DHS 120.16(1)(1) Applicability. This section applies to health care plans that either voluntarily submit health care plan data directly to the department or submit it to the department through the data collection of other state agencies. DHS 120.16(2)(2) Data to be collected. The department shall collect all of the following types of data from each participating health care plan or through a designated state agency: DHS 120.16(2)(a)(a) Financial data. Information regarding the financial status of the health care plan secured under the authority of the commissioner of insurance. DHS 120.16(2)(b)(b) Market conduct. Information regarding the conduct of the health care plan in the marketplace secured under the authority of the commissioner of insurance. DHS 120.16(2)(c)(c) Quality indicators. Measures of quality of care provided by the health care plan from the office of the commissioner of insurance. DHS 120.16 NoteNote: Quality indicators include Health Plan Employer Data and Information (HEDIS) measures and Consumer Assessment of Health Plans (CAHPS) patient satisfaction measures.
DHS 120.16(2)(d)(d) Grievances and complaints data. Measures of grievances and complaints filed by enrollees of the health care plan from the office of the commissioner of insurance and the department of employee trust funds. DHS 120.16(3)(3) Data submission procedures. State agencies specified in sub. (2) shall forward to the department information specified in sub. (2) in electronic files on an annual basis. The information shall be in a format that has been agreed upon by the department and the state agencies. DHS 120.16(4)(4) Data verification, review and comment procedures. Each of the state agencies specified in sub. (2) shall verify that the information provided to the department has been reviewed and meets the agency’s standards for release to the public. DHS 120.16(5)(5) Data adjustment methods. The department shall include caveats regarding the information the department releases to the public, when needed, to assist consumers in understanding the differences in populations served by the health care plans. Caveats may include references to large populations, such as commercial, medical assistance or medicare populations. DHS 120.16 HistoryHistory: Cr. Register, December, 2000, No. 540, eff. 1-1-01. DHS 120.20(1)(1) Standard reports. The department shall prepare the paper reports listed in this subsection and shall make these paper reports available to the public at a charge that meets the department’s cost of printing, copying and mailing a report to the requester. The department shall make electronic copies of the reports available from the department’s website at no charge. DHS 120.20(2)(2) Prohibition on early release of reports. If the department releases drafts of any of the standard reports to health care providers for comment, health care providers or subsequent holders of the drafts may not release these reports or data elements from the reports. DHS 120.20(3)(a)(a) Except as prohibited under par. (b), the data used to compile the reports under this chapter are not subject to inspection, copying or receipt as specified in the open records provisions under s. 19.35 (1), Stats. When the department completes the reports and distributes them to the governor and legislature the reports shall be publicly available. DHS 120.20 HistoryHistory: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 03-033: am. (3) (b) Register December 2003 No. 576, eff. 1-1-04. DHS 120.21DHS 120.21 Guide to Wisconsin hospitals. DHS 120.21(1)(1) Data sources. The guide to Wisconsin hospitals shall be based on data derived from all of the following sources: