LRBa1628/3
PJK:jld&nwn:rs
2009 - 2010 LEGISLATURE
ASSEMBLY AMENDMENT 1,
TO 2009 ASSEMBLY BILL 675
March 2, 2010 - Offered by Representative Roys.
AB675-AA1,1,11 At the locations indicated, amend the bill as follows:
AB675-AA1,1,2 21. Page 3, line 23: after that line insert:
AB675-AA1,1,3 3" Section 5m. 619.04 (3) of the statutes is amended to read:
AB675-AA1,2,34 619.04 (3) The plan shall operate subject to the supervision and approval of a
5board of governors consisting of 3 representatives of the insurance industry
6appointed by and to serve at the pleasure of the commissioner, a person to be named
7by the State Bar Association, a person to be named by the Wisconsin Academy of Trial
8Lawyers, 2 persons to be named by the Wisconsin Medical Society, a person to be
9named by the Wisconsin Hospital Association, a person to be named by the Wisconsin
10Nurses Association,
the commissioner or a designated representative employed by
11the office of the commissioner, and 4 public members at least 2 of whom are not
12attorneys or physicians and are not professionally affiliated with any hospital or
13insurance company, appointed by the governor for staggered 3-year terms. The

1commissioner or the commissioner's representative shall be the chairperson of the
2board of governors. Board members shall be compensated at the rate of $50 per diem
3plus actual and necessary travel expenses.".
AB675-AA1,2,4 42. Page 4, line 6: after that line insert:
AB675-AA1,2,6 5" Section 6m. 655.001 (7t) (a) of the statutes, as affected by 2009 Wisconsin Act
6.... (this act), is renumbered 655.001 (7t) and amended to read:
AB675-AA1,2,117 655.001 (7t) Except as provided in par. (b), "health "Heath care practitioner"
8means a health care professional, as defined in s. 180.1901 (1m), who is an employee
9of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has
10the authority to provide health care services that are not under the direction and
11supervision of a physician or, nurse anesthetist, or nurse-midwife.".
AB675-AA1,2,13 123. Page 4, line 8: delete the material beginning with "person" and ending with
13"s. 441.15" on line 9 and substitute "nurse-midwife".
AB675-AA1,2,14 144. Page 4, line 9: after that line insert:
AB675-AA1,2,16 15" Section 7b. 655.001 (7t) (b) of the statutes, as created by 2009 Wisconsin Act
16.... (this act), is repealed.
AB675-AA1, s. 7d 17Section 7d. 655.001 (9c) of the statutes is created to read:
AB675-AA1,2,1918 655.001 (9c) "Nurse-midwife" means a person who is licensed to practice
19nurse-midwifery under s. 441.15.
AB675-AA1, s. 7f 20Section 7f. 655.002 (1) (a) of the statutes is amended to read:
AB675-AA1,2,2321 655.002 (1) (a) A physician or, a nurse anesthetist, or a nurse-midwife for
22whom this state is a principal place of practice and who practices his or her profession
23in this state more than 240 hours in a fiscal year.
AB675-AA1, s. 7h 24Section 7h. 655.002 (1) (b) (intro.) of the statutes is amended to read:
AB675-AA1,3,2
1655.002 (1) (b) (intro.) A physician or, a nurse anesthetist, or a nurse-midwife
2for whom Michigan is a principal place of practice, if all of the following apply:
AB675-AA1, s. 7i 3Section 7i. 655.002 (1) (b) 1. of the statutes is amended to read:
AB675-AA1,3,54 655.002 (1) (b) 1. The physician or, nurse anesthetist, or nurse-midwife is a
5resident of this state.
AB675-AA1, s. 7j 6Section 7j. 655.002 (1) (b) 2. of the statutes is amended to read:
AB675-AA1,3,97 655.002 (1) (b) 2. The physician or, nurse anesthetist, or nurse-midwife
8practices his or her profession in this state or in Michigan or a combination of both
9more than 240 hours in a fiscal year.
AB675-AA1, s. 7k 10Section 7k. 655.002 (1) (b) 3. of the statutes is amended to read:
AB675-AA1,3,1511 655.002 (1) (b) 3. The physician or, nurse anesthetist, or nurse-midwife
12performs more procedures in a Michigan hospital than in any other hospital. In this
13subdivision, "Michigan hospital" means a hospital located in Michigan that is an
14affiliate of a corporation organized under the laws of this state that maintains its
15principal office and a hospital in this state.
AB675-AA1, s. 7m 16Section 7m. 655.002 (1) (c) of the statutes is amended to read:
AB675-AA1,3,2417 655.002 (1) (c) A physician or, nurse anesthetist, or nurse-midwife who is
18exempt under s. 655.003 (1) or (3), or a nurse-midwife who is exempt under s. 655.03
19(4),
but who practices his or her profession outside the scope of the exemption and
20who fulfills the requirements under par. (a) in relation to that practice outside the
21scope of the exemption. For a physician or a, nurse anesthetist, or nurse-midwife
22who is subject to this chapter under this paragraph, this chapter applies only to
23claims arising out of practice that is outside the scope of the exemption under s.
24655.003 (1) or (3) or (4).
AB675-AA1, s. 7p 25Section 7p. 655.002 (1) (d) of the statutes is amended to read:
AB675-AA1,4,4
1655.002 (1) (d) A partnership comprised of physicians or, nurse anesthetists,
2or nurse-midwives
and organized and operated in this state for the primary purpose
3of providing the medical services of physicians or, nurse anesthetists, or
4nurse-midwives
.
AB675-AA1, s. 7q 5Section 7q. 655.002 (1) (e) of the statutes is amended to read:
AB675-AA1,4,86 655.002 (1) (e) A corporation organized and operated in this state for the
7primary purpose of providing the medical services of physicians or, nurse
8anesthetists, or nurse-midwives.
AB675-AA1, s. 7r 9Section 7r. 655.002 (1) (em) of the statutes is amended to read:
AB675-AA1,4,1210 655.002 (1) (em) Any organization or enterprise not specified under par. (d) or
11(e) that is organized and operated in this state for the primary purpose of providing
12the medical services of physicians or, nurse anesthetists, or nurse-midwives.
AB675-AA1, s. 7t 13Section 7t. 655.002 (2) (a) of the statutes is amended to read:
AB675-AA1,4,1714 655.002 (2) (a) A physician or, nurse anesthetist, or nurse-midwife for whom
15this state is a principal place of practice but who practices his or her profession fewer
16than 241 hours in a fiscal year, for a fiscal year, or a portion of a fiscal year, during
17which he or she practices his or her profession.
AB675-AA1, s. 7v 18Section 7v. 655.002 (2) (b) of the statutes is amended to read:
AB675-AA1,4,2519 655.002 (2) (b) Except as provided in sub. (1) (b), a physician or, nurse
20anesthetist, or nurse-midwife for whom this state is not a principal place of practice,
21for a fiscal year, or a portion of a fiscal year, during which he or she practices his or
22her profession in this state. For a health care provider who elects to be subject to this
23chapter under this paragraph, this chapter applies only to claims arising out of
24practice that is in this state and that is outside the scope of an exemption under s.
25655.003 (1) or (3) or (4).".
AB675-AA1,4,26
15. Page 4, line 10: delete lines 10 and 11.
AB675-AA1,5,2 26. Page 4, line 11: after that line insert:
AB675-AA1,5,3 3" Section 8f. 655.003 (1) of the statutes is amended to read:
AB675-AA1,5,74 655.003 (1) A physician or, a nurse anesthetist, or a nurse-midwife who is a
5state, county, or municipal employee, or federal employee or contractor covered
6under the federal tort claims act, as amended, and who is acting within the scope of
7his or her employment or contractual duties.
AB675-AA1, s. 8h 8Section 8h. 655.003 (3) of the statutes is amended to read:
AB675-AA1,5,139 655.003 (3) A physician or, a nurse anesthetist, or a nurse-midwife who
10provides professional services under the conditions described in s. 146.89 or 250.042
11(4) (b)
, with respect to those professional services provided by the physician or, nurse
12anesthetist, or nurse-midwife for which he or she is covered by s. 165.25 and
13considered an agent of the department, as provided in s. 165.25 (6) (b).
AB675-AA1, s. 8j 14Section 8j. 655.003 (4) of the statutes is created to read:
AB675-AA1,5,1615 655.003 (4) A nurse-midwife who is considered to be an employee of the federal
16public health service under 42 USC 233 (g).".
AB675-AA1,5,17 177. Page 4, line 16: after that line insert:
AB675-AA1,5,19 18" Section 10. 655.005 (2) (a) of the statutes, as affected by 2009 Wisconsin Act
19.... (this act), is amended to read:
AB675-AA1,5,2320 655.005 (2) (a) An employee of a health care provider if the employee is a
21physician or a, nurse anesthetist, or nurse-midwife or is a health care practitioner
22who is providing health care services that are not under the direction and
23supervision of a physician or, nurse anesthetist, or nurse-midwife.
AB675-AA1, s. 11 24Section 11. 655.005 (2) (b) of the statutes is amended to read:
AB675-AA1,6,9
1655.005 (2) (b) A service corporation organized under s. 180.1903 by health care
2professionals, as defined under s. 180.1901 (1m), if the board of governors determines
3that it is not the primary purpose of the service corporation to provide the medical
4services of physicians or, nurse anesthetists, or nurse-midwives. The board of
5governors may not determine under this paragraph that it is not the primary purpose
6of a service corporation to provide the medical services of physicians or, nurse
7anesthetists, or nurse-midwives unless more than 50% of the shareholders of the
8service corporation are neither not physicians nor, nurse anesthetists, or
9nurse-midwives
.
AB675-AA1, s. 12 10Section 12. 655.23 (5m) of the statutes is amended to read:
AB675-AA1,6,1311 655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of
12a physician or, nurse anesthetist, or nurse-midwife and his or her corporation,
13partnership, or other organization or enterprise under s. 655.002 (1) (d), (e), or (em).
AB675-AA1, s. 13 14Section 13. 655.27 (3) (a) 4. of the statutes is amended to read:
AB675-AA1,6,1815 655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e),
16(em), or (f), risk factors and past and prospective loss and expense experience
17attributable to employees of that health care provider other than employees licensed
18as a physician or, nurse anesthetist , or nurse-midwife.
AB675-AA1, s. 14 19Section 14. 655.27 (3) (b) 2f. of the statutes is created to read:
AB675-AA1,6,2420 655.27 (3) (b) 2f. With respect to fees paid by nurse-midwives, the rule may
21provide for a separate payment classification or for a payment classification that is
22combined with one or more other categories of health care providers, as the
23commissioner, after approval by the board of governors, determines is appropriate
24for pooling risks under the fund.
AB675-AA1, s. 15 25Section 15. 655.27 (3) (b) 2m. of the statutes is amended to read:
AB675-AA1,7,7
1655.27 (3) (b) 2m. In addition to the fees and payment classifications described
2under subds. 1. and 2. to 2f., the commissioner, after approval by the board of
3governors, may by rule establish a separate payment classification for physicians
4satisfying s. 655.002 (1) (b) and, a separate fee for nurse anesthetists satisfying s.
5655.002 (1) (b), and a separate fee for nurse-midwives satisfying s. 655.002 (1) (b)
6which take into account the loss experience of health care providers for whom
7Michigan is a principal place of practice.
AB675-AA1, s. 16 8Section 16. 655.275 (5) (b) 3. of the statutes is created to read:
AB675-AA1,7,109 655.275 (5) (b) 3. If a claim was paid for damages arising out of the rendering
10of care by a nurse-midwife, with at least one nurse-midwife.
AB675-AA1, s. 17 11Section 17. Nonstatutory provisions.
AB675-AA1,7,15 12(1) Expiration of term of member on board of governors. Notwithstanding
13the length of terms specified for the members of the board of governors under section
14619.04 (3) of the statutes, as affected by this act, the initial member named by the
15Wisconsin Nurses Association shall be appointed for a term expiring on May 1, 2013.
AB675-AA1,7,25 16(2) Notice of effective date of rule for fees. The commissioner of insurance
17shall promulgate a rule under section 655.27 (3) (b) of the statutes, as affected by this
18act, that takes into account participation in the injured patients and families
19compensation fund by nurse-midwives. The rule may provide for a separate
20payment classification or for a payment classification that is combined with one or
21more other categories of health care providers, as the commissioner, after approval
22by the board of governors, determines is appropriate for pooling risks under the fund.
23When the rule has been promulgated and is in effect, the commissioner of insurance
24shall publish a notice in the Wisconsin Administrative Register that specifies the
25effective date of the rule.
AB675-AA1, s. 18
1Section 18. Effective dates. This act takes effect on the first day of the 3rd
2month beginning after the date published by the commissioner of insurance in the
3Wisconsin Administrative Register under 2009 Wisconsin Act .... (this act), section
417 (2), except as follows:
AB675-AA1,8,9 5(1) The treatment of sections 50.36 (3i), 441.51 (1) (a) and (c), (2) (b), and (4),
6619.04 (3), 655.001 (9c), and 655.005 (2) (a) (by Section 9) of the statutes, the
7renumbering and amendment of section 655.001 (7t) of the statutes, the creation of
8section 655.001 (7t) (b) of the statutes, and Section 17 of this act take effect on the
9day after publication.".
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