Wisconsin Legislature: DHS 120.12(4)(d)

12. Use of nursing home services, if applicable, including beds set up and staffed, discharges and days of care.

13. Medical staff information, including availability of contractual arrangements with physicians in a paid capacity, total number of active or associate medical staff by selected specialty and number of board certified medical staff by selected specialty, if applicable.

14. Number of personnel on the hospital’s payroll, including hospital personnel, trainees and nursing home personnel by occupational category and by full-time or part-time status.

1. A hospital shall submit to the department the data specified in par. (b) according to a schedule specified by the department.

Note: 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.

2. The department may change the due date specified in subd. 1. and if the department does so, the department shall notify each hospital of the change at least 30 days before the data are due.

3. The department may grant an extension of a deadline specified in this paragraph 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 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 prior to the date that the data are due. The department may grant an extension for up to 30 calendar days.

(d) Data verification, review and comment procedures.

1. Each hospital shall review the data for accuracy and completeness prior to submitting the survey to the department.

2. The department shall check the accuracy and completeness of all submitted information.

3. If the department has contacted the hospital and has determined that resubmission of the survey is necessary, the department shall return questionable survey response data to the hospital that submitted the survey with information for revision and resubmission.

4. The hospital shall resubmit the survey returned by the department to the hospital within 10 working days after the hospital’s receipt of the questionable survey.

5. After the department has made any revisions under subd. 3. in the information for a particular hospital, the department shall send the hospital a copy of all variables submitted by that hospital to the department or subsequently corrected by the department.

6. The hospital shall review the survey for accuracy and completeness and shall supply the department within the 10 working days specified in subd. 4. after receipt of the questionable survey with any corrections.

a. Within the 10-working day period under subd. 4., the chief executive officer or designee of each hospital shall submit to the department a signed affirmation statement.

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.

c. If the department discovers survey errors after the department’s release of the data or if a hospital representative notifies the department of survey errors after the department’s release of the data, the department shall note the data errors as caveats to the completed datasets.

(e) Data adjustment methods. There shall be no adjustment methods for annual hospital survey data submitted by hospitals.

(f) Waiver from data submission requirements.

1. There shall be no waivers from the data submission requirements under this subsection.

2. Hospitals that close, merge or change their reporting fiscal year shall submit an annual survey [for] the applicable partial year.

Note: A missing word is shown in brackets.

(4) Published notices of hospital rate increases or charges in excess of rates.

(a) Data to be collected. Under s. DHS 120.09 (4), hospitals shall submit all newspaper notices and affidavits of publication to the department.

(b) Data submission procedures. Under s. DHS 120.09 (4), hospitals shall submit a newspaper notice and affidavit of publication to the department within 14 calendar days after the hospital receives the affidavit of publication.

(c) Data verification, review and comment procedures. There shall be no verification, review and comment procedures for published notices submitted by hospitals.

(d) Data adjustment methods. There shall be no adjustment methods for published notices submitted by hospitals.

(e) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this subsection.

(5) Uniform inpatient discharge data.

(a) Data to be collected. Hospitals shall submit to the department all of the following data for each patient:

1. Federal tax identification number of the hospital.

2. Patient control number.

3. Patient medical record or chart number.

4. Discharge date.

5. Patient zip code.

6. Patient birth date.

7. Patient gender.

8. Admission date.

9. Type of admission.

10. Source of admission.

11. Patient discharge status.

12. Condition codes.

13. Adjusted total charges and components of those charges.

14. Leave days.

15. Primary payer identifier and type.

16. Secondary payer identifier and type.

17. Principal and other diagnosis codes.

18. External cause of injury codes.

19. Principal and other procedure codes.

20. Date of principal procedure.

21. Attending physician license number.

22. Other physician license number, if applicable.

23. Patient race.

24. Patient ethnicity.

25. Type of bill identifying the location of service.

26. Encrypted case identifier.

27. Insured’s policy number.

28. Diagnosis present at admission.

(b) Data submission procedures.

1. Each hospital shall electronically submit the data elements required under par. (a). The method of submission, data formats and coding specifications shall be defined in the department’s data submission manual.

2. Hospitals shall send the data to the department within 45 calendar days of the last day of each calendar quarter using the department’s electronic submission system. Calendar quarters shall begin on January 1, April 1, July 1 and October 1 and shall end on March 31, June 30, September 30 and December 31.

3. Upon written request, the department shall provide consultation to a hospital to enable the hospital to submit data according to department specifications.

4. The department may grant an extension of the time limits specified under subd. 2. 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 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 prior to the date that the data are due. The department may grant an extension for up to 30 calendar days.

5. Each hospital shall submit inpatient data electronically with physical specifications, format and record layout in accordance with the department’s data submission manual.

a. To ensure confidentiality, hospitals using qualified vendors to submit data shall submit to the department an original trading partner agreement that has been signed and notarized by the qualified vendor and the hospital.

b. Hospitals shall be accountable for their qualified vendor’s failure to submit data in the formats required by the department.

(c) Data verification, review and comment procedures. The data verification, review and comment procedures specified in s. DHS 120.11 (1) to (3) shall apply.

(d) Physician verification, review and comment on hospital-submitted claims data. The data verification, review and comment procedures specified in s. DHS 120.11 (1), (2) and (4) shall apply.

(e) Data adjustment methods. The department shall adjust health care charge and mortality information for case mix and severity using commonly acceptable methods and tools designed for administrative claims information to perform adjustments for a class of health care providers.

(f) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this subsection.

(g) Compliant data submission.

1. To be considered compliant with this chapter, a facility’s data submission shall be all of the following:

a. Submitted to the department electronically, as specified in the data submission manual.

b. Consist of an individual facility data file.

c. Meet the department standard of 10% or fewer records that do not pass the department’s error checking procedures on or before the data submission due date.

2. Facilities that fail to achieve a compliant data submission as required under this subsection may be subject to forfeitures.

(5m) Emergency department data.