50.375(5)
(5) The department shall respond to any complaint received by the department concerning noncompliance by a hospital with the requirements of
subs. (2) and
(3) and shall periodically review hospital procedures to determine whether a hospital is in compliance with the requirements.
50.375 History
History: 2007 a. 102.
50.377(1)(1) Whoever violates a requirement under
s. 50.375 (2) or
(3) may be required to forfeit not less than $2,500 nor more than $5,000 for each violation.
50.377(2)
(2) The department may directly assess forfeitures provided for under
sub. (1). If the department determines that a forfeiture should be assessed for a particular violation, the department shall send a notice of assessment to the hospital. The notice shall specify the amount of the forfeiture assessed, the violation and the statute or rule alleged to have been violated, and shall inform the hospital of the right to a hearing under
sub. (3).
50.377(3)
(3) A hospital may contest an assessment of a forfeiture by sending, within 10 days after receipt of notice under
sub. (2), a written request for a hearing under
s. 227.44 to the division of hearings and appeals created under
s. 15.103 (1). The administrator of the division may designate a hearing examiner to preside over the case and recommend a decision to the administrator under
s. 227.46. The decision of the administrator of the division shall be the final administrative decision. The division shall commence the hearing within 30 days after receipt of the request for a hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings before the division are governed by
ch. 227. In any petition for judicial review of a decision by the division, the party, other than the petitioner, who was in the proceeding before the division shall be the named respondent.
50.377(4)
(4) All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under
sub. (3), within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order. The department shall remit all forfeitures paid to the secretary of administration for deposit in the school fund.
50.377(5)
(5) The attorney general may bring an action in the name of the state to collect any forfeiture imposed under this section if the forfeiture has not been paid following the exhaustion of all administrative and judicial reviews. The only issue to be contested in any such action shall be whether the forfeiture has been paid.
50.377 History
History: 2007 a. 102;
2009 a. 2 s.
70.
50.38
50.38
Hospital assessment. 50.38(1)
(1) In this section "eligible hospital" means a hospital that is not any of the following:
50.38(1)(c)
(c) A general psychiatric hospital for which the department has issued a certificate of approval under
s. 50.35 that applies only to the psychiatric hospital, and that is not a satellite of an acute care hospital.
50.38(2)(a)(a) For the privilege of doing business in this state, there is imposed on each eligible hospital that is not a critical access hospital an assessment each state fiscal year that is equal to a uniform percentage, determined under
sub. (3), of the hospital's gross patient revenues, as reported under
s. 153.46 (5) and determined by the department. The assessments shall be deposited in the hospital assessment fund.
50.38(2)(b)
(b) For the privilege of doing business in this state, there is imposed on each critical access hospital an assessment each state fiscal year that is equal to a uniform percentage, determined under
sub. (3), of the critical access hospital's gross inpatient revenues, as reported under
s. 153.46 (5) and determined by the department. The assessments shall be deposited in the critical access hospital assessment fund.
50.38(3)
(3) The department shall establish the percentage that is applicable under
sub. (2) (a) and
(b) so that the total amount of assessments collected under
sub. (2) (a) in a state fiscal year is equal to the amount in the schedule under
s. 20.005 (3) for the appropriation under
s. 20.435 (4) (xc) for that fiscal year.
50.38(4)
(4) Except as provided in
sub. (5), each eligible hospital shall pay the applicable annual assessment under
sub. (2) in 4 equal amounts that are due by September 30, December 31, March 31, and June 30 of each year.
50.38(5)
(5) At the discretion of the department, a hospital that is unable timely to make a payment by a date specified under
sub. (4) may be allowed to make a delayed payment. A determination by the department that a hospital may not make a delayed payment under this subsection is final and is not subject to review under
ch. 227.
50.38(6)(a)1.1. If the federal government does not provide federal financial participation under the federal Medicaid program for amounts collected under
sub. (2) (a) that are used to make payments required under
s. 49.45 (3) (e) 11. or
(5r), that are transferred under
sub. (8) and used to make payments from the Medical Assistance trust fund, or that are transferred under
sub. (9) and expended under
s. 20.435 (4) (jw), the department shall, from the fund from which the payment or expenditure was made, refund eligible hospitals, other than critical access hospitals, the amount for which the federal government does not provide federal financial participation.
50.38(6)(a)2.
2. If the department makes a refund under
subd. 1. as result of failure to obtain federal financial participation under the federal Medicaid program for a payment required under
s. 49.45 (3) (e) 11. or
(5r) or a payment from the Medical Assistance trust fund, the department shall recoup the part of the payment for which the federal government does not provide federal financial participation.
50.38(6)(a)3.
3. Moneys recouped under
subd. 2. for payments made from the hospital assessment fund shall be deposited in the hospital assessment fund.
50.38(6)(a)4.
4. Moneys recouped under
subd. 2. for payments made from the Medical Assistance trust fund shall be deposited in the Medical Assistance trust fund.
50.38(6)(b)
(b) On June 30 of each state fiscal year, the department shall, from the appropriation account under
s. 20.435 (4) (xc), refund to eligible hospitals, other than critical access hospitals, the difference between the amount in the schedule under
s. 20.005 (3) for that appropriation and the amount expended or encumbered from that appropriation in the fiscal year.
50.38(6)(c)
(c) The department shall allocate any refund under this subsection to eligible hospitals, other than critical access hospitals, in proportion to the percentage of the total assessments collected under
sub. (2) (a) that each hospital paid.
50.38(6m)(a)1.1. If the federal government does not provide federal financial participation under the federal Medicaid program for amounts collected under
sub. (2) (b) that are used to make payments required under
s. 49.45 (3) (e) 12. or that are transferred under
sub. (10) and used to make payments from the Medical Assistance trust fund, the department shall, from the fund from which the payment or expenditure was made, refund critical access hospitals the amount for which the federal government does not provide federal financial participation.
50.38(6m)(a)2.
2. If the department makes a refund under
subd. 1. as result of failure to obtain federal financial participation under the federal Medicaid program for a payment required under
s. 49.45 (3) (e) 12. or a payment from the Medical Assistance trust fund, the department shall recoup the part of the payment for which the federal government does not provide federal financial participation.
50.38(6m)(a)3.
3. Moneys recouped under
subd. 2. for payments made from the critical access hospital assessment fund shall be deposited in the critical access hospital assessment fund.
50.38(6m)(a)4.
4. Moneys recouped under
subd. 2. for payments made from the Medical Assistance trust fund shall be deposited in the Medical Assistance trust fund.
50.38(6m)(b)
(b) On June 30 of each state fiscal year, the department shall, from the appropriation account under
s. 20.435 (4) (xe), refund to critical access hospitals any unencumbered moneys in the critical access hospital assessment fund.
50.38(6m)(c)
(c) The department shall allocate any refund under this subsection to critical access hospitals in proportion to the percentage of the total assessments collected under
sub. (2) (b) that each critical access hospital paid.
50.38(7)
(7) By January 1 of each year the department shall report to the joint committee on finance all of the following information for the state fiscal year ending the previous June 30:
50.38(7)(a)
(a) The amount each eligible hospital paid under
sub. (2).
50.38(7)(c)
(c) The total amounts that each eligible hospital received from health maintenance organizations under
s. 49.45 (59) (b).
50.38(7)(d)
(d) The total amount of payment increases the department made, in connection with implementation of the hospital assessments under
sub. (2), for inpatient and outpatient hospital services that are reimbursed on a fee-for-service basis.
50.38(7)(e)
(e) The total amount of payments that the department made to each hospital under the Medical Assistance Program under
subch. IV of ch. 49.
50.38(7)(f)
(f) The portion of capitated payments that the department made to each health maintenance organization under the Medical Assistance Program under
subch. IV of ch. 49 from appropriation accounts of general purpose revenues that is for inpatient and outpatient hospital services.
50.38(7)(g)
(g) The results of any audits conducted by the department under
s. 49.45 (59) (e) 3. and any actions taken by the department as a result of the audits.
50.38(8)
(8) In each state fiscal year, the secretary of administration shall transfer from the hospital assessment fund to the Medical Assistance trust fund an amount equal to the amount in the schedule under
s. 20.005 (3) for the appropriation under
s. 20.435 (4) (xc) for that fiscal year minus the state share of payments to hospitals required under
s. 49.45 (3) (e) 11., and minus any refunds paid to hospitals from the hospital assessment fund under
sub. (6) (a) in that fiscal year.
50.38(9)
(9) On June 30 of each state fiscal year, the secretary of administration shall transfer from the Medical Assistance trust fund to the appropriation account under
s. 20.435 (4) (jw), an amount equal to 0.5 percent of the amount transferred under
sub. (8).
50.38(10)
(10) In each state fiscal year, the secretary of administration shall transfer from the critical access hospital assessment fund to the Medical Assistance trust fund an amount equal to the amount collected under
sub. (2) (b) minus the state share of the amount required to be expended under
s. 49.45 (3) (e) 12., minus the amounts appropriated under
s. 20.285 (1) (qe) and
(qj), and minus any refunds paid to critical access hospitals from the critical access hospital assessment fund under
sub. (6m) (a) in that fiscal year.
50.38 History
History: 2009 a. 2,
190;
2011 a. 260 s.
81.
50.39
50.39
Exemptions and enforcement. 50.39(1)
(1)
Sections 50.32 to
50.39 and the rules promulgated pertaining thereto shall apply to all facilities coming under the definition of a "hospital" which are not specifically exempt by
ss. 50.32 to
50.39.
50.39(2)
(2) The use of the title "hospital" to represent or identify any facility which does not meet the definition of a "hospital" as provided herein or is not subject to approval under
ss. 50.32 to
50.39 is prohibited, except that institutions governed by
s. 51.09 are exempt.
50.39(3)
(3) Facilities governed by
ss. 45.50,
48.62,
49.70,
49.72,
50.02,
51.09, and
252.10, juvenile correctional facilities as defined in
s. 938.02 (10p), correctional institutions governed by the department of corrections under
s. 301.02, and the offices and clinics of persons licensed to treat the sick under
chs. 446,
447, and
448 are exempt from
ss. 50.32 to
50.39.
Sections 50.32 to
50.39 do not abridge the rights of the medical examining board, physical therapy examining board, podiatry affiliated credentialing board, dentistry examining board, pharmacy examining board, chiropractic examining board, and board of nursing in carrying out their statutory duties and responsibilities.
50.39(4)
(4) All orders issued by the department pursuant to
ss. 50.32 to
50.39 shall be enforced by the attorney general. The circuit court of Dane County shall have jurisdiction to enforce such orders by injunctional and other appropriate relief.
50.39(5)(a)(a) The department may, in the event of an emergency condition that imminently threatens the health or safety of patients of a hospital, suspend new admissions to all or a part of the hospital until such time as the department decides that the hospital has removed or corrected the causes or deficiencies creating the emergency.
50.39(5)(b)
(b) Immediately upon the suspension of new admissions under
par. (a), the department shall notify the hospital in writing. Notice of the suspension shall include a clear and concise statement of the causes or deficiencies creating the emergency condition on which the suspension is based and notice of the opportunity for a hearing on the suspension or on recision of the suspension under
s. 227.44. If the hospital desires to contest the suspension, it shall provide written notice to the department of a request for a hearing within 10 days after receipt of the notice of suspension. If the hospital desires to contest failure by the department to rescind the suspension, it shall provide written notice to the department of a request for a hearing.
50.39(6)
(6) In addition to any other remedies provided by law, any person suffering a pecuniary loss because of a violation of
s. 50.36 (3) (a) may bring a civil action in any court of competent jurisdiction to recover the amount of the pecuniary loss, together with costs and disbursements, including reasonable attorney fees.
50.39 History
History: 1971 c. 164;
1975 c. 39;
1975 c. 413 ss.
4,
18;
1975 c. 430 s.
80; Stats. 1975 s. 50.39;
1977 c. 203;
1979 c. 89,
221,
337,
355;
1985 a. 332 s.
251 (1);
1989 a. 31,
37,
107;
1991 a. 39;
1993 a. 27,
30,
107;
1995 a. 27,
77;
1997 a. 175;
1999 a. 9;
2005 a. 22,
344;
2007 a. 97;
2009 a. 113,
149;
2011 a. 258.
50.39 Cross-reference
Cross-reference: See also ch.
DHS 124, Wis. adm. code.
50.49
50.49
Licensing and regulation of home health agencies. 50.49(1)(1)
Definitions. As used in this section, unless a different meaning appears from the context:
50.49(1)(a)
(a) "Home health agency" means an organization that:
50.49(1)(a)1.
1. Primarily provides skilled nursing and other therapeutic services;
50.49(1)(a)2.
2. Has policies established by a professional group including at least one physician and at least one registered nurse to govern services, and provides for supervision of these services by a physician or a registered nurse; and
50.49(1)(b)
(b) "Home health services" means the following items and services that are furnished to an individual, who is under the care of a physician, physician assistant, or advanced practice nurse prescriber, by a home health agency, or by others under arrangements made by the home health agency, that are under a plan for furnishing those items and services to the individual that is established and periodically reviewed by a physician, physician assistant, or advanced practice nurse prescriber and that are, except as provided in
subd. 6., provided on a visiting basis in a place of residence used as the individual's home:
50.49(1)(b)1.
1. Part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse;
50.49(1)(b)2.
2. Physical or occupational therapy or speech-language pathology;
50.49(1)(b)3.
3. Medical social services under the direction of a physician;
50.49(1)(b)4.
4. Medical supplies, other than drugs and biologicals, and the use of medical appliances, while under such a plan;
50.49(1)(b)5.
5. In the case of a home health agency which is affiliated or under common control with a hospital, medical services provided by an intern or resident-in-training of such hospital, under an approved teaching program of such hospital; and
50.49(1)(b)6.
6. Any of the foregoing items and services which are provided on an outpatient basis, under arrangements made by the home health agency, at a hospital or extended care facility, or at a rehabilitation center which meets such standards as may be prescribed by rule, and the furnishing of which involves the use of equipment of such a nature that the items and services cannot readily be made available to the individual in such place of residence, or which are furnished at such facility while the individual is there to receive any such item or service, but not including transportation of the individual in connection with any such item or service.
50.49(1)(c)
(c) "Patient" means individuals cared for or treated by home health agencies.
50.49(2)(a)(a) The department may develop, establish and enforce standards for the care, treatment, health, safety, welfare and comfort of patients by home health agencies and for the maintenance and operation of home health agencies which, in the light of advancing knowledge, will promote safe and adequate care and treatment of such patients by home health agencies.
50.49(2)(b)
(b) The department shall, by rule, set a license fee to be paid by home health agencies.
50.49(3)
(3) Administration. The administration of this section shall be under the department which shall make or cause to be made such inspections and investigations as it deems necessary.
50.49(4)
(4) Licensing, inspection and regulation. Except as provided in
sub. (6m), the department may register, license, inspect and regulate home health agencies as provided in this section. The department shall ensure, in its inspections of home health agencies, that a sampling of records from private pay patients are reviewed. The department shall select the patients who shall receive home visits as a part of the inspection. Results of the inspections shall be made available to the public at each of the regional offices of the department. If the department takes enforcement action against a home health agency for a violation of this section or rules promulgated under this section, and the department subsequently conducts an on-site inspection of the home health agency to review the home health agency's action to correct the violation, the department may impose a $200 inspection fee on the home health agency.
50.49(5)
(5) Application for registration and license. 50.49(5)(a)(a) Registration shall be in writing in such form and contain such information as the department requires.
50.49(5)(b)
(b) The application for a license shall be in writing upon forms provided by the department and shall contain such information as it requires.
50.49(6)
(6) Issuance of license; inspection and investigation; annual report; nontransferability; content. 50.49(6)(a)(a) Except as provided in
s. 50.498, the department shall issue a home health agency license if the applicant is fit and qualified, and if the home health agency meets the requirements established by this section. The department, or its designated representatives, shall make such inspections and investigations as are necessary to determine the conditions existing in each case and file written reports. Each licensee shall annually file a report with the department.
50.49(6)(b)
(b) A home health agency license is valid until suspended or revoked, except as provided in
s. 50.498.
50.49(6)(c)
(c) Each license shall be issued only for the home health agency named in the application and is not transferable or assignable. Any license granted shall state such additional information and special limitations as the department, by rule, prescribes.
50.49(6)(d)
(d) Every 12 months, on a schedule determined by the department, a licensed home health agency shall submit an annual report in the form and containing the information that the department requires, including payment of the fee required under
sub. (2) (b). If a complete annual report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
50.49(6m)
(6m) Exceptions. None of the following is required to be licensed as a home health agency under
sub. (4), regardless of whether any of the following provides services that are similar to services provided by a home health agency:
50.49(6m)(am)
(am) An entity with which a care management organization, as defined in
s. 46.2805 (1), contracts for care management services under
s. 46.284 (4) (d), for purposes of providing the contracted services.
