153.45(3)
(3) The department may, but is not required to, release health care provider-specific and employer-specific data, except in public use data files as specified under
sub. (1) (b), in a manner that is specified in rules promulgated by the department.
153.45(4)
(4) The department shall prohibit purchasers of data from rereleasing individual data elements of health care data files.
153.45(5)
(5) The department may not release any health care information that is subject to rules promulgated under
s. 153.75 (1) (b) until the verification, comment and review procedures required under those rules have been complied with. Nothing in this subsection prohibits release of health care provider-specific information to the health care provider to whom the information relates.
153.45(6)
(6) The department may not sell or distribute databases of information, from health care providers who are not hospitals or ambulatory surgery centers, that are able to be linked with public use data files, unless first approved by the independent review board.
153.50
153.50
Protection of patient confidentiality. 153.50(1)(b)1.1. "Patient-identifiable data", for information submitted by hospitals and ambulatory surgery centers, means all of the following data elements:
153.50(1)(b)2.
2. "Patient-identifiable data", for information submitted by health care providers who are not hospitals or ambulatory surgery centers, means all of the following data elements:
153.50(1)(b)2.b.
b. Whether the patient's condition is related to employment, and occurrence and place of an auto accident or other accident.
153.50(1)(b)2.c.
c. Date of first symptom of current illness, of current injury or of current pregnancy.
153.50(1)(b)2.d.
d. First date of the patient's same or similar illness, if any.
153.50(1)(b)2.e.
e. Dates that the patient has been unable to work in his or her current occupation.
153.50(1)(c)
(c) "Small number" means a number that is insufficiently large to be statistically significant, as determined by the department.
153.50(3)
(3) Departmental measures to ensure protection of patient identity. To ensure that the identity of patients is protected when information obtained by the department is disseminated, the department shall do all of the following:
153.50(3)(a)
(a) Aggregate any data element category containing small numbers, using procedures that are developed by the department and approved by the board and that follow commonly accepted statistical methodology.
153.50(3)(b)
(b) Remove and destroy all of the following data elements on the uniform patient billing forms that are received by the department under the requirements of this chapter:
153.50(3)(b)3.
3. Any other insured's name, employer name and date of birth.
153.50(3)(b)4.
4. The signature of the patient or other authorized signature.
153.50(3)(b)5.
5. The signature of the insured or other authorized signature.
153.50(3)(b)7.
7. The patient's account number, after use only as verification of data by the department.
153.50(3)(c)
(c) Develop, for use by purchasers of data under this chapter, a data use agreement that specifies data use restrictions, appropriate uses of data and penalties for misuse of data, and notify prospective and current purchasers of data of the appropriate uses.
153.50(3)(d)
(d) Require that a purchaser of data under this chapter sign and have notarized the data use agreement of the department specified in
par. (c).
153.50(3m)
(3m) Health care provider measures to ensure patient identity protection. A health care provider that is not a hospital or ambulatory surgery center shall, before submitting information required by the department under this chapter, convert to a payer category code as specified by the department any names of an insured's payer or other insured's payer.
153.50(4)
(4) Release of patient-identifiable data. 153.50(4)(a)(a) Except as specified in
par. (b), under the procedures specified in
sub. (5), release of patient-identifiable data may be made only to any of the following:
153.50(4)(a)1.
1. An agent of the department who is responsible for the patient-identifiable data in the department, in order to store the data and ensure the accuracy of the information in the database of the department.
153.50(4)(a)2.
2. A health care provider or the agent of a health care provider, to ensure the accuracy of the information in the database of the department.
153.50(4)(a)3.
3. The department, for purposes of epidemiological investigation or to eliminate the need for duplicative databases.
153.50(4)(a)4.
4. An entity that is required by federal or state statute to obtain patient-identifiable data for purposes of epidemiological investigation or to eliminate the need for duplicative databases.
153.50(4)(b)
(b) Of information submitted by health care providers that are not hospitals or ambulatory surgery centers, patient-identifiable data that contain a patient's date of birth may be released under
par. (a) only under circumstances as specified by rule by the department.
153.50(5)
(5) Procedures for release of patient-identifiable data. 153.50(5)(a)(a) The department may not release or provide access to patient-identifiable data to a person authorized under
sub. (4) (a) unless the authorized person requests the department, in writing, to release the patient-identifiable data. The request shall include all of the following:
153.50(5)(a)3.
3. For a person who is authorized under
sub. (4) (a) to receive or have access to patient-identifiable data, evidence, in writing, that indicates that authorization.
153.50(5)(a)4.
4. For an entity that is authorized under
sub. (4) (a) 4. to receive or have access to patient-identifiable data, evidence, in writing, of all of the following:
153.50(5)(a)4.a.
a. The federal or state statutory requirement to obtain the patient-identifiable data.
153.50(5)(a)4.b.
b. Any federal or state statutory requirement to uphold the patient confidentiality provisions of this chapter or patient confidentiality provisions that are more restrictive than those of this chapter; or, if the latter evidence is inapplicable, an agreement, in writing, to uphold the patient confidentiality provisions of this chapter.
153.50(5)(b)
(b) Upon receipt of a request under
par. (a), the department shall, as soon as practicable, comply with the request or notify the requester, in writing, of all of the following:
153.50(5)(b)1.
1. That the department is denying the request in whole or in part.
153.50(5m)
(5m) Employers not to request patient-identifiable data. Notwithstanding
subs. (4) and
(5) no employer may request the release of or access to patient-identifiable data of an employee of the employer.
153.50(6)(a)(a) The department may not require a health care provider submitting health care information under this chapter to include the patient's name, street address or social security number.
153.50(6)(b)
(b) The department may not require under this chapter a health care provider that is not a hospital or ambulatory surgery center to submit uniform patient billing forms.
153.50(6)(c)
(c) A health care provider that is not a hospital or ambulatory surgery center may not submit any of the following to the department under the requirements of this chapter:
153.50(6)(c)4.
4. Data regarding insureds other than the patient, other than the payer category code under
sub. (3m).
153.50(6)(d)
(d) If a health care provider that is not a hospital or ambulatory surgery center submits a data element that is specified in
par. (c) 1. to
10., the department shall immediately return this information to the health care provider or, if discovered later, shall remove and destroy the information.
153.50(6)(e)
(e) A health care provider may not submit information that uses any of the following as a patient account number:
153.50(6)(e)1.
1. The patient's social security number or any substantial portion of the patient's social security number.
153.50(6)(e)2.
2. A number that is related to another patient identifying number.
153.55
153.55
Protection of confidentiality. Data obtained under this chapter is not subject to inspection, copying or receipt under
s. 19.35 (1).
153.55 History
History: 1997 a. 231;
1999 a. 9.
153.60
153.60
Assessments to fund operations of department and board. 153.60(1)(1) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures under this chapter for the department and the board for that fiscal year for data collection, database development and maintenance, generation of data files and standard reports, orientation and training provided under
s. 153.05 (9) and maintaining the board. The department shall assess the estimated total amount for that fiscal year less the estimated total amount to be received for purposes of administration of this chapter under
s. 20.435 (4) (hi) during the fiscal year, the unencumbered balance of the amount received for purposes of administration of this chapter under s.
20.435 (4) (hi) from the prior fiscal year and the amount in the appropriation account under s.
20.435 (1) (dg), 1997 stats., for the fiscal year, to health care providers who are in a class of health care providers from whom the department collects data under this chapter in a manner specified by the department by rule. The department shall obtain approval from the board for the amounts of assessments for health care providers other than hospitals and ambulatory surgery centers. The department shall work together with the department of regulation and licensing to develop a mechanism for collecting assessments from health care providers other than hospitals and ambulatory surgery centers. No health care provider that is not a facility may be assessed under this subsection an amount that exceeds $75 per fiscal year. Each hospital shall pay the assessment on or before December 1. All payments of assessments shall be deposited in the appropriation under
s. 20.435 (4) (hg).
153.60(3)
(3) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures required for the collection, database development and maintenance and generation of public data files and standard reports for health care plans that voluntarily agree to supply health care data under
s. 153.05 (6r). The department shall assess the estimated total amount for that fiscal year to health care plans in a manner specified by the department by rule and may enter into an agreement with the office of the commissioner of insurance for collection of the assessments. Each health plan that voluntarily agrees to supply this information shall pay the assessments on or before December 1. All payments of assessments shall be deposited in the appropriation under
s. 20.435 (4) (hg) and may be used solely for the purposes of
s. 153.05 (6r).
