:

SB21,1090,15 102.13 (4) The rights of employees right of an employee to begin or maintain proceedings for the collection of compensation and to receive weekly indemnities which that accrue and become payable shall not be suspended or barred under sub. (1) when an the employee refuses to submit to a physical examination, upon the request of the employer or worker's compensation insurer or at the direction of the department division or an examiner, which that would require the employee to travel a distance of 100 miles or more from his or her place of residence, unless the employee has claimed compensation for treatment from a practitioner whose office is located 100 miles or more from the employee's place of residence or the department division or examiner determines that any other circumstances warrant the examination. If the employee has claimed compensation for treatment from a practitioner whose office is located 100 miles or more from the employee's place of residence, the employer or insurer may request, or the department division or an examiner may direct, the employee to submit to a physical examination in the area where the employee's treatment practitioner is located.

SB21,2765 Section 2765. 102.13 (5) of the statutes is amended to read:

SB21,1090,25 102.13 (5) The department division may refuse to receive testimony as to conditions determined from an autopsy if it appears that the party offering the testimony had procured the autopsy and had failed to make reasonable effort to notify at least one party in adverse interest or the department division at least 12 hours before the autopsy of the time and place it at which the autopsy would be performed, or that the autopsy was performed by or at the direction of the coroner or medical examiner or at the direction of the district attorney for purposes not authorized by under ch. 979. The department division may withhold findings until an autopsy is held in accordance with its directions.

SB21,2766 Section 2766. 102.14 (title) of the statutes is amended to read:

SB21,1091,2 102.14 (title) Jurisdiction of department office; advisory committee.

SB21,2767 Section 2767. 102.14 (1) of the statutes is amended to read:

SB21,1091,5 102.14 (1) This Except as otherwise provided, this chapter shall be administered by the department office.

SB21,2768 Section 2768. 102.14 (2) of the statutes is amended to read:

SB21,1091,15 102.14 (2) The council on worker's compensation shall advise the department office in carrying out the purposes of this chapter . Such council, shall submit its recommendations with respect to amendments to this chapter to each regular session of the legislature, and shall report its views upon any pending bill relating to this chapter to the proper legislative committee. At the request of the chairpersons of the senate and assembly committees on labor, the department office shall schedule a meeting of the council with the members of the senate and assembly committees on labor to review and discuss matters of legislative concern arising under this chapter.

SB21,2769 Section 2769. 102.15 (1) of the statutes is amended to read:

SB21,1091,18 102.15 (1) Subject to this chapter, the department division may adopt its own rules of procedure and may change the same from time to time.

SB21,2770 Section 2770. 102.15 (2) of the statutes is amended to read:

SB21,1091,22 102.15 (2) The department division may provide by rule the conditions under which transcripts or electronic recordings of testimony and proceedings shall be furnished.

SB21,2771 Section 2771. 102.15 (3) of the statutes is amended to read:

SB21,1092,5 102.15 (3) All testimony at any hearing held under this chapter shall be taken down by a stenographic reporter, except that in case of an emergency, as determined by recorded by electronic means. That testimony need not be transcribed, unless the examiner conducting the hearing, testimony may be recorded by a recording machine orders otherwise. The division shall furnish a copy of an electronic recording made under this subsection or a transcript ordered under this subsection to the parties upon payment of any fee required by the division by rule.

SB21,2772 Section 2772. 102.16 (1) of the statutes is amended to read:

SB21,1092,23 102.16 (1) Any controversy concerning compensation or a violation of sub. (3), including controversies a controversy in which the state may be a party, shall be submitted to the department division in the manner and with the effect provided in this chapter. Every compromise of any claim for compensation may be reviewed and set aside, modified or confirmed by the department within Within one year from after the date the on which a compromise of any claim for compensation is filed with the department, or from division or the date on which an award has been entered, based thereon, or the department may take that action based on a compromise, the division, on its own motion or upon application made within one year that period, may review and set aside, modify, or confirm the compromise. Unless the word "compromise" appears in a stipulation of settlement, the settlement shall not be deemed considered a compromise, and further claim is not barred except as provided in s. 102.17 (4) regardless of whether an award is made. The employer, insurer, or dependent under s. 102.51 (5) shall have equal rights with the employee to have review of a compromise or any other stipulation of settlement reviewed under this subsection. Upon petition filed with the department division, the department division may set aside the award or otherwise determine the rights of the parties.

SB21,2773 Section 2773. 102.16 (1m) (a) of the statutes is amended to read:

SB21,1093,16 102.16 (1m) (a) If an insurer or self-insured employer concedes by compromise under sub. (1) or stipulation under s. 102.18 (1) (a) that the insurer or self-insured employer is liable under this chapter for any health services provided to an injured employee by a health service provider, but disputes the reasonableness of the fee charged by the health service provider, the department division may include in its order confirming the compromise or stipulation a determination made by the office under sub. (2) as to the reasonableness of the fee or the department, if such a determination has not yet been made, the division may notify, or direct the insurer or self-insured employer to notify, the health service provider under sub. (2) (b) that the reasonableness of the fee is in dispute. The department shall deny payment of a health service fee that the department determines under this paragraph to be unreasonable. A health service provider and an insurer or self-insured employer that are parties to a fee dispute under this paragraph are bound by the department's determination under this paragraph on the reasonableness of the disputed fee, unless that determination is set aside, reversed, or modified by the department under sub. (2) (f) or is set aside on judicial review as provided in sub. (2) (f).

SB21,2774 Section 2774. 102.16 (1m) (b) of the statutes is amended to read:

SB21,1094,15 102.16 (1m) (b) If an insurer or self-insured employer concedes by compromise under sub. (1) or stipulation under s. 102.18 (1) (a) that the insurer or self-insured employer is liable under this chapter for any treatment provided to an injured employee by a health service provider, but disputes the necessity of the treatment, the department division may include in its order confirming the compromise or stipulation a determination made by the office under sub. (2m) as to the necessity of the treatment or the department, if such a determination has not yet been made, the division may notify, or direct the insurer or self-insured employer to notify, the health service provider under sub. (2m) (b) that the necessity of the treatment is in dispute. Before determining under this paragraph the necessity of treatment provided to an injured employee, the department may, but is not required to, obtain the opinion of an expert selected by the department who is qualified as provided in sub. (2m) (c). The standards promulgated under sub. (2m) (g) shall be applied by an expert and by the department in rendering an opinion as to, and in determining, necessity of treatment under this paragraph. In cases in which no standards promulgated under sub. (2m) (g) apply, the department shall find the facts regarding necessity of treatment. The department shall deny payment for any treatment that the department determines under this paragraph to be unnecessary. A health service provider and an insurer or self-insured employer that are parties to a dispute under this paragraph over the necessity of treatment are bound by the department's determination under this paragraph on the necessity of the disputed treatment, unless that determination is set aside, reversed, or modified by the department under sub. (2m) (e) or is set aside on judicial review as provided in sub. (2m) (e).

SB21,2775 Section 2775. 102.16 (1m) (c) of the statutes is amended to read:

SB21,1095,10 102.16 (1m) (c) If an insurer or self-insured employer concedes by compromise under sub. (1) or stipulation under s. 102.18 (1) (a) that the insurer or self-insured employer is liable under this chapter for the cost of a prescription drug dispensed under s. 102.425 (2) for outpatient use by an injured employee, but disputes the reasonableness of the amount charged for the prescription drug, the department division may include in its order confirming the compromise or stipulation a determination made by the office under s. 102.425 (4m) as to the reasonableness of the prescription drug charge or the department, if such a determination has not yet been made, the division may notify, or direct the insurer or self-insured employer to notify, the pharmacist or practitioner dispensing the prescription drug under s. 102.425 (4m) (b) that the reasonableness of the prescription drug charge is in dispute. The department shall deny payment of a prescription drug charge that the department determines under this paragraph to be unreasonable. A pharmacist or practitioner and an insurer or self-insured employer that are parties to a dispute under this paragraph over the reasonableness of a prescription drug charge are bound by the department's determination under this paragraph on the reasonableness of the disputed prescription drug charge, unless that determination is set aside, reversed, or modified by the department under s. 102.425 (4m) (e) or is set aside on judicial review as provided in s. 102.425 (4m) (e).

SB21,2776 Section 2776. 102.16 (2) (a) of the statutes is amended to read:

SB21,1095,25 102.16 (2) (a) Except as provided in this paragraph, the department office has jurisdiction under this subsection, sub. (1m) (a), and s. 102.17 to resolve a dispute between a health service provider and an insurer or self-insured employer over the reasonableness of a fee charged by the health service provider for health services provided to an injured employee who claims benefits under this chapter. A health service provider may not submit a fee dispute to the department office under this subsection before all treatment by the health service provider of the employee's injury has ended if the amount in controversy, whether based on a single charge or a combination of charges for one or more days of service, is less than $25. After all treatment by a health service provider of an employee's injury has ended, the health service provider may submit any fee dispute to the department office, regardless of the amount in controversy. The department office shall deny payment of a health service fee that the department office determines under this subsection to be unreasonable.

SB21,2777 Section 2777. 102.16 (2) (am) of the statutes is amended to read:

SB21,1096,6 102.16 (2) (am) A health service provider and an insurer or self-insured employer that are parties to a fee dispute under this subsection are bound by the department's office's determination under this subsection on the reasonableness of the disputed fee, unless that determination is set aside on judicial review as provided in par. (f).

SB21,2778 Section 2778. 102.16 (2) (b) of the statutes is amended to read:

SB21,1096,15 102.16 (2) (b) An insurer or self-insured employer that disputes the reasonableness of a fee charged by a health service provider or the department office under sub. (1m) (a) or s. 102.18 (1) (bg) 1. shall provide reasonable written notice to the health service provider that the fee is being disputed. After receiving reasonable written notice under this paragraph or under sub. (1m) (a) or s. 102.18 (1) (bg) 1. that a health service fee is being disputed, a health service provider may not collect the disputed fee from, or bring an action for collection of the disputed fee against, the employee who received the services for which the fee was charged.

SB21,2779 Section 2779. 102.16 (2) (c) of the statutes is amended to read:

SB21,1097,2 102.16 (2) (c) After a fee dispute is submitted to the department office, the insurer or self-insured employer that is a party to the dispute shall provide to the department office information on that fee and information on fees charged by other health service providers for comparable services. The insurer or self-insured employer shall obtain the information on comparable fees from a database that is certified by the department office under par. (h). Except as provided in par. (e) 1., if the insurer or self-insured employer does not provide the information required under this paragraph, the department office shall determine that the disputed fee is reasonable and order that it be paid. If the insurer or self-insured employer provides the information required under this paragraph, the department office shall use that information to determine the reasonableness of the disputed fee.

SB21,2780 Section 2780. 102.16 (2) (d) of the statutes is amended to read:

SB21,1097,19 102.16 (2) (d) The department office shall analyze the information provided to the department office under par. (c) according to the criteria provided in this paragraph to determine the reasonableness of the disputed fee. Except as provided in 2011 Wisconsin Act 183, section 30 (2) (b), the department office shall determine that a disputed fee is reasonable and order that the disputed fee be paid if that fee is at or below the mean fee for the health service procedure for which the disputed fee was charged, plus 1.2 standard deviations from that mean, as shown by data from a database that is certified by the department office under par. (h). Except as provided in 2011 Wisconsin Act 183, section 30 (2) (b), the department office shall determine that a disputed fee is unreasonable and order that a reasonable fee be paid if the disputed fee is above the mean fee for the health service procedure for which the disputed fee was charged, plus 1.2 standard deviations from that mean, as shown by data from a database that is certified by the department office under par. (h), unless the health service provider proves to the satisfaction of the department office that a higher fee is justified because the service provided in the disputed case was more difficult or more complicated to provide than in the usual case.

SB21,2781 Section 2781. 102.16 (2) (e) 1. of the statutes is amended to read:

SB21,1098,3 102.16 (2) (e) 1. Subject to subd. 2., if an insurer or self-insured employer that disputes the reasonableness of a fee charged by a health service provider cannot provide information on fees charged by other health service providers for comparable services because the database to which the insurer or self-insured employer subscribes is not able to provide accurate information for the health service procedure at issue, the department office may use any other information that the department office considers to be reliable and relevant to the disputed fee to determine the reasonableness of the disputed fee.

SB21,2782 Section 2782. 102.16 (2) (e) 2. of the statutes is amended to read:

SB21,1098,7 102.16 (2) (e) 2. Notwithstanding subd. 1., the department office may use only a hospital radiology database that has been certified by the department office under par. (h) to determine the reasonableness of a hospital fee for radiology services.

SB21,2783 Section 2783. 102.16 (2) (f) of the statutes is amended to read:

SB21,1098,16 102.16 (2) (f) Within 30 days after a determination under this subsection, the department office may set aside, reverse, or modify the determination for any reason that the department office considers sufficient. Within 60 days after a determination under this subsection, the department office may set aside, reverse, or modify the determination on grounds of mistake. A health service provider, insurer, or self-insured employer that is aggrieved by a determination of the department office under this subsection may seek judicial review of that determination in the same manner that compensation claims are reviewed under s. 102.23.

SB21,2784 Section 2784. 102.16 (2) (h) of the statutes is amended to read:

SB21,1099,2 102.16 (2) (h) The department office shall promulgate rules establishing procedures and requirements for the fee dispute resolution process under this subsection, including rules specifying the standards that health service fee databases must meet for certification under this paragraph. Using those standards, the department office shall certify databases of the health service fees that various health service providers charge. In certifying databases under this paragraph, the department office shall certify at least one database of hospital fees for radiology services, including diagnostic and interventional radiology, diagnostic ultrasound, and nuclear medicine.

SB21,2785 Section 2785. 102.16 (2m) (a) of the statutes is amended to read:

SB21,1099,16 102.16 (2m) (a) Except as provided in this paragraph, the department office has jurisdiction under this subsection, sub. (1m) (b), and s. 102.17 to resolve a dispute between a health service provider and an insurer or self-insured employer over the necessity of treatment provided for an injured employee who claims benefits under this chapter. A health service provider may not submit a dispute over necessity of treatment to the department office under this subsection before all treatment by the health service provider of the employee's injury has ended if the amount in controversy, whether based on a single charge or a combination of charges for one or more days of service, is less than $25. After all treatment by a health service provider of an employee's injury has ended, the health service provider may submit any dispute over necessity of treatment to the department office, regardless of the amount in controversy. The department office shall deny payment for any treatment that the department office determines under this subsection to be unnecessary.