Section 153.75. Rule making.

 

(1)  The department shall promulgate the following rules, of which pars. (a) , (b) , (f) , (h) , (m) , (n) , (o) , (r) , (t) , and (u) shall apply only if the contract under s. 153.05 (2r) is terminated under s. 153.455 (3) and s. 153.455 (4) applies:

(a) Providing procedures, for information submitted by health care providers who are not hospitals or ambulatory surgery centers, to ensure the protection of patient confidentiality under s. 153.50 .

(b) Establishing procedures under which health care providers who are not hospitals or ambulatory surgery centers are permitted to review, verify and comment on information and include the comments with the information.

(f) Governing the release of health care provider-specific and employer-specific data under s. 153.45 (1m) and (3) .

(g) Establishing criteria for the publication and contents of notices under s. 153.08 .

(h) Defining the term “major purchaser, payer or provider of health care services" for the purposes of s. 153.05 (6) .

(k) Establishing methods and criteria for assessing health care providers under s. 153.60 (1) .

(m) Specifying the classes of health care providers, other than hospitals and ambulatory surgery centers, from whom claims data and other health care information will be collected.

(n) Specifying the uniform data set of health care information, as adjusted for case mix and severity, to be collected from health care providers other than hospitals and ambulatory surgery centers.

(o) Specifying the means by which the information in par. (b) will be collected, including the procedures for submission of data by electronic means.

(p) Specifying the methods for using and disseminating health care data in order for health care providers other than hospitals and ambulatory surgery centers to provide health care that is effective and economically efficient and for consumers and purchasers to make informed decisions in selecting health care plans and health care providers.

(q) Specifying the information to be provided by the department in the consumer guide under s. 153.21 (1) .

(r) Specifying the standard reports that will be issued by the department in addition to those required in s. 153.21 (1) .

(s) Defining “individual data elements" for purposes of s. 153.45 (4) .

(t) Establishing standards for determining under s. 153.05 (13) if a requirement under s. 153.05 (1) (a) , (5) (a) , or (8) (a) is burdensome for a health care provider other than a hospital or ambulatory surgery center.

(u) Specifying the methods for adjusting health care information obtained from health care providers other than hospitals and ambulatory surgery centers for case mix and severity.

(2)  The department may promulgate all of the following rules, which shall apply only if the contract under s. 153.05 (2r) is terminated under s. 153.455 (3) and s. 153.455 (4) applies:

(a) Exempting certain classes of health care providers that are not hospitals or ambulatory surgery centers from providing all or portions of the data required under this subchapter.

(c) Providing for the efficient collection, analysis and dissemination of health care information which the department may require under this subchapter.

1987 a. 399 ; 1989 a. 18 ; 1993 a. 16 ; 1997 a. 27 , 231 ; 2003 a. 33 ; 2005 a. 228 ; 2009 a. 274 .

Note

2015 Wis. Act 55 consolidated s. 153.60 (1) with s. 153.60 (intro.) and the consolidated provision was renumbered to be s. 153.60 and amended. The provision for the assessment of health care providers in the former s. 153.60 (1) was deleted from the consolidated s. 153.60 by the Act 55 amendment, rendering par. (k) without effect. Corrective legislation is pending. Microsoft Windows NT 6.1.7601 Service Pack 1 Cross-reference: See also ch. DHS 120 , Wis. adm. code. Microsoft Windows NT 6.1.7601 Service Pack 1