EmR1306. Relating to: Injured Patients and Families Compensation Fund Annual Fund and Mediation Panel Fees, and ISO code amendments for the fiscal year beginning July 1, 2013  


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    EmR1306

    Filed with LRB:  June 10, 2013

    Publication Date:  June 12, 2013

    Effective Dates:  June 12, 2013 through November 8, 2013

    Hearing Date:  July 23, 2013

    EMERGENCY ORDER AMENDING, REPEALING AND CREATING A RULE.

    Office of the Commissioner of Insurance

     

    Rule No . 042-13 :  To amend s. Ins 17.01 (3), and 17.28 (3) (c) and to repeal and recreate s. Ins 17.28 (6), Wis. Admin. Code.

     

    Relating to : Injured Patients and Families Compensation Fund Annual Fund and Mediation Panel Fees, and ISO code amendments for the fiscal year beginning July 1, 2013, and affecting small business.

     

    The statement of scope for this rule SS 042-13, was approved by the Governor on April 16, 2013, published in Register No. 688, on April 30, 2013, and approved by the Commissioner on May 10, 2013. 

     

    This emergency rule was approved by the Governor on June 4, 2013.

    _____________________________________________________________________________

    FINDING OF EMERGENCY

    The Commissioner of Insurance finds that an emergency exists and that the attached rule is necessary for the immediate preservation of the public peace, health, safety, or welfare. Facts constituting the emergency are as follows:

    These changes must be in place with an effective date prior to July 1, 2013 in order for the new fiscal year assessments to be issued in accordance with s. 655.27 (3), Wis. Stats.  The permanent rule-making process cannot be completed prior to the effective date of the new fee schedule.  The fiscal year fund fees were established by the Board of Governors at the meeting held on December 19, 2012 and the mediation panel fees established by the Board of Governors at the meeting held on March 20, 2013.

    _____________________________________________________________________________

    ANALYSIS PREPARED BY THE OFFICE OF THE COMMISSIONER OF INSURANCE (OCI)

        1.     Statutes interpreted:

    ss. 655.27 (3), and 655.61, Wis. Stats.

        2.     Statutory authority:

    ss. 601.41 (3), 655.004, 655.27 (3) (b), and 655.61, Wis. Stats.

       3.      Explanation of OCI’s authority to promulgate the proposed rule:

    The injured patients and families compensation fund (“fund”), was established by and operated under Ch. 655, Stats.  The commissioner of insurance with approval of the board of governors (“board”) is required to annually set the fees for the fund and the medical mediation panel by administrative rule.  The proposed fees comply with the limitation delineated in s. 655.27 (3) (br), Stats.  Section 655.04, Stats., provides that the director of state courts and the commissioner may promulgate rules necessary to enable them to perform their responsibilities under this chapter.  Pursuant to s. 655.27 (3) (b), Stats., the commissioner, after approval by the board, shall by rule set the fees to the fund and s. 655.61, Stats., requires the board, by rule, to set the fees charged to health care providers at a level sufficient to provide the necessary revenue to fund the medical mediation panels.  Further, s. 601.41 (3), Stats., provides that the commissioner shall have rule-making authority pursuant to s. 227.11 (2), Stats.

        4.     Related statutes or rules:

    None.

        5.     Plain language analysis:

    This proposed rule establishes the fees that participating health care providers must pay to the fund for the fiscal year beginning July 1, 2013.  These fees represent a 5% decrease from fees paid for the 2012-2013 fiscal year.  The board approved these fees at its meeting on December 19, 2012, based on the recommendation of the board's actuarial and underwriting committee and reports of the fund’s actuaries. 

    The board is also required to promulgate by rule the annual fees for the operation of the injured patients and families compensation medical mediation system, based on the recommendation of the director of state courts.  The recommendation of the director of state courts was reviewed by the board’s actuarial and underwriting committee.  This rule implements the funding level approved by the board on March 20, 2013 by establishing mediation panel fees for the next fiscal year at $0 for physicians and $0 per occupied bed for hospitals, representing a decrease of $22.50 per physician and a decrease of $4.50 per occupied bed for hospitals from 2012-13 fiscal year mediation panel fees.

    Finally this rule includes changes to the Insurance Services Office (ISO) code listing to address corrections to several classification specialties as well as new classification specialties.  ISO codes are the numerical designation for a health care provider’s specialty and are used to classify the provider for assessment purposes.  Errors identified in the ISO codes or specialty narratives for three specialties have been corrected.  A third specialty had duplicate listings resulting in the exclusion of another specialty which has now been added.  The Doctor of Osteopathy (D.O.) designated ISO codes have been added for two specialties previously listed only under the Doctor of Medicine (M.D.) ISO codes.

        6.     Summary of and comparison with any existing or proposed federal statutes and regulations:

    To the fund board’s and OCI’s knowledge there is no existing or proposed federal regulation that is intended to address fund rates, administration or to fund medical mediation panel activities.

        7.     Comparison with rules in adjacent states:

    To the fund board’s and OCI’s knowledge there are no similar rules in the adjacent states to compare this rule to as none of adjacent states have a fund created by statute where rates are directed to be established yearly by rule as is true in Wisconsin.

        8.     A summary of the factual data and analytical methodologies that OCI used in support of the proposed rule:

    None.  This rule establishes annual fund fees pursuant to the requirements of the above-noted Wisconsin statutes.  The recommendation to the board regarding the fund fee and the medical mediation panel assessment is developed and reviewed annually by the fund’s actuaries and the board’s actuarial and underwriting committee.  The actuarial and underwriting committee after review and discussion with the fund’s actuaries present the information and the actuaries report to the board for consideration.  This proposed rule reflects the rates approved by the board at the December 19, 2012 and March 20, 2013 board meetings.

        9.     Analysis and supporting documentation that OCI used in support of OCI’s determination of the rule’s effect on small business or in preparation of an economic impact analysis:

    This decrease in fund fees will have a positive effect on small businesses in Wisconsin, particularly those that employ physicians and other health care professionals.  The mediation panel fee is assessed only on physicians and hospitals, not on corporations or other health care entities that will also benefit from the reduction to zero fees for fiscal year 2014.  The fund fee decrease will affect only those small businesses that pay the fund fees and mediation panel fees on behalf of their employed physicians.  The fund fee decrease will not have a significant effect nor should it negatively affect the small business’s ability to compete with other providers. 

      10.     Effect on small business:

    This rule will have little or no effect on small businesses.  The decrease contained in the proposed rule will require providers to pay reduced fund fees which will decrease the operational expenses for the providers.  The decrease in fees promulgated by this rule should not result in a significant fiscal effect on the private sector. 

      11.     A copy of any comments and opinion prepared by the Board of Veterans Affairs under s. 45.03 (2m), Stats., for rules proposed by the Department of Veterans Affairs.

                      None.

      12.     Agency contact person:

    A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the Web site at: http://oci.wi.gov/ocirules.htm

    or by contacting Inger Williams, OCI Services Section, at:

    Phone:          (608) 264-8110

    Email:           inger.williams@wisconsin.gov

    Address:       125 South Webster St – 2 nd Floor, Madison WI 53703-3474

    Mail:             PO Box 7873, Madison, WI 53707-7873

      13.     Place where comments are to be submitted and deadline for submission:

    The deadline for submitting comments is 4:00 p.m. on the 14 th day after the date for the hearing stated in the Notice of Hearing.

    Mailing address:

    Julie E. Walsh

    Legal Unit - OCI Rule Comment for Rule Ins 1701

    Office of the Commissioner of Insurance

    PO Box 7873

    Madison WI 53707-7873

    Street address:

    Julie E. Walsh

    Legal Unit - OCI Rule Comment for Rule Ins 1701

    Office of the Commissioner of Insurance

    125 South Webster St – 2 nd Floor

    Madison WI 53703-3474

    Email address:

    Julie E. Walsh

    Julie.Walsh@wisconsin.gov

    Web site: http://oci.wi.gov/ocirules.htm

     

    _____________________________________________________________________________

    The proposed rule changes are:

    SECTION 1. Ins 17.01 (3) is amended to read :

    Ins 17.01 (3) FEE SCHEDULE.  The following fee schedule shall be effective July 1, 2012 2013 :

    (a)   For physicians--  $22.50 $0 .

    (b)   For hospitals, per occupied bed-- $4.50 $0 .

     

    SECTION 2. Ins 17.28 (3) (c) 1., 2., and 3., are amended to read:

    Ins 17.28 (3) (c) 1.  Class 1:

     

     

    Administrative Medicine

    80120

     

    Aerospace Medicine

    80230

     

    Allergy

    80254

     

    Allergy (D.O.)

    84254

     

    Cardiovascular Disease—no surgery or catheterization

    80255

     

    Cardiovascular Disease—no surgery or catheterization (D.O.)

    84255

     

    Dermatology—no surgery

    80256

     

    Dermatology—no surgery (D.O.)

    84256

     

    Diabetes—no surgery

    80237

     

    Endocrinology—no surgery

    80238

     

    Endocrinology—no surgery (D.O.)

    84238

     

    Family or General Practice—no surgery

    80420

     

    Family or General Practice—no surgery (D.O.)

    84420

     

    Forensic Medicine—Legal Medicine

    80240

     

    Forensic Medicine—Legal Medicine (D.O.)

    84240

     

    Gastroenterology—no surgery

    80241

     

    Gastroenterology—no surgery (D.O.)

    84241

     

    General Preventive Medicine—no surgery

    80231

     

    General Preventive Medicine—no surgery (D.O.)

    84231

     

    Geriatrics—no surgery

    80243

     

    Geriatrics—no surgery (D.O.)

    84243

     

    Gynecology—no surgery

    80244

     

    Gynecology—no surgery (D.O.)

    84244

     

    Hematology—no surgery

    80245

     

    Hematology—no surgery (D.O.)

    84245

     

    Hypnosis

    80232

     

    Infectious Diseases—no surgery

    80246

     

    Infectious Diseases—no surgery (D.O.)

    84246

     

    Internal Medicine—no surgery

    80257

     

    Internal Medicine—no surgery  (D.O.)

    84257

     

    Laryngology—no surgery

    80258

     

    Manipulator (D.O.)

    84801

     

    Neoplastic Disease—no surgery

    80259

     

    Nephrology—no surgery

    80260

     

    Nephrology – no surgery (D.O.)

    84260

     

    Neurology—no surgery

    80261

     

    Neurology—no surgery (D.O.)

    84261

     

    Nuclear Medicine

    80262

     

    Nuclear Medicine (D.O.)

    84262

     

    Nutrition

    80248

     

    Occupation Medicine

    80233

     

    Occupation Medicine (D.O.)

    84233

     

    Oncology – no surgery

    80302

     

    Oncology – no surgery (D.O.)

    84302

     

    Ophthalmology—no surgery

    80263

     

    Ophthalmology—no surgery (D.O.)

    84263

     

    Osteopathy—manipulation only

    84801

     

    Otology – no surgery

    80247

    80264

    Otorhinolaryngology—no surgery

    80265

     

    Otorhinolaryngology—no surgery (D.O.)

    84265

     

    Pain Management – no surgery

    80208

     

    Pain Management – no surgery (D.O.)

    84208

     

    Pathology—no surgery

    80266

     

    Pathology—no surgery (D.O.)

    84266

     

    Pediatrics—no surgery

    80267

     

    Pediatrics—no surgery (D.O.)

    84267

     

    Pharmacology—Clinical

    80234

     

    Physiatry—Physical Medicine (D.O.)

    84235

     

    Physiatry—Physical Medicine & Rehabilitation

    80235

     

    Physicians—no surgery

    80268

     

    Physicians—no surgery (D.O.)

    84268

     

    Psychiatry

    80249

     

    Psychiatry—(D.O.)

    84249

     

    Psychoanalysis

    80250

     

    Psychosomatic Medicine

    80251

     

    Psychosomatic Medicine (D.O.)

    84251

     

    Public Health

    80236

     

    Pulmonary Disease—no surgery

    80269

     

    Pulmonary Disease—no surgery (D.O.)

    84269

     

    Radiology—diagnostic

    80253

     

    Radiology—diagnostic (D.O.)

    84253

     

    Radiopaque dye

    80449

     

    Radiopaque dye (D.O.)

    84449

     

    Rheumatology—no surgery

    80252

     

    Rheumatology—no surgery (D.O.)

    84252

     

    Rhinology – no surgery

    80264

    80247

    Shock Therapy

    80431

     

    Shock Therapy (D.O.)

    84431

     

    Shock Therapy—insured

    80162

     

    Urgent Care—Walk-in or After Hours

    80424

     

    Urgent Care—Walk-in or After Hours (D.O.)

    84424

     

    Urology —no surgery

    80121

     

     

     

     

    2.     Class 2:

     

     

    Acupuncture

     80437

     

    Acupuncture (D.O.)

     84437

     

    Anesthesiology

     80151

     

    Anesthesiology (D.O.)

     84151

     

    Angiography-Arteriography—catheterization

     80422

     

    Angiography-Arteriography—catheterization (D.O.)

     84422

     

    Broncho-Esophagology

     80101

     

    Cardiovascular Disease—minor surgery

     80281

     

    Cardiovascular Disease—minor surgery (D.O.)

     84281

     

    Colonoscopy-ERCP-Pneu or mech esoph dil (D.O.)

     84443

     

    Colonoscopy-ERCP-pneu. or mech.

     80443

     

    Dermatology—minor surgery

     80282

     

    Dermatology – minor surgery (D.O.)

     84282

     

    Diabetes – minor surgery

     80271

     

    Dermatology Diabetes —minor surgery (D.O.)

      84282

    84271

    Emergency Medicine—No Major Surgery

     80102

     

    Emergency Medicine—No Major Surgery (DO)

     84102

     

    Employed Physician or Surgeon

     80177

     

    Employed Physician or Surgeon (D.O.)

     84177

     

    Endocrinology—minor surgery

     80272

     

    Endocrinology—minor surgery (D.O.)

     84272

     

    Family Practice—and general practice minor surgery—No OB

     80423

     

    Family Practice—and general practice minor surgery—No OB (D.O.)

     84423

     

    Family or General Practice—including OB

     80421

     

    Family or General Practice – including OB (D.O.)

     84421

     

    Gastroenterology—minor surgery

     80274

     

    Gastroenterology—minor surgery (D.O.)

     84274

     

    Geriatrics—minor surgery

     80276

     

    Geriatrics—minor surgery (D.O.)

     84276

     

    Gynecology—minor surgery

     80277

     

    Gynecology—minor surgery (D.O.)

     84277

     

    Hematology—minor surgery

     80278

     

    Hematology—minor surgery (D.O.)

     84278

     

    Hospitalist

     80296

     

    Hospitalist (D.O.)

     84296

     

    Infectious Diseases—minor surgery

     80279

     

    Intensive Care Medicine

     80283

     

    Intensive Care Medicine (D.O.)

     84283

     

    Internal Medicine—minor surgery

     80284

     

    Internal Medicine—minor surgery (D.O.)

     84284

     

    Laparoscopy

     80440

     

    Laparoscopy (D.O.)

     84440

     

    Laryngology—minor surgery

     80285

     

    Myelography – Discogram-Pneumoencephalo

     80428

     

    Myelography-Discogram-Pneumoencephalo (D.O.)

     84428

     

    Needle Biopsy

     80446

     

    Needle Biopsy (D.O.)

     84446

     

    Nephrology—minor surgery

     80287

     

    Neonatology

     80298

     

    Neonatology (D.O.)

     84298

     

    Neoplastic Disease—minor surgery

     80286

     

    Neurology—minor surgery

     80288

     

    Neurology—minor surgery (D.O.)

     84288

     

    Oncology – minor surgery

     80301

     

    Oncology – minor surgery (D.O.)

     84301

     

    Ophthalmology—minor surgery

     80289

     

    Ophthalmology—minor surgery (D.O.)

     84289

     

    Otology – minor surgery

     80290

     

    Otorhinolaryngology—minor surgery

     80291

     

    Otorhinolaryngology—minor surgery (D.O.)

     84291

     

    Pain Management – Basic procedures

     80182

     

    Pain Management – Basic procedures (D.O.)

     84182

     

    Pathology—minor surgery

     80292

     

    Pathology—minor surgery (D.O.)

     84292

     

    Pediatrics—minor surgery

     80293

     

    Pediatrics—minor surgery (D.O.)

     84293

     

    Phlebography-Lymphangeography

     80434

     

    Phlebography-Lymphangeography (D.O.)

     84434

     

    Physicians—minor surgery

     80294

     

    Physicians – minor surgery (D.O.)

     84294

     

    Radiation Therapy—lasers

     80425

     

    Radiation Therapy—lasers (D.O.)

     84425

     

    Radiation Therapy – other than lasers

     80165

     

    Radiology—diagnostic-interventional
    procedures

     80280

     

    Radiology—diagnostic-interventional
    procedures (D.O.)

     84280

     

    Rhinology – minor surgery

     80270

     

    Surgery—Colon & Rectal

     80115

     

    Surgery —Endocrinology

     80103

     

    Surgery—Gastroenterology

     80104

     

    Surgery – Gastroenterology (D.O.)

     84104

     

    Surgery—General Practice or Family Practice

     80117

     

    Surgery—General Practice or Family Practice  (D.O.)

     84117

     

    Surgery—Geriatrics

     80105

     

    Surgery—Neoplastic

     80107

     

    Surgery—Nephrology

     80108

     

    Surgery—Ophthalmology

     80114

     

    Surgery—Ophthalmology (D.O.)

      84114

     

    Surgery—Urological

     80145

     

    Surgery—Urological (D.O.)

     84145

     

     

     

     

    3.     Class 3:

     

     

    Emergency Medicine—includes major surgery

     80157

    Emergency Medicine—includes major surgery (D.O.)

     84157

    Otology—surgery

     80158

    Radiation Therapy – employed physician

     80163

    Radiation Therapy – employed physician (D.O.)

     84163

    Shock Therapy – employed physician

     80161

    Shock Therapy – employed physician (D.O.)

     84161

    Surgery—Abdominal

     80166

    Surgery – Bariatrics

     80476

    Surgery – Bariatrics (D.O.)

     84476

    Surgery—Cardiac

     80141

    Surgery—Cardiovascular Disease

     80150

    Surgery—Cardiovascular Disease (D.O.)

     84150

    Surgery—General

     80143

    Surgery—General (D.O.)

     84143

    Surgery—Gynecology

     80167

    Surgery—Gynecology (D.O.)

     84167

    Surgery—Hand

     80169

    Surgery—Head & Neck

     80170

    Surgery – Laryngology

     80106

    Surgery—Orthopedic

     80154

    Surgery—Orthopedic (D.O.)

     84154

    Surgery—Otorhinolaryngology-no plastic
    surgery

     80159

    Surgery—Plastic

     80156

    Surgery—Plastic (D.O.)

     84156

    Surgery—Plastic-Otorhinolaryngology

     80155

    Surgery—Plastic-Otorhinolaryngology (D.O.)

     84155

    Surgery—Rhinology

     80160

    Surgery—Thoracic

     80144

    Surgery—Thoracic (D.O.)

     84144

    Surgery—Traumatic

     80171

    Surgery—Traumatic (D.O.)

      84171

    Surgery—Vascular

     80146

    Surgery – Vascular (D.O.)

     84146

    Weight Control—Bariatrics

     80180

     

     

    SECTION 3. Ins 17.28 (6) is repealed and recreated to read:

    (6) Fee schedule.   The following fee schedule is in effect from July 1, 2013 to June 30, 2014:

    (a)    Except as provided in pars. (b) to (f) and sub. (6e), for a physician for

    whom this state is a principal place of practice:

                                     Class 1…. $1,457                 Class 3….$  5,828

     

                                     Class 2…. $2,623                Class 4….$9,616

     

         (b)  For a resident acting within the scope of a residency or fellowship program:

                                     Class 1….. $  729                Class 3….$2,916

                                     Class 2….. $1,312                Class 4….$4,811

         (c)  For a resident practicing part-time outside the scope of a residency or fellowship program:

                                     All classes………………………………   $874

        

         (d)  For a Medical College of Wisconsin, Inc., full-time faculty member:

    Class 1….. $  583                 Class 3… .$2,332

    Class 2…..$1,049                  Class 4… .$3,848

         (e)  For physicians who practice part-time:

         1.  For a physician who practices fewer than 500 hours during the fiscal year, limited to office practice and nursing home and house calls, and who does not practice obstetrics or surgery or assist in surgical procedures:                 ..$  364

         2.  For a physician who practices 1040 hours or less during the fiscal year, including those who practice fewer than 500 hours during the fiscal year whose practice is not limited to office practice, nursing homes or house calls or who do practice obstetrics, surgery or assist in surgical procedures:

                                     Class 1…..$   874                 Class 3….$3,496

                                     Class 2…..$1,573                Class 4….$5,768

         (f)  For a physician for whom this state is not a principal place of practice:

                                     Class 1…..$  729                  Class 3….$2,916

                                     Class 2…..$1,312                 Class 4….$4,811

         (g)  For a nurse anesthetist for whom this state is a principal place of practice:                                                                                                                 $  358

         (h)  For a nurse anesthetist for whom this state is not a principal place of practice:……………………………………………………………………………………………$  179

         (i)  For a hospital, all of the following fees:

         1.  Per occupied bed………………………………………………………………………$    87

    2.  Per 100 outpatient visits during the last calendar year for which totals are available:………………………………………………………………………………………….$  4.35

         (j)  For a nursing home, as described under s. 655.002 (1) (j), Stats., that is wholly owned and operated by a hospital and that has health care liability insurance separate from that of the hospital by which it is owned and operated:

         Per occupied bed……………………………………………………………………….…..$   17

         (k)  For a partnership comprised of physicians or nurse anesthetists, organized for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:

         1.  a.  If the total number of partners and employed physicians and nurse anesthetists is from 2 to 10…………………………………………………………………………………………$   51

                 b.  If the total number of partners and employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………..$  503

                c.  If the total number of partners and employed physicians and nurse anesthetists exceeds 100……………………………………………………..……………………………..…$1,252

         2.  The following fee for each full-time equivalent allied health care professional employed by the partnership as of the most recent completed survey submitted:

         Employed Health Care Professionals                                                                     Fund Fee

    Nurse Practitioners……………………………………………………..………………..….$   364

    Advanced Nurse Practitioners……………………………………….……………..…………510

    Nurse Midwives………………………………………………………..…..…………………3,205

    Advanced Nurse Midwives………………………………………………..…………………3,351

    Advanced Practice Nurse Prescribers ………………………………..…………..…………..510

    Chiropractors……………………………………………………………………………..……...583

    Dentists…………………………………………………………………..………………..……..291

    Oral Surgeons……………………………………………………………………..…………..2,186

    Podiatrists-Surgical…………………………………………………….………………..……6,192

    Optometrists………………………………………………………..…………..……………….291

    Physician Assistants………………………………………………………………………..…..291

         (L)  For a corporation, including a service corporation, with more than one shareholder organized under ch. 180, Stats., for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:

         1.  a.  If the total number of shareholders and employed physicians and nurse anesthetists is from 2 to 10……………………………………………………………...…….$   51

               b.  If the total number of shareholders and employed physicians and nurse anesthetists is from 11 to 100…………………………………………………………..……$  503

               c.  If the total number of shareholders and employed physicians or nurse anesthetists exceeds 100……………………………………………………….…………….$1,252

         2.  The following fee for each full-time equivalent allied health care professional employed by the corporation as of the most recent completed survey submitted:

    Employed Health Care Professionals                                                                            Fund Fee

         Nurse Practitioners…………………………………………….………………………….$   364

         Advanced Nurse Practitioners………………………………..……..………………………510

         Nurse Midwives………………………………………………..……………………………3,205

         Advanced Nurse Midwives………………………………….………..……………………3,351

         Advanced Practice Nurse Prescribers ……………………..………………………..……….510          Chiropractors…………………………………………………….………………..…………...583

         Dentists………………………………………………………………………..………………..291

         Oral Surgeons…………………………………………………….………..………………..2,186

         Podiatrists-Surgical………………………………………………..……………..…………6,192

         Optometrists…………………………………………………………..……………..………….291

         Physician Assistants…………………………………………………..……..………………..291

         (m)  For a corporation organized under ch. 181, Stats., for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:

         1.  a.  If the total number of employed physicians and nurse anesthetists is from 1 to 10……………………………………………………………..……………………………….$    51

              b.  If the total number of employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………………...$  503

              c.  If the total number of employed physicians or nurse anesthetists exceeds 100………………………………………………………………………………………..……….$1,252

         2.  The following fee for each full-time equivalent allied health care professional employed by the corporation as of the most recent completed survey submitted:

    Employed Health Care Professionals            Fund Fee

         Nurse Practitioners ……………………………………………………………….……….$   364

         Advanced Nurse Practitioners…………………………………………………….……….…510

         Nurse Midwives…………………………………………………………………………....…3,205

         Advanced Nurse Midwives…………………………………………………………….……3,351

         Advanced Practice Nurse Prescribers …………………………………………………….…..510

         Chiropractors………………………………………………………………………………..…...583

         Dentists……………………………………………………………………..………………..…..291

         Oral Surgeons……………………………………………………………….………..…..…..2,186

         Podiatrists-Surgical…………………………………………………..…….….………..……6,192

         Optometrists…………………………………………………………………………….……….291

         Physician Assistants …………………………………………………………………………..291

         (n)  For an operational cooperative sickness care plan as described under s. 655.002 (1) (f), Stats., all of the following fees:

         1.  Per 100 outpatient visits during the last calendar year for which totals are available…………………………………………………………………………….………………$0.11

         2.  2.5% of the total annual fees assessed against all of the employed physicians.

         3.  The following fee for each full-time equivalent allied health care professional employed by the operational cooperative sickness plan as of the most recent completed survey submitted:

    Employed Health Care Professionals            Fund Fee

         Nurse Practitioners…………………………………………………………………..…….$   364

         Advanced Nurse Practitioners…………………………………………………………….…510

         Nurse Midwives………………………………………………………………………..…….3,205

         Advanced Nurse Midwives…………………………………………………..…………….3,351

         Advanced Practice Nurse Prescribers ………………………………………..……………..510

         Chiropractors……………………………………………………………………..……….…...583

         Dentists……………………………………………………………………………………..…..291

         Oral Surgeons………………………………………………………………………..….…..2,186

         Podiatrists-Surgical………………………………………………………………..……..…6,192

         Optometrists………………………………………………………………………….…..…….291

         Physician Assistants……………………………………………………….…………..……..291

         (o)  For a freestanding ambulatory surgery center, as defined in s. DHS 120.03 (13), per 100 outpatient visits during the last calendar year for which totals are available:………………………………………………………………………………………….$22.73

         (p)  For an entity affiliated with a hospital, the greater of $100 or whichever of the following applies:

         1.  7.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has occurrence coverage.

         2.  10.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has claims-made coverage.

         (q)  For an organization or enterprise not specified as a partnership or corporation that is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:

         1.  a.  If the total number of employed physicians and nurse anesthetists is from 1 to 10………………………………………………………………………………...………………$   51

         b. If the total number of employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………………...$   503

         c.  If the total number of employed physicians or nurse anesthetists exceeds

    100………………………………………………………………………………………………$1,252

         2. The following for each full-time equivalent allied health care professional employed by the organization or enterprise not specified as a partnership, corporation, or an operational cooperative health care plan as of the most recent completed survey submitted:

    Employed Health Care Professionals           Fund Fee

         Nurse Practitioners……………………………………………………………………….$   364

         Advanced Nurse Practitioners…………………………………………..…..………………510

         Nurse Midwives………………………………………………………………..……………3,205

         Advanced Nurse Midwives…………………………………………………….…..………3,351

         Advanced Practice Nurse Prescribers …………………………………………..…………..510

         Chiropractors………………………………………………………………………...………...583

         Dentists…………………………………………………………………………..……………..291

         Oral Surgeons………………………………………………………………..………………2,186

         Podiatrists-Surgical……………………………………………………………..……………6,192

         Optometrists………………………………………………………………………….……….….291

         Physician Assistants………………………………………………………………..…………..291

     

    SECTION 4. These changes may be enforced under s. Ins 17.01 (2) (d) and (e).

     

    SECTION 5 . EFFECTIVE DATE.  These emergency rule changes will take effect on the date of publication as provided in s. 227.24(1)(c), Stats.

     

     

     

    Dated at Madison, Wisconsin, this    7 th      day of     June   , 2013.

     

     

     

                                                                        _________________________________________

                                                                         Theodore K. Nickel

                                                                         Commissioner of Insurance

     


     

    Office of the Commissioner of Insurance

    Fiscal Estimate

     

    for Section Ins 17.01, 17.28 (3) (c) and (6) relating to Injured Patients and Families Compensation Fund Annual fund and Mediation Panel Fees and ISO code amendments for the fiscal year beginning July 1, 2013 and affecting small business

     

     

     

    This rule change will have no significant effect on the private sector as this proposed rule reduces fees to participants in the fund and reduces mediation panel fees to zero.  The fund is a segregated account and does not impact state funds.  The rule decreases fees and therefore does not have an effect on county, city, village, town, school district, technical college district and sewerage district fiscal liabilities and revenues. 

     

     


    STATE OF WISCONSIN

    DEPARTMENT OF ADMINISTRATION

    DOA-2049 (C04/2011)

                    Division of Executive Budget and Finance

    101 East Wilson Street, 10th Floor

    P.O. Box 7864

    Madison, WI  53707-7864

    FAX: (608) 267-0372

     

    ADMINISTRATIVE RULES – FISCAL ESTIMATE

     

    1.    Fiscal Estimate Version

     

     

     

     

           Original     Updated     Corrected

     

     

    2.    Administrative Rule Chapter Title and Number

         INS 1728

     

    3.    Subject

          Injured Patients and Families Compensation Fund Annual fund and Mediation Panel Fees and ISO code amendments for the fiscal year beginning July 1, 2013 and affecting small business

     

    4.   State Fiscal Effect:   

     

      No Fiscal Effect

     

     Indeterminate

     

     Increase Existing Revenues

     

     Decrease Existing Revenues

      Increase Costs

           Yes      No    May be possible to absorb

                                          within agency’s  budget.

      Decrease Costs

     

    5.   Fund Sources Affected:

     GPR         FED       PRO      PRS     SEG      SEG-S

    6.   Affected Ch. 20, Stats. Appropriations:

    None

     

    7.    Local Government Fiscal Effect:

     

     No Fiscal Effect

     

     Indeterminate

     Increase Revenues

     

     Decrease Revenues

     Increase Costs

     

     Decrease Costs

     

    8.  Local Government Units Affected:

     Towns      Villages     Cities     Counties     School Districts    WTCS Districts  Others: None

     

    9.   Private Sector Fiscal Effect (small businesses only):

     

     No Fiscal Effect

     

     Indeterminate

     

     

     Increase Revenues

     

     Decrease Revenues

     

          Yes     No       May have significant

                                            economic impact on a

                                            substantial number of 

                                            small businesses

     Increase Costs

     

          Yes    No    May have significant

                                        economic impact on a

                                        substantial number of

                                        small businesses

     

     Decrease Costs

     

    10.  Types of Small Businesses Affected:

     

    Small businesses that employ physicians or other health care professionals participating in the Fund.

     

    11.  Fiscal Analysis Summary

     

    No significant impact.  Slight decrease in fund fees and zero medical mediation fees.

     

    12. Long-Range Fiscal Implications

     

    None

     

    13.  Name - Prepared by

    Julie E. Walsh

    Telephone Number

    (608) 264-8101

    Date

    June 5, 2013

     

    14.  Name – Analyst Reviewer

         

    Telephone Number

         

    Date

         

     

    Signature—Secretary or Designee

     

    Telephone Number

    (608) 267-3782

    Date

    June 7, 2013

     

     

     

     

     

     

     

     

    Wi_seal

     
    S tate  of  W isconsin   /   OFFICE OF THE COMMISSIONER OF INSURANCE

     

    125 South Webster Street · P.O. Box 7873

    Madison, Wisconsin 53707-7873

    Phone: (608) 266-3585 · Fax: (608) 266-9935

    E-Mail: ociinformation@wisconsin.gov

    Web Address: oci.wi.gov

     

     

    Scott Walker, Governor

    Theodore K. Nickel, Commissioner

     

    Wisconsin.gov

     
     

     

     

     

     

     

     

     

     

     


    STATE OF WISCONSIN                                           ³

                                                                                 ³  SS

    OFFICE OF THE COMMISSIONER OF INSURANCE ³

     

     

              I, Theodore K. Nickel, Commissioner of Insurance and custodian of the official records, certify that the annexed emergency rule affecting Section Ins 17.01, 17.28 (3) and 17.28 (6), Wis. Adm. Code, relating to the Injured Pateints and Families Compensation Fund annual fund and mediation panel fees, and ISO code amendments for the fiscal year beginning July 1, 2013 and affecting small business, is duly approved and adopted by this Office on June 7, 2013.

     

              I further certify that I have compared this copy with the original on file in this Office and that it is a true copy of the original, and the whole of the original.

     

    IN TESTIMONY WHEREOF, I have hereunto set my hand at 125 South Webster Street, Madison, Wisconsin,

    on June 7, 2013.

     

     

     

                                                    _______________________________________

                                                    Theodore K. Nickel

                                                    Commissioner of Insurance