146.885
146.885
Acceptance of assignment for medicare. The department shall annually provide aging units, as defined in
s. 46.82 (1) (a), with enrollment cards for and materials explaining the voluntary program that is specified in
s. 71.55 (10) (b), for distribution to individuals who are eligible or potentially eligible for participation in the program. The state medical society shall supply the department with the enrollment cards and the explanatory materials for distribution under this section.
146.885 History
History: 1989 a. 294,
359; Stats. 1989 s. 146.885;
1991 a. 235.
146.89
146.89
Volunteer health care provider program. 146.89(1)
(1) In this section, "volunteer health care provider" means an individual who is licensed as a physician under
ch. 448, dentist under
ch. 447, registered nurse, practical nurse or nurse-midwife under
ch. 441 or optometrist under
ch. 449 or certified as a physician's assistant under
ch. 448 and who receives no income from the practice of that health care profession or who receives no income from the practice of that health care profession when providing services at the nonprofit agency specified under
sub. (3).
146.89(2)(a)1.1. A volunteer health care provider may participate under this section only if he or she submits a joint application with a nonprofit agency in a county that is specified under
sub. (3) (a) 1. to the department of administration and that department approves the application. The department of administration shall provide application forms for use under this subdivision.
146.89(2)(a)2.
2. A volunteer health care provider may participate under this section only if he or she submits a joint application with a nonprofit agency in a county that is specified under
sub. (3) (a) 2. to the department of administration and that department approves the application after first submitting the application to the joint committee on finance for review under the procedures specified in
s. 13.10, and obtaining approval from the joint committee on finance for the application. The department of administration shall disapprove the application if the joint committee on finance has disapproved it. The department of administration shall provide application forms for use under this subdivision.
146.89(2)(b)
(b) The department of administration may send an application to the medical examining board for evaluation. The medical examining board shall evaluate any application submitted by the department of administration and return the application to the department of administration with the board's recommendation regarding approval.
146.89(2)(c)
(c) The department of administration shall notify the volunteer health care provider and the nonprofit agency of the department's decision to approve or disapprove the application.
146.89(2)(d)
(d) Approval of an application of a volunteer health care provider is valid for one year. If a volunteer health care provider wishes to renew approval, he or she shall submit a joint renewal application with a nonprofit agency to the department of administration. The department of administration shall provide renewal application forms that are developed by the department of health and family services and that include questions about the activities that the individual has undertaken as a volunteer health care provider in the previous 12 months.
146.89(3)
(3) Any volunteer health care provider and nonprofit agency whose joint application is approved under
sub. (2) shall meet the following applicable conditions:
146.89(3)(a)1.1. The volunteer health care provider shall provide services under
par. (b) without charge in Brown, Dane, Dodge, Fond du Lac, Kenosha, La Crosse, Milwaukee, Outagamie, Racine, Rock or Sheboygan county at the nonprofit agency if the nonprofit agency in that county has received approval under
sub. (2) (a) 1.
146.89(3)(a)2.
2. The volunteer health care provider shall provide services under
par. (b) without charge in any county, other than those counties specified in
subd. 1., at the nonprofit agency, if the nonprofit agency in that county has received approval under
sub. (2) (a) 2.
146.89(3)(b)
(b) The nonprofit agency may provide the following health care services:
146.89(3)(c)
(c) The nonprofit agency may not provide emergency medical services, hospitalization or surgery.
146.89(3)(d)
(d) The nonprofit agency shall provide health care services primarily to low-income persons who are uninsured and who are not recipients of any of the following:
146.89(4)
(4) Volunteer health care providers who provide services under this section are, for the provision of these services, state agents of the department of health and family services for purposes of
ss. 165.25 (6),
893.82 (3) and
895.46.
146.905
146.905
Reduction in fees prohibited. 146.905(1)
(1) Except as provided in
sub. (2), a health care provider, as defined in
s. 146.81 (1), that provides a service or a product to an individual with coverage under a disability insurance policy, as defined in
s. 632.895 (1) (a), may not reduce or eliminate or offer to reduce or eliminate coinsurance or a deductible required under the terms of the disability insurance policy.
146.905(2)
(2) Subsection (1) does not apply if payment of the total fee would impose an undue financial hardship on the individual receiving the service or product.
146.905 History
History: 1991 a. 250;
1995 a. 225.
146.91
146.91
Long-term care insurance. 146.91(1)
(1) In this section, "long-term care insurance" means insurance that provides coverage both for an extended stay in a nursing home and home health services for a person with a chronic condition. The insurance may also provide coverage for other services that assist the insured person in living outside a nursing home including but not limited to adult day care and continuing care retirement communities.
146.91(2)
(2) The department, with the advice of the council on long-term care insurance, the office of the commissioner of insurance, the board on aging and long-term care and the department of employe trust funds, shall design a program that includes the following:
146.91(2)(a)
(a) Subsidizing premiums for persons purchasing long-term care insurance, based on the purchasers' ability to pay.
146.91(2)(b)
(b) Reinsuring by the state of policies issued in this state by long-term care insurers.
146.91(2)(c)
(c) Allowing persons to retain liquid assets in excess of the amounts specified in
s. 49.47 (4) (b) 3g.,
3m. and
3r., for purposes of medical assistance eligibility, if the persons purchase long-term care insurance.
146.91(3)
(3) The department shall collect any data on health care costs and utilization that the department determines to be necessary to design the program under
sub. (2).
146.91(5)
(5) In designing the program, the department shall consult with the federal department of health and human services to determine the feasibility of procuring a waiver of federal law or regulations that will maximize use of federal medicaid funding for the program designed under
sub. (2).
146.91(6)
(6) The department, with the advice of the council on long-term care insurance, may examine use of tax incentives for the sale and purchase of long-term care insurance.
146.91 History
History: 1987 a. 27;
1989 a. 56.
146.93
146.93
Primary health care program. 146.93(1)(a)(a) From the appropriation under
s. 20.435 (1) (gp), the department shall maintain a program for the provision of primary health care services based on the primary health care program in existence on June 30, 1987. The department may promulgate rules necessary to implement the program.
146.93(1)(c)
(c) The department shall seek to obtain a maximum of donated or reduced-rate health care services for the program and shall seek to identify and obtain a maximum of federal funds for the program.
146.93(2)
(2) The program under
sub. (1) (a) shall provide primary health care, including diagnostic laboratory and X-ray services, prescription drugs and nonprescription insulin and insulin syringes.
146.93(3)
(3) The program under
sub. (1) (a) shall be implemented in those counties with high unemployment rates and within which a maximum of donated or reduced-rate health care services can be obtained.
146.93(4)
(4) The health care services of the program under
sub. (1) (a) shall be provided to any individual residing in a county under
sub. (3) who meets all of the following criteria:
146.93(4)(a)
(a) The individual is either unemployed or is employed less than 25 hours per week.
146.93(4)(b)
(b) The individual's family income is not greater than 150% of the federal poverty line, as defined under
42 USC 9902 (2).
146.93(4)(c)
(c) The individual does not have health insurance or other health care coverage and is unable to obtain health insurance or other health care coverage.
146.99
146.99
Assessments. The department shall, within 90 days after the commencement of each fiscal year, estimate the total amount of expenditures and the department shall assess the estimated total amount under
s. 20.435 (1) (gp) to hospitals, as defined in
s. 50.33 (2), in proportion to each hospital's respective gross private-pay patient revenues during the hospital's most recently concluded entire fiscal year. Each hospital shall pay its assessment on or before December 1 for the fiscal year. All payments of assessments shall be deposited in the appropriation under
s. 20.435 (1) (gp).
146.995
146.995
Reporting of wounds and burn injuries. 146.995(2)(a)(a) Any person licensed, certified or registered by the state under
ch. 441,
448 or
455 who treats a patient suffering from any of the following shall report in accordance with
par. (b):
146.995(2)(a)2.
2. Any wound other than a gunshot wound if the person has reasonable cause to believe that the wound occurred as a result of a crime.
146.995(2)(a)3.
3. Second-degree or 3rd-degree burns to at least 5% of the patient's body or, due to the inhalation of superheated air, swelling of the patient's larynx or a burn to the patient's upper respiratory tract, if the person has reasonable cause to believe that the burn occurred as a result of a crime.
146.995(2)(b)
(b) For any mandatory report under
par. (a), the person shall report the patient's name and the type of wound or burn injury involved as soon as reasonably possible to the local police department or county sheriff's office for the area where the treatment is rendered.
146.995(2)(c)
(c) Any such person who intentionally fails to report as required under this subsection may be required to forfeit not more than $500.
146.995(3)
(3) Any person reporting in good faith under
sub. (2), and any inpatient health care facility that employs the person who reports, are immune from all civil and criminal liability that may result because of the report. In any proceeding, the good faith of any person reporting under this section shall be presumed.
146.995(4)
(4) The reporting requirement under
sub. (2) does not apply under any of the following circumstances:
146.995(4)(a)
(a) The patient is accompanied by a law enforcement officer at the time treatment is rendered.
146.995(4)(b)
(b) The patient's name and type of wound or burn injury have been previously reported under
sub. (2).
146.995(4)(c)
(c) The wound is a gunshot wound and appears to have occurred at least 30 days prior to the time of treatment.
