DHS 120.11(2)(2) Definition. In this section, “facility” means hospitals and freestanding ambulatory surgery centers. DHS 120.11(3)(3) Facility data verification, review and comment procedures. DHS 120.11(3)(a)(a) Each facility shall review its collected data for accuracy and completeness before submitting the data to the department. DHS 120.11(3)(b)(b) The department shall check the accuracy and completeness of all submitted data and record all questionable data based on standard edits or the electronic editing features of the department’s data submission system. DHS 120.11(3)(c)(c) If the department determines data submitted by the facility to be questionable, and the department has determined that the data cannot be verified or corrected by telephone or electronic means, the department may return the questionable data to the facility or the facility’s qualified vendor with information for revision and resubmission. DHS 120.11(3)(d)1.c.c. Supply the department with the affirmation statement that was included with the data profile. The affirmation statement shall be signed by the chief executive officer or designee indicating that the facility’s data are accurate and complete. Facilities submitting affirmation statements to the department electronically shall use the digital signature approved by the department and returned by the facility during the timeframes for data submission specified by the department. A signature on the electronic data affirmation statement represents the signatory’s acknowledgement that the data is accurate to the best of his or her knowledge and that the data submitter may no longer submit revised data. DHS 120.11(3)(d)2.2. Failure to comply with subd. 1. shall result in the facility being non-compliant with this subsection and the facility may be subject to forfeitures under this chapter. DHS 120.11(3)(e)(e) After the department has made any revisions under par. (d) in the data for a particular facility, the department shall send the facility all of the following: DHS 120.11(3)(g)(g) If the department discovers data errors after the department’s release of the data or if a facility representative notifies the department of data errors after the department’s release of the data, the department shall note the data errors as caveats to the completed datasets. DHS 120.11(4)(4) Physician verification, review and comment on facility-submitted data. DHS 120.11(4)(a)(a) During the facility-submitted data verification, review and comment procedures described in sub. (3), the department shall give a physician the opportunity to concurrently review the facility-submitted data associated with the physician’s license number. DHS 120.11(4)(b)(b) The department shall notify each physician with a Wisconsin license number appearing in the facility-submitted data of the physician’s opportunity to review that data. DHS 120.11(4)(c)(c) The department shall notify each identified physician using the physician’s last known address on file with the department of safety and professional services or information provided by the facility that may be more current. DHS 120.11(4)(d)2.2. An indication that the physician has 10 working days from the date the notice was sent to notify the department that the physician intends to review the requested data before the data is released. DHS 120.11(4)(d)3.3. A statement informing the physician that the department will not provide further notice of the physician’s right to review if the physician chooses not to review the data at that time. DHS 120.11(4)(e)1.1. If a physician files a timely request to review data before release, the department shall make the data available to the physician as it is submitted to the department. The department’s report shall contain a “permission to change” authorization form that may be duplicated in the event of multiple problems. DHS 120.11(4)(e)2.2. If the physician wants to dispute the data, the physician shall attest to the problem associated with the data on the authorization form, and an authorized representative of the facility shall indicate on the form if the facility agrees to the change. DHS 120.11(4)(e)3.3. The physician shall return the form to the department within 20 working days after the date on which the data were made available to the physician. DHS 120.11(4)(e)4.4. When the department receives the signed “permission to change” form, the department shall change the data within the facility dataset before its release. DHS 120.11(4)(e)5.5. If the facility does not agree to the physician’s change, the physician may submit his or her written comments on the data to the department within the same 20 working days after the date of the department transmittal. The facility shall also submit its reason for concluding that the submitted data are correct within the same 20 working days. The department may not change the data submitted by the facility, but shall include both sets of comments with the data released to data requesters. DHS 120.11(4)(e)6.6. A physician desiring to comment on data he or she submits shall submit his or her comments in a standard electronic word processing format. Comments shall be limited to a maximum of 1000 words. All comments shall be submitted no later than the 20th working day following the department’s transmittal. DHS 120.11(4)(f)(f) If the department receives comments from a physician after the release of data, the department shall retain the comments and provide them as part of the documentation released to future data requesters. The department shall note as caveats to the completed data the subsequent discovery of data errors by either the department or the data submitter after the release of data. DHS 120.11 HistoryHistory: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 01-051: am. (1) and (3) (d) 1., Register September 2001 No. 549 eff. 10-1-01; CR 03-033: am. (3) (c), (d) 1. (intro.), (4) (e) 1. and 2., r. (3) (f) Register December 2003 No. 576, eff. 1-1-04; correction in (4) (c) made under s. 13.92 (4) (b) 6., Stats., Register February 2012 No. 674. DHS 120.12DHS 120.12 Data to be submitted by hospitals. DHS 120.12(1)(a)(a) Data to be collected. Hospitals shall provide all of the following data: DHS 120.12(1)(a)1.1. A set of definitions describing terms used by the hospital throughout the uncompensated health care plan. DHS 120.12(1)(a)2.2. The procedures the hospital uses to determine a patient’s ability to pay for health care services received and to verify financial information from the patient. DHS 120.12(1)(a)3.3. The hospital’s means of informing the public about charity care available at that hospital and a description of the procedure for obtaining the care. DHS 120.12(1)(a)4.4. The amount of any state loan funds, excluding fund proceeds from the Wisconsin health and educational facilities authority, outstanding with a continuing obligation during the previous year. DHS 120.12(1)(b)1.1. Every hospital shall annually file with the department within 120 calendar days following the close of the hospital’s fiscal year the plan required under par. (a). DHS 120.12 NoteNote: Health care providers who are required to send their information directly to the department should use the following address: Bureau of Health Information and Policy, P. O. Box 2659, Madison, Wisconsin 53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street, Madison, Wisconsin.
DHS 120.12(1)(b)2.2. The department may grant an extension of a deadline specified under subd. 1. only when the hospital adequately justifies to the department the hospital’s need for additional time. In this subdivision, “adequate justification” means a delay due to a strike, fire, natural disaster or delay due to catastrophic computer failure. A hospital desiring an extension shall submit a request for an extension in writing to the department at least 10 calendar days before the date the data are due. The department may grant an extension for up to 30 calendar days. DHS 120.12(1)(c)1.1. Each hospital shall review the plan for accuracy and completeness prior to submitting the plan to the department. DHS 120.12(1)(c)2.2. The department shall notify a hospital if the plan or any elements of the plan appear to contain questionable data. DHS 120.12(1)(c)3.3. The hospital shall either verify the accuracy of the plan or send a corrected plan to the department within 10 working days from the date the department notified the hospital of the questionable data. DHS 120.12(1)(c)4.a.a. Within the same 10-working day period under subd. 3., the chief executive officer or designee of each hospital shall submit to the department a signed affirmation statement. DHS 120.12(1)(c)4.b.b. Hospitals submitting affirmation statements to the department electronically shall use a digital signature approved by the department and returned by the hospital during the timeframes for data submission specified by the department. A signature on the electronic data affirmation statement represents the signatory’s acknowledgment that the data is accurate and the data submitter may no longer submit revised data. DHS 120.12(1)(c)4.c.c. If the department discovers data errors after the department’s release of the data or if a hospital representative notifies the department of data errors after the department’s release of the data, the department shall note the data errors as caveats to the completed datasets. DHS 120.12(1)(d)(d) Data adjustment methods. There shall be no adjustment methods for uncompensated health care services report data submitted by hospitals. DHS 120.12(1)(e)(e) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this subsection. DHS 120.12(2)(b)1.1. ‘General hospital data.’ Hospitals shall report all of the following financial data to the department in the format specified by the department, in accordance with this subsection and department instructions that are based on guidelines from the 2003 update of the Health Care Organizations — AICPA Audit and Accounting Guide, published by the American institute of certified public accountants, generally accepted accounting principles and the national annual survey of hospitals conducted by the American hospital association. DHS 120.12(2)(b)1.a.a. Gross revenue the hospital derives from services it provides to patients and the sources of that revenue. DHS 120.12(2)(b)1.b.b. Deductions from gross revenue the hospital derives from services it provides to patients and the sources of that revenue, including contractual adjustments, charity care and other noncontractual deductions. DHS 120.12(2)(b)1.q.q. The dollar difference between gross and net revenue figures for the current and previous fiscal years. DHS 120.12(2)(b)1.r.r. The amount of the dollar difference between gross and net revenue figures attributable to a price change, the amount attributable to a utilization change and the amount attributable to any other cause for the current and previous fiscal years. DHS 120.12(2)(b)2.2. ‘Prior year hospital uncompensated care charge data.’ The number of patients obtaining uncompensated health care services from the hospital in its most recently completed fiscal year, and the total accrued charges for those services, as determined by all of the following: DHS 120.12(2)(b)2.a.a. The number of patients whose accrued charges were attributed to charity care in that fiscal year. DHS 120.12(2)(b)2.b.b. The total accrued charges for charity care, based on revenue foregone at full established rates, in that fiscal year. DHS 120.12(2)(b)2.c.c. The number of patients whose accrued charges were determined to be a bad debt expense in that fiscal year. DHS 120.12(2)(b)2.d.d. The total bad debt expense, as obtained from the hospital’s final audited financial statements in that fiscal year. DHS 120.12(2)(b)3.3. ‘Anticipated hospital uncompensated care charge data.’ The projected number of patients anticipated to obtain uncompensated health care services from the hospital in its ensuing fiscal year, and the projected charges for those services, as determined by all of the following: DHS 120.12(2)(b)3.a.a. The hospital’s projected number of patients anticipated to obtain charity care for that fiscal year. DHS 120.12(2)(b)3.b.b. The hospital’s projected total charges attributed to charity care for that fiscal year. DHS 120.12(2)(b)3.c.c. The hospital’s projected number of patients anticipated to incur bad debt expenses. DHS 120.12(2)(b)3.e.e. A rationale for the hospital’s projections under subdpars. a. to d., considering the hospital’s total patients and total accrued charges for the most recently completed fiscal year. DHS 120.12(2)(b)4.4. ‘Hospital uncompensated care obligation data.’ If the hospital has a current obligation or obligations under 42 CFR Part 124, the hospital shall report the date or dates the obligation or obligations went into effect, the amount of the total federal assistance believed to be under obligation at the hospital and the date or dates the obligation or obligations will be satisfied.
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