Rule-Making Notices (Hearing Notices)

Optometrists...............................................................291

Physician Assistants...................................................291

(o) For a freestanding ambulatory surgery center, as defined in s. DHS 120.03 (13), per 100 outpatient visits during the last calendar year for which totals are available:...$22.73

(p) For an entity affiliated with a hospital, the greater of $100 or whichever of the following applies:

1. 7.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has occurrence coverage.

2. 10.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has claims-made coverage.

(q) For an organization or enterprise not specified as a partnership or corporation that is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:

1. a. If the total number of employed physicians and nurse anesthetists is from 1 to 10..............................................$51

b. If the total number of employed physicians and nurse anesthetists is from 11 to 100........................................$503

c. If the total number of employed physicians or nurse anesthetists exceeds 100............................................$1,252

2. The following for each full-time equivalent allied health care professional employed by the organization or enterprise not specified as a partnership, corporation, or an operational cooperative health care plan as of the most recent completed survey submitted:

Employed Health Care Professionals Fund Fee

Nurse Practitioners.................................................$ 364

Advanced Nurse Practitioners.....................................510

Nurse Midwives.......................................................3,205

Advanced Nurse Midwives......................................3,351

Advanced Practice Nurse Prescribers..........................510

Chiropractors..............................................................583

Dentists.......................................................................291

Oral Surgeons..........................................................2,186

Podiatrists-Surgical..................................................6,192

Optometrists................................................................291

Physician Assistants....................................................291

SECTION 4. These changes may be enforced under s. Ins 17.01 (2) (d) and (e).

SECTION 5. EFFECTIVE DATE. This rule shall take effect on the first day of the month following publication in the Wisconsin Administrative Register as provided in s. 227.22 (2) (intro.), Stats.

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA-2049 (C04/2011)					Division of Executive Budget and Finance 101 East Wilson Street, 10th Floor P.O. Box 7864 Madison, WI 53707-7864 FAX: [phone]
ADMINISTRATIVE RULES — FISCAL ESTIMATE
1.   Fiscal Estimate Version
X Original ⍽ Updated ⍽ Corrected
2.   Administrative Rule Chapter Title and Number Section Ins 17.28
3.   Subject Injured Patients and Families Compensation Fund Annual fund and Mediation Panel Fees and ISO code amendments for the fiscal year beginning July 1, 2013 and affecting small business.
4.   State Fiscal Effect:
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues					⍽ Increase Costs X Yes ⍽ No   May be possible to absorb       within agency's budget. ⍽ Decrease Costs
5.   Fund Sources Affected: ⍽ GPR   ⍽ FED   ⍽ PRO   ⍽ PRS   X SEG   ⍽ SEG-S						6.   Affected Ch. 20, Stats. Appropriations: None
7.   Local Government Fiscal Effect:
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Revenues ⍽ Decrease Revenues			⍽ Increase Costs ⍽ Decrease Costs
8.   Local Government Units Affected: ⍽ Towns ⍽ Villages ⍽ Cities ⍽ Counties ⍽ School Districts ⍽ WTCS Districts ⍽ Others: None
9.   Private Sector Fiscal Effect (small businesses only):

X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Revenues X Decrease Revenues ⍽ Yes X No   May have significant     economic impact on a     substantial number of     small businesses		⍽ Increase Costs ⍽ Yes X No   May have significant     economic impact on a     substantial number of     small businesses ⍽ Decrease Costs
10.   Types of Small Businesses Affected:
Small businesses that employ physicians or other health care professionals participating in the Fund.
11.   Fiscal Analysis Summary
No significant impact. Slight decrease in fund fees and zero medical mediation fees.
12.   Long-Range Fiscal Implications
None
13.   Name - Prepared by Julie E. Walsh		Telephone Number [phone]		Date June 5, 2013
14.   Name – Analyst Reviewer		Telephone Number		Date
Signature—Secretary or Designee		Telephone Number [phone]		Date June 7, 2013

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA-2049 (R03/2012)	Division of Executive Budget and Finance 101 East Wilson Street, 10th Floor P.O. Box 7864 Madison, WI 53707-7864 FAX: [phone]
ADMINISTRATIVE RULES Fiscal Estimate & Economic Impact Analysis

1. Type of Estimate and Analysis
X Original   ⍽ Updated   ⍽ Corrected
2. Administrative Rule Chapter, Title and Number
Agency 145, ss. Ins 17.01 (3), and 17.28 (3) and (6)
3. Subject
Injured Patients and Families Compensation Fund Annual Fund fees and Mediation Panel Fees, and ISO code amendments for fiscal year beginning July 1, 2013.
4. Fund Sources Affected			5. Chapter 20, Stats. Appropriations Affected
⍽ GPR   ⍽ FED   ⍽ PRO   ⍽ PRS   X SEG   ⍽ SEG-S			None
6. Fiscal Effect of Implementing the Rule
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues		⍽ Increase Costs ⍽ Could Absorb Within Agency's Budget ⍽ Decrease Cost
7. The Rule Will Impact the Following (Check All That Apply)
⍽ State's Economy ⍽ Local Government Units		X Specific Businesses/Sectors ⍽ Public Utility Rate Payers X Small Businesses (if checked, complete Attachment A)
8. Would Implementation and Compliance Costs Be Greater Than $20 million? ⍽ Yes   X No
9. Policy Problem Addressed by the Rule
To establish the annual fees that participating health care providers must pay to the Injured Patients and Families Compensation Fund ("Fund") as required by s. 655.27 (3), Wis. Stats., for fiscal year beginning July 1, 2013. The proposed rule will also establish the mediation panel fees for fiscal year 2014 commencing on July 1, 2013. This rule provides the Fund with appropriate and adequate funding and solvency for future years. This is the main vehicle for achieving and maintaining the Fund's solvency.
10. Summary of the businesses, business sectors, associations representing business, local governmental units, and individuals that may be affected by the proposed rule that were contacted for comments.
OCI solicited comments generally through publication requesting comments from the public utilizing the OCI website. Additionally OCI solicited comments from businesses, individuals, and local government units related to the implementation and compliance costs. Solicitations were sent to health insurance members of OCI's Health and Life Insurance Advisory Council and interested parties. Members included health insurance companies, health insurance agent representatives, consumer representatives, provider representatives and representatives of small business. Additional solicitations were made to associations representing various affected parties and local government representatives including: •   Wisconsin Association of Health Plans •   Wisconsin Association of Health Underwriters •   Independent Insurance Agents Association of Wisconsin •   National Federation of Independent Business — Wisconsin •   Wisconsin Association of Nurse Anesthetists •   Wisconsin Manufacturers and Commerce •   Wisconsin Dental Association •   Wisconsin Medical Society
•   Professional Insurance Agents of Wisconsin •   National Association of Insurance and Financial Advisors — Wisconsin •   Wisconsin Hospital Association •   Wisconsin Association for Justice •   The League of Wisconsin Municipalities •   Wisconsin Counties Association •   Wisconsin Towns Association •   Wisconsin Association of School Boards •   Wisconsin Association of School District Administrators
11. Identify the local governmental units that participated in the development of this EIA.
None beyond solicitation for comments.
12. Summary of Rule's Economic and Fiscal Impact on Specific Businesses, Business Sectors, Public Utility Rate Payers, Local Governmental Units and the State's Economy as a Whole (Include Implementation and Compliance Costs Expected to be Incurred)
All health care provider participants in the Fund as set forth in s. 655.002 (1), Wis. Stat., will be required to pay a 5% reduced assessment for their medical malpractice coverage under Ch.655, Wis. Stat. The impact is considered to be minimal and in fact positive to the participants. In addition the reduction of mediation panel fees to zero is also beneficial.
13. Benefits of Implementing the Rule and Alternative(s) to Implementing the Rule
The proposed rule will benefit Fund participants by ensuring that fee revenue is adequate to cover anticipated administrative, operating and claims payments costs. The alternatives to this rule would be to establish a Fund fee increase, to maintain current fee amounts or to assess fees lower than the proposed 5% reduction in Fund fees. A greater reduction in fees would leave the Fund with inadequate funding to cover actuarially-based projected costs, while a fee increase or static fee level would present an unnecessary cost to Fund participants. The proposed rule does not significantly impact Wisconsin's economy, productivity, jobs or the overall economic competitiveness of Wisconsin. Wisconsin's health care marketplace is strengthened with an affordable layer of medical malpractice coverage. The Fund has existed in Wisconsin since 1975. Fund participants will benefit from a stable and solvent fund. Additionally, Fund participants should not experience increased compliance costs with the reduction of fund and mediation panel fees.
14. Long Range Implications of Implementing the Rule
The long-range implication of the rule as proposed will be an adequately funded and solvent Fund.
15. Compare With Approaches Being Used by Federal Government
Federal government does not address this subject matter.
16. Compare With Approaches Being Used by Neighboring States (Illinois, Iowa, Michigan and Minnesota)
None of the neighboring states have a patient compensation fund or a general program of state-sponsored liability insurance for physicians.
17. Contact Name				18. Contact Phone Number
Louie Cornelius				608-264-8113

This document can be made available in alternate formats to individuals with disabilities upon request.

ATTACHMENT A

1. Summary of Rule's Economic and Fiscal Impact on Small Businesses (Separately for each Small Business Sector, Include Implementation and Compliance Costs Expected to be Incurred)

The agency does not anticipate any implementation costs or additional compliance costs for fund participants. All health care provider participants in the Fund as set forth in s. 655.002 (1), Wis. Stat., will be required to pay the reduced assessment for their medical malpractice coverage under ch. 655, Wis. Stat. The impact will be further reduced by the reduction to zero for mediation panel fees.

2. Summary of the data sources used to measure the Rule's impact on Small Businesses

The Fund contracts for actuarial services to develop the documentation and analysis necessary for the Actuarial and Underwriting Committee of the Fund. The documentation includes an actuarially indicated rate level for break even financial projections against expected claims reflective of all physician classifications. Since some physicians are small employer practices this information does relay information to the Committee and Board for the impact on small businesses directly impacted by the proposal. The actuarial firm presents its analysis to the Actuarial and Underwriting Committee of the Fund Board of Governors. The Committee reviews all documentation and projections and makes a recommendation to the full Board of Governors for consideration. The Fund Board of Governors reviewed the Committee's recommendation at its December 19, 2012 meeting as well as the underlying analysis by the actuarial firm. Following deliberation, the Board of Governors affirmed the Committee's recommendation of a decrease of 5% for Fund fees and at the March 20, 2013 meeting affirmed the change to the mediation panel fees to zero for both physicians and hospitals.

3. Did the agency consider the following methods to reduce the impact of the Rule on Small Businesses?

⍽ Less Stringent Compliance or Reporting Requirements ⍽ Less Stringent Schedules or Deadlines for Compliance or Reporting ⍽ Consolidation or Simplification of Reporting Requirements ⍽ Establishment of performance standards in lieu of Design or Operational Standards ⍽ Exemption of Small Businesses from some or all requirements X Other, describe: The Board of Governors discussed maintaining fees at 2013 levels but determined that such action was unnecessary in light of the Fund's present financial condition and the reduced fees would adequately fund the Fund for claims incurred during fiscal year 2014 without shifting the burden of funding to future years and providers.

4. Describe the methods incorporated into the Rule that will reduce its impact on Small Businesses

The proposed increase is below break-even financing for the Fund but sufficient to cover anticipated claims, administrative and operating expenses.

5. Describe the Rule's Enforcement Provisions

This rule proposes fees. Failure to pay Fund fees is governed by s. Ins 17.01, Wis. Adm. Code, which requires the Fund to notify the medical examining board of each physician who has not paid the fee and notify the Department of Health Services of each hospital that has not paid the fee as required.

6. Did the Agency prepare a Cost Benefit Analysis (if Yes, attach to form)

⍽ Yes X No

Notice of Hearing

Revenue

rulemaking_notices CR 13-034 CR 13-034

NOTICE IS HEREBY GIVEN that, pursuant to s. 565.02 (4) (a), Stats., the Department of Revenue will hold a public hearing to consider permanent rules revising Chapter Tax 61, relating to lottery retailers.

Hearing Information

Date:   Friday, July 12, 2013
Time:   3:00 p.m.
Location:   Events Room
  State Revenue Building
  2135 Rimrock Road
  Madison, WI 53713

Handicap access is available at the hearing location.

Appearances at the Hearing and Submittal of Written Comments

Interested persons are invited to appear at the hearing and may make an oral presentation. It is requested that written comments reflecting the oral presentation be given to the department at the hearing. Written comments may also be submitted to the contact person listed below or to adminrules.wisconsin.gov no later than July 12, 2013, and will be given the same consideration as testimony presented at the hearing.

Dale Kleven

Department of Revenue

Mail Stop 6-40

2135 Rimrock Road

P.O. Box 8933

Madison, WI 53708-8933

Telephone: [phone]

E-mail: [e-mail]

Analysis by the Department of Revenue

Statute interpreted

Sections 565.10 (1) and 565.17 (2), Stats.

Statutory authority

Section 565.02 (4) (a), Stats.

Explanation of agency authority

Section 565.02 (4) (a), Stats., provides the department may promulgate rules “[i]mplementing the provisions of this chapter."

Related statute or rule

There are no other applicable statutes or rules.

Plain language analysis

The proposed rule makes the following changes:

•   Amends s. Tax 61.08 (11) (h) and (k) to eliminate discretionary authority of the Lottery Administrator that is not provided by law.

•   Creates a provision in s. Tax 61.08 (13) to allow a retailer's account to be credited for the value paid for instant scratch tickets that have been stolen.

Summary of, and comparison with, existing or proposed federal regulation

There is no existing or proposed federal regulation that is intended to address the activities to be regulated by the rule.

Comparison with rules in adjacent states

The department is not aware of a similar rule in an adjacent state.

Summary of factual data and analytical methodologies

2012 Executive Order 61 and 2011 Wisconsin Act 46 requires state agencies to work with the Small Business Regulatory Review Committee to review the agency's administrative rules that may be particularly onerous to small businesses in Wisconsin . In response, the department initiated a comprehensive review of all of its administrative rules. The changes described above were identified as part of that review. No other data was used in the preparation of this rule order or this analysis.

Analysis and supporting documents used to determine effect on small business

This rule order makes changes to reflect current law and current department policy. It makes no policy or other changes having an effect on small business.

Anticipated costs incurred by private sector

This rule order does not have a fiscal effect on the private sector.

Effect on Small Business

This rule order does not affect small business.

Agency Contact Person

Please contact Dale Kleven at [phone] or [e-mail], if you have any questions regarding this rule order.

Text of Proposed Rule

SECTION 1. Tax 61.08 (11) (h) and (k) and (13) (a) are amended to read:

Tax 61.08 (11) (h) The retailer may not add any service fee, handling fee or other expense to the purchase of a ticket or share without the written permission of the administrator.

(k) The retailer may not conduct sales of lottery tickets or shares to off-premises customers by telephone, email, instant messaging or similar electronic means, or by mail, parcel, delivery service or similar service, without the written permission of the administrator.

(13) (a) The retailer shall be responsible for the condition and security of lottery tickets received. If the retailer's lottery tickets are lost, stolen, mutilated, damaged, unaccountable or otherwise unsalable, the retailer shall be solely responsible for those tickets. The Except as provided in pars. (c) and (cm), the administrator may not reimburse the retailer for those losses other than unsalable tickets under par. (c).

SECTION 2. Tax 61.08 (13) (cm) is created to read:

Tax 61.08 (13) (cm) 1. The administrator may credit the retailer's account for the value the retailer paid for instant scratch tickets that are stolen. In determining whether to provide credit, the administrator may consider the following factors:

a. Compliance with the reporting requirement under par. (b).

b. Whether the theft has been reported to law enforcement.

c. Final return date of the game to which the stolen tickets belong.

d. Validation of any ticket that is reported stolen.

e. The retailer's prior record of reporting stolen tickets to the department.

f. Security of the retailer's business and the place where tickets are stored.

g. Any other facts and circumstances the administrator believes pertinent.

2. Credit under this paragraph shall be the retailer's purchase price, and any credit shall be made to the retailer's electronic fund transfer account.

SECTION 3. Effective date. This rule shall take effect on the first day of the month following publication in the Wisconsin Administrative Register as provided in s. 227.22 (2) (intro.), Stats.

ADMINISTRATIVE RULES Fiscal Estimate & Economic Impact Analysis
Type of Estimate and Analysis
X Original ⍽ Updated ⍽ Corrected
Administrative Rule Chapter, Title and Number
Chapter Tax 61 — Retailers
Subject
Lottery retailers
Fund Sources Affected			Chapter 20 , Stats. Appropriations Affected
⍽ GPR ⍽ FED ⍽ PRO ⍽ PRS X SEG ⍽ SEG-S
Fiscal Effect of Implementing the Rule
⍽ No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues X Decrease Existing Revenues		X Increase Costs X Could Absorb Within Agency's Budget ⍽ Decrease Costs
The Rule Will Impact the Following (Check All That Apply)
⍽ State's Economy ⍽ Local Government Units		⍽ Specific Businesses/Sectors ⍽ Public Utility Rate Payers
Would Implementation and Compliance Costs Be Greater Than $20 million? ⍽ Yes X No
Policy Problem Addressed by the Rule
The rule does not create or revise policy, other than to reflect current law and department policy.
Summary of Rule's Economic and Fiscal Impact on Specific Businesses, Business Sectors, Public Utility Rate Payers, Local Governmental Units and the State's Economy as a Whole (Include Implementation and Compliance Costs Expected to be Incurred)
As indicated in the attached fiscal estimate, the proposed rule is expected to result in no significant change to total ticket sales or lottery operations, and has minimal fiscal effect. No comments concerning the economic effect of the rule were submitted in response to the department's solicitation.
Benefits of Implementing the Rule and Alternative(s) to Implementing the Rule
Clarifications and guidance provided by administrative rules may lower the compliance costs for lottery retailers. If the rule is not implemented, Chapter Tax 61 will be incomplete in that it will not reflect current law or department policy.
Long Range Implications of Implementing the Rule
No long-range implications are anticipated.
Compare With Approaches Being Used by Federal Government
N/A
Compare With Approaches Being Used by Neighboring States (Illinois, Iowa, Michigan and Minnesota)
N/A

FISCAL ESTIMATE FORM				2013 Session
X ORIGINAL ⍽UPDATED	LRB #
	INTRODUCTION #
⍽ CORRECTED ⍽SUPPLEMENTAL	Admin rule #		Tax 61: Lottery retailers
Subject Proposed order of the Department of Revenue relating to lottery retailers.
Fiscal Effect

State: ⍽ No State Fiscal Effect   Check columns below only if bill makes a direct appropriation or   affects a sum sufficient appropriation ⍽ Increase Existing Appropriation     ⍽ Increase Existing Revenues ⍽ Decrease Existing Appropriation     X Decrease Existing Revenues ⍽ Create New Appropriation			X Increase Costs — May be Possible to Absorb Within Agency's Budget X Yes ⍽No ⍽ Decrease Costs
Local: X No Local Government Costs
1. ⍽ Increase Costs	3. ⍽ Increase Revenues		5. Types of Local Governmental Units Affected:
⍽ Permissive ⍽ Mandatory	⍽ Permissive ⍽ Mandatory		⍽ Towns ⍽ Villages ⍽ Cities
2. ⍽ Decrease Costs	4. ⍽ Decrease Revenues		⍽ Counties ⍽ Others
⍽ Permissive ⍽ Mandatory	⍽ Permissive ⍽ Mandatory		⍽ School Districts ⍽ WTCS Districts
Fund Sources Affected ⍽ GPR ⍽ FED ⍽ PRO ⍽ PRS X SEG ⍽ SEG-S		Affected Ch. 20 Appropriations

Assumptions Used in Arriving at Fiscal Estimate

The proposed rule updates Chapter Tax 61 of the Administrative Code, pertaining to the state lottery, to eliminate discretionary authority provided to the lottery administrator that is not allowed under current law. The proposed rule also amends ch. Tax 61 provisions to provide the administrator authority to reimburse retailers for stolen tickets.