SB665: Bill Text

SB665,32 Section 32. 102.17 (1) (cg) of the statutes is amended to read:

SB665,19,17 102.17 (1) (cg) 1. Except as provided in subd. 2m., the department division shall require each applicant for a license under par. (c) who is an individual to provide the department division with the applicant's social security number, and shall require each applicant for a license under par. (c) who is not an individual to provide the department division with the applicant's federal employer identification number, when initially applying for or applying to renew the license.

SB665,19,24 2. If an applicant who is an individual fails to provide the applicant's social security number to the department division or if an applicant who is not an individual fails to provide the applicant's federal employer identification number to the department division, the department division may not issue or renew a license under par. (c) to or for the applicant unless the applicant is an individual who does not have a social security number and the applicant submits a statement made or subscribed under oath or affirmation as required under subd. 2m.

SB665,20,5 2m. If an applicant who is an individual does not have a social security number, the applicant shall submit a statement made or subscribed under oath or affirmation to the department division that the applicant does not have a social security number. The form of the statement shall be prescribed by the department division. A license issued in reliance upon a false statement submitted under this subdivision is invalid.

SB665,20,11 3. The department of workforce development division may not disclose any information received under subd. 1. to any person except to the department of revenue for the sole purpose of requesting certifications under s. 73.0301, the department of workforce development for the sole purpose of requesting certifications under s. 108.227, or the department of children and families for purposes of administering s. 49.22.

SB665,33 Section 33. 102.17 (1) (cr) of the statutes is amended to read:

SB665,20,18 102.17 (1) (cr) The department division shall deny an application for the issuance or renewal of a license under par. (c), or revoke such a license already issued, if the department of revenue certifies under s. 73.0301 that the applicant or licensee is liable for delinquent taxes. Notwithstanding par. (c), an action taken under this paragraph is subject to review only as provided under s. 73.0301 (5) and not as provided in ch. 227.

SB665,34 Section 34. 102.17 (1) (ct) of the statutes is repealed and recreated to read:

SB665,20,25 102.17 (1) (ct) The division shall deny an application for the issuance or renewal of a license under par. (c), or revoke such a license already issued, if the department certifies under s. 108.227 that the applicant or licensee is liable for delinquent contributions, as defined in s. 108.227 (1) (d). Notwithstanding par. (c), an action taken under this paragraph is subject to review only as provided under s. 108.227 (5) and not as provided in ch. 227.

SB665,35 Section 35. 102.17 (2) of the statutes is amended to read:

SB665,21,13 102.17 (2) If the division has reason to believe that the payment of compensation has not been made, the division may on its own motion give notice to the parties, in the manner provided for the service of an application, of a time and place when a hearing will be held for the purpose of determining the facts, or if the department has reason to believe that the payment of compensation has not been made, the department may request that the division give such a notice of hearing. The notice shall contain a statement of the matter to be considered. All provisions of this chapter governing proceedings on an application shall apply, insofar as applicable, to a proceeding under this subsection. When the division schedules a hearing on its own motion, as provided in this subsection, neither the division does not become nor the department becomes a party in interest, and is not neither the division nor the department shall be required to appear as a party at the hearing.

SB665,36 Section 36. 102.175 (2) of the statutes is amended to read:

SB665,21,22 102.175 (2) If after a hearing or a prehearing conference the department or the division determines that an injured employee is entitled to compensation but that there remains in dispute only the issue of which of 2 or more parties is liable for that compensation, the department or the division may order one or more parties to pay compensation in an amount, time, and manner as determined by the department or the division. If the department or the division later determines that another party is liable for compensation, the department or the division shall order that other party to reimburse any party that was ordered to pay compensation under this subsection.

SB665,37 Section 37. 102.18 (1) (bg) 1. of the statutes is amended to read:

SB665,22,9 102.18 (1) (bg) 1. If the division finds under par. (b) that an 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 that the reasonableness of the fee charged by the health service provider is in dispute, the division may include in its order under par. (b) a determination made by the department under s. 102.16 (2) as to the reasonableness of the fee or, 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 s. 102.16 (2) (b) that the reasonableness of the fee is in dispute. This subdivision does not apply to a health service provided to an injured employee beginning on the date on which the notice under s. 102.423 (1) (a) is published in the Wisconsin Administrative Register.

SB665,38 Section 38. 102.18 (1) (bp) of the statutes is amended to read:

SB665,23,2 102.18 (1) (bp) If the department or the division determines that the employer or insurance carrier suspended, terminated, or failed to make payments or failed to report an injury as a result of malice or bad faith, the department or the division may include a penalty in an award to an employee for each event or occurrence of malice or bad faith. That penalty is the exclusive remedy against an employer or insurance carrier for malice or bad faith. If the penalty is imposed for an event or occurrence of malice or bad faith that causes a payment that is due an injured employee to be delayed in violation of s. 102.22 (1) or overdue in violation of s. 628.46 (1), the department or the division may not also order an increased payment under s. 102.22 (1) or the payment of interest under s. 628.46 (1). The department or the division may award an amount that the department or the division considers just, not to exceed the lesser of 200 percent of total compensation due or $30,000 for each event or occurrence of malice or bad faith. The department or the division may assess the penalty against the employer, the insurance carrier, or both. Neither the employer nor the insurance carrier is liable to reimburse the other for the penalty amount. The division department may, by rule, define actions that demonstrate malice or bad faith.

SB665,39 Section 39. 102.18 (2) (a) of the statutes is amended to read:

SB665,23,6 102.18 (2) (a) The department shall have and maintain on its staff such examiners as are necessary to hear and decide claims for compensation described in s. 102.16 (1) (b) 1. and to assist in the effective administration of this chapter.

SB665,40 Section 40. 102.18 (5) of the statutes is amended to read:

SB665,23,20 102.18 (5) If it appears to the department or the division that a mistake may have been made as to cause of injury in the findings, order, or award upon an alleged injury based on accident, when in fact the employee was suffering from an occupational disease, within 3 years after the date of the findings, order, or award the department or the division may, upon its own motion, with or without hearing, set aside the findings, order, or award, or the department or the division may take that action upon application made within those 3 years. After an opportunity for hearing, the division may, if in fact the employee is suffering from disease arising out of the employment, make new findings, and a new order or award, or the division may reinstate the previous findings, order, or award. The department may, if in fact the employee is suffering from disease arising out of the employment, make new findings, and a new order or award, or the department may reinstate the previous findings, order, or award when no hearing is requested.

SB665,41 Section 41. 102.18 (6) of the statutes is amended to read:

SB665,24,2 102.18 (6) In case of disease arising out of employment, the department or the division may from time to time review its findings, order, or award, and make new findings, or a new order or award, based on the facts regarding disability or otherwise as those facts may appear at the time of the review. This subsection shall not affect the application of the limitation in s. 102.17 (4).

SB665,42 Section 42. 102.33 (1m) of the statutes is created to read:

SB665,24,8 102.33 (1m) Each employer shall post, in each workplace, a notice in a form approved by the department setting forth employees' rights under this chapter. The department shall, in conjunction with its activities under s. 102.14 (2m), include in the notice information to educate injured employees regarding opiate therapies, opiate addiction, and alternative treatments for pain.

SB665,43 Section 43. 102.33 (2) (b) 7. of the statutes is created to read:

SB665,24,15 102.33 (2) (b) 7. The requester is the department of health services, a county department of social services under s. 46.215 or 46.22, or a county department of human services under s. 46.23, and the request is limited to the name and address of the employee who is the subject of the record, the name and address of the employee's employer, and any financial information about that employee contained in the record.

SB665,44 Section 44. 102.39 of the statutes is repealed.

SB665,45 Section 45. 102.423 of the statutes is created to read:

SB665,24,25 102.423 Health service fee schedule. (1) Health service fee schedule. (a) By January 1, 2019, the department shall establish a schedule of the maximum fees that a health care provider may charge an employer or insurer for health services provided to an injured employee who claims benefits under this chapter. When that schedule is established, the department shall notify the legislative reference bureau and the legislative reference bureau shall publish that notice in the Wisconsin Administrative Register. For the health services in the schedule, the department shall do all of the following:

SB665,25,4 1. Based on sources obtained by the department, determine, to the extent possible, the average negotiated price made for group health benefit plans, as defined in s. 632.745 (9), group health plans, as defined in s. 632.745 (10), and self-insured health plans, as defined in s. 632.745 (24).

SB665,25,8 2. Determine the rates under the program under 42 USC 1395 et seq. for health services using the Medicare billing code system, including Current Procedural Terminology codes, as maintained by the American Medical Association, and Healthcare Common Procedural Coding System codes.

SB665,25,10 3. Set the maximum fee for each health service included in the schedule by doing all of the following:

SB665,25,13 a. Using the rates for health services determined under subd. 2., determine as a percentage the average variance between those amounts and the amounts under subd. 1.

SB665,25,15 b. Increase the rates for health services determined under subd. 2. by the percentage determined under subd. 3. a.

SB665,25,17 c. Subject to subd. 4., increase the amounts determined under subd. 3. b. by 2.5 percent for administrative costs.

SB665,26,5 4. Prior to the date on which the notice is published in the Wisconsin Administrative Register under this paragraph, one or more health care providers may petition the department to hold a public hearing to gather information to be used to determine if the increase under subd. 3. c. for administrative costs is sufficient to pay for the unique administrative costs incurred in treating worker's compensation patients as compared to patients whose bills are paid by other means. If the department determines, based on the request and information gathered and submitted, that the percentage increase under subd. 3. c. for unique administrative costs is generally insufficient to pay for the unique administrative costs incurred by health care providers for treating worker's compensation patients, the department shall establish and apply an alternative increase for the unique administrative costs that is not more than 10 percent of the cost of the service as determined under subd. 3. b.

SB665,26,9 (b) 1. In this paragraph, “consumer price index" means the average of the consumer price index for medical care services over each 12-month period for all urban consumers, U.S. city average, as determined by the bureau of labor statistics of the federal department of labor.

SB665,26,14 2. On each January 1, beginning with January 1, 2020, the department shall adjust the maximum fees established under par. (a) by the percentage difference between the consumer price index for the 12-month period ending on December 31 of the preceding year and the consumer price index for the 12-month period ending on December 31 of the year before the preceding year.

SB665,26,18 (c) No less often than every 10 years, the department shall obtain health service negotiated price data from the sources specified in par. (a) 1., redetermine the average negotiated prices specified in par. (a) 1., and revise the maximum fees established under par. (a) based on that redetermined average.

SB665,26,20 (d) The department shall publish the fee schedule established under par. (a) on the department's Internet site.

SB665,26,25 (2) Liability of employer or insurer. (a) The liability of an employer or insurer for a health service included in the fee schedule established under sub. (1) is limited to the maximum fee allowed under the schedule for that health service as of the date on which the health service was provided or the health care provider's actual fee for the health service as of that date, whichever is less.

SB665,27,4 (b) A health care provider that provides health services to an injured employee under this chapter may not collect, or bring an action to collect, from the injured employee any charge that is in excess of the liability of the employer or insurer under this subsection.

SB665,27,7 (c) This subsection first applies to a health service provided to an injured employee on the date on which the notice under sub. (1) (a) is published in the Wisconsin Administrative Register.

SB665,27,9 (3) Records. Records related to the collection of any information under sub. (1) (a) 1. are not subject to the right of inspection and copying under s. 19.35 (1).

SB665,27,10 (4) Rules. The department shall promulgate rules to implement this section.

SB665,46 Section 46. 102.425 (2m) of the statutes is created to read:

SB665,27,13 102.425 (2m) Opiates and pain relief. (a) In this subsection, “opiate” has the meaning given in s. 961.01 (16).

SB665,27,18 (b) No practitioner may dispense more than a 7-day supply of an opiate to treat an injury for which an employer or insurer is liable under this chapter. Notwithstanding s. 102.16 (2m) (c), a supply greater than a 7-day supply shall be considered to be unnecessary treatment for purposes of s. 102.16 (2m) without the need for a written opinion under s. 102.16 (2m) (c).

SB665,47 Section 47. 102.427 of the statutes is created to read:

SB665,27,22 102.427 Electronic billing. Any health service provider that provides care to an injured employee under this chapter shall use an electronic billing system and be able to receive payments electronically.

SB665,48 Section 48. 102.44 (1) (ag) of the statutes is amended to read:

SB665,28,8 102.44 (1) (ag) Notwithstanding any other provision of this chapter, every employee who is receiving compensation under this chapter for permanent total disability or continuous temporary total disability more than 24 months after the date of injury resulting from an injury that occurred prior to January 1, 2003 2005, shall receive supplemental benefits that shall be payable by the employer or the employer's insurance carrier, or in the case of benefits payable to an employee under s. 102.66, shall be paid by the department out of the fund created under s. 102.65. Those supplemental benefits shall be paid only for weeks of disability occurring after January 1, 2005 2007, and shall continue during the period of such total disability subsequent to that date.

SB665,49 Section 49. 102.44 (1) (am) of the statutes is amended to read:

SB665,28,14 102.44 (1) (am) If the employee is receiving the maximum weekly benefits in effect at the time of the injury, the supplemental benefit for a week of disability occurring after March 2, 2016 the effective date of this paragraph .... [LRB inserts date], shall be an amount that, when added to the regular benefit established for the case, shall equal $669 $711.

SB665,50 Section 50. 102.44 (1) (b) of the statutes is amended to read:

SB665,28,21 102.44 (1) (b) If the employee is receiving a weekly benefit that is less than the maximum benefit that was in effect on the date of the injury, the supplemental benefit for a week of disability occurring after March 2, 2016 the effective date of this paragraph .... [LRB inserts date], shall be an amount sufficient to bring the total weekly benefits to the same proportion of $669 $711 as the employee's weekly benefit bears to the maximum in effect on the date of injury.

SB665,51 Section 51. 102.44 (2) of the statutes is amended to read:

SB665,29,3 102.44 (2) In case of permanent total disability, aggregate indemnity shall be weekly indemnity for the period that the employee may live. Total impairment for industrial use of both eyes, the loss of both arms at or near the shoulder, the loss of both legs at or near the hip, or the loss of one arm at the shoulder and one leg at the hip constitutes permanent total disability. This enumeration is not exclusive, but in other cases the department or the division shall find the facts.

SB665,52 Section 52. 102.44 (6) (b) of the statutes is amended to read:

SB665,29,10 102.44 (6) (b) If during the period set forth in s. 102.17 (4) the employment relationship is terminated by the employer at the time of the injury or by the employee because his or her physical or mental limitations prevent his or her continuing in such employment, or if during that period a wage loss of 15 percent or more occurs, the department or the division may reopen any award and make a redetermination taking into account loss of earning capacity.

SB665,53 Section 53. 102.525 of the statutes is created to read:

SB665,29,15 102.525 Additional payment for permanent partial disability. (1) If any of the following applies during the period set forth in s. 102.17 (4) with respect to an employee who sustains a disability specified under s. 102.52, the number of weeks for which indemnity shall be payable shall be increased by 15 percent:

SB665,29,18 (a) The employment relationship is terminated by the employer at the time of the injury or by the employee because his or her physical or mental limitations prevent his or her continuing in the employment.

SB665,29,19 (b) The percentage of wage loss during the period is 15 percent or more.

SB665,29,21 (2) For the purpose of determining the percentage of wage loss under sub. (1) (b), all of the following apply:

SB665,29,23 (a) Wage loss shall be determined based on wages as determined under s. 102.11.

SB665,29,25 (b) The percentage wage loss shall be determined using actual average wages over a period of at least 13 weeks following the employee's injury.

SB665,30,2 (c) The determination of wage loss may not take into account any of the following:

SB665,30,4 1. Any period during which benefits are payable for temporary disability under s. 102.43 (5).

SB665,30,5 2. Any period during which the employee received benefits under ch. 108.

SB665,30,6 3. Any payments for permanent partial disability under s. 102.52.

SB665,30,10 (3) For the purposes of sub. (1), if an employer makes a good faith offer of employment that is refused by the employee without just cause, the employee is considered to have returned to work at the amount of wages the employee would have received but for the employee's refusal of employment.

SB665,30,12 (4) An increase under sub. (1) shall be applied after the application of any increase under s. 102.53 or 102.54.

SB665,54 Section 54. 102.61 (2) of the statutes is amended to read:

SB665,30,20 102.61 (2) The department, the division, the commission, and the courts shall determine the rights and liabilities of the parties under this section in like manner and with like effect as the department, the division, the commission, and the courts determine other issues under this chapter. A determination under this subsection may include a determination based on the evidence regarding the cost or scope of the services provided by a private rehabilitation counselor under sub. (1m) (a) or the cost or reasonableness of a rehabilitative training program developed under sub. (1m) (a).

SB665,55 Section 55. 102.62 of the statutes is amended to read:

SB665,31,12 102.62 Primary and secondary liability; unchangeable. In case of liability under s. 102.57 or 102.60, the liability of the employer shall be primary and the liability of the insurance carrier shall be secondary. If proceedings are had before the department or the division for the recovery of that liability, the department or the division shall set forth in its award the amount and order of liability as provided in this section. Execution shall not be issued against the insurance carrier to satisfy any judgment covering that liability until execution has first been issued against the employer and has been returned unsatisfied as to any part of that liability. Any provision in any insurance policy undertaking to guarantee primary liability or to avoid secondary liability for a liability under s. 102.57 or 102.60 is void. If the employer has been adjudged bankrupt or has made an assignment for the benefit of creditors, if the employer, other than an individual, has gone out of business or has been dissolved, or if the employer is a corporation and its charter has been forfeited or revoked, the insurer shall be liable for the payment of that liability without judgment or execution against the employer, but without altering the primary liability of the employer.

SB665,56 Section 56. 102.75 (1m) of the statutes is amended to read:

SB665,31,18 102.75 (1m) The moneys collected under subs. (1) and (1g) and under ss. 102.28 (2) and 102.31 (7), together with all accrued interest, shall constitute a separate nonlapsible fund designated as the worker's compensation operations fund. Moneys in the fund may be expended only as provided in ss. 20.427 (1) (ra) and 20.445 (1) (ra), (rb), (rc), and (rp) and may not be used for any other purpose of the state.

SB665,57 Section 57. 102.80 (1) (d) of the statutes is amended to read:

SB665,31,21 102.80 (1) (d) Amounts collected from employees or dependents of employees under s. 102.81 (4) (b) and (c).

SB665,58 Section 58. 102.81 (4) (b) (intro.) of the statutes is amended to read:

SB665,31,25 102.81 (4) (b) (intro.) If the employee or dependent receives compensation from the employee's employer or a 3rd party liable under s. 102.29, pay to the department the lesser of the following:

SB665,59 Section 59. 102.81 (4) (b) 2. of the statutes is amended to read:

SB665,32,3 102.81 (4) (b) 2. The amount after attorney fees and costs that the employee or dependent received from the employer or 3rd party.

SB665,60 Section 60. 102.81 (4) (c) of the statutes is created to read:

SB665,32,7 102.81 (4) (c) If the employee or dependent receives compensation from a 3rd party that is liable under s. 102.29, pay to the department the proceeds as specified under s. 102.29 (1) (b).

SB665,61 Section 61. 102.81 (5) of the statutes is amended to read: