Ins 17.28(4)(cs)1.1. If a provider who has paid all or part of the annual fee is or becomes ineligible to participate in the fund under s.
655.003 (1) or
(3), Stats., or because he or she does not practice in this state, the fund shall issue a full refund of any amount the provider paid for fund coverage for which he or she was not eligible.
Ins 17.28(4)(cs)2.
2. If a provider that has paid all or part of the annual fee is ineligible for fund coverage because the provider is not in compliance with sub.
(3e), the fund shall issue a full refund of the amount paid for the period of noncompliance, beginning with the date the noncompliance began.
Ins 17.28(4)(d)1.1. If a provider's change of classification under sub.
(6) during a fiscal year results in an increased annual fee, the fund shall adjust the provider's annual fee to equal the sum of the following:
Ins 17.28(4)(d)1.a.
a. One twenty-fourth of the annual fee for the provider's former classification for each full semimonthly period from the due date of the provider's first payment during the current fiscal year to the date of the change.
Ins 17.28(4)(d)1.b.
b. One twenty-fourth of the annual fee for the provider's new classification for each full or partial semimonthly period from the date of the change to the next June 30.
Ins 17.28(4)(d)2.
2. The fund shall bill the provider for the total amount of the increase under subd.
1. if the provider has already paid the total annual fee, or shall prorate the increase over the remaining installment payments.
Ins 17.28(4)(e)1.1. If a provider's change of classification under sub.
(6) during a fiscal year results in a decreased annual fee, the fund shall adjust the provider's annual fee to equal the sum of the following:
Ins 17.28(4)(e)1.a.
a. One twenty-fourth of the annual fee for the provider's former classification for each full or partial semimonthly period from the due date of the provider's first payment during the current fiscal year to the date of the change.
Ins 17.28(4)(e)1.b.
b. One twenty-fourth of the annual fee for the provider's new classification for each full semimonthly period from the date of the change to the next June 30.
Ins 17.28(4)(e)2.
2. The fund shall credit the amount of the decrease under subd.
1. over any remaining installment payments. If the provider has already paid the total annual fee, the fund shall issue a refund if the amount of the refund is more than $10. The fund shall credit any amount of $10 or less to the provider's account. If the provider no longer participates in the fund, a credit of $10 or less shall lapse to the fund.
Ins 17.28(4)(f)
(f) Refund of other charges. If a provider is entitled to a refund or credit under this subsection, the fund shall also issue a refund or credit of the unearned portion of any amounts paid as surcharges using the same method used to calculate a refund or credit of an annual fee. A mediation fund fee is refundable only if the provider did not participate in the injured patients and families compensation fund for any part of the fiscal year.
Ins 17.28(4)(g)
(g) Refund for administrative error. In addition to any refund authorized under par.
(c),
(cm),
(cs),
(e) or
(f), the fund may issue a refund to correct an administrative error in the current or any previous fiscal year.
Ins 17.28(4)(h)
(h) Billing; entire fiscal year. Except as provided in sub.
(6e) (b), for each fiscal year, the fund shall issue to each provider participating in the fund an initial bill which shall include all of the following:
Ins 17.28(4)(h)3.
3. The balance and accrued interest, if any, due from a prior fiscal year.
Ins 17.28(4)(h)4.
4. Notice of the provider's right to pay the amount due in full or in instalments.
Ins 17.28(4)(h)5.
5. The minimum amount due if the provider elects installment payments.
Ins 17.28(4)(i)
(i) Billing; partial fiscal year. The fund shall issue each provider entering the fund after the beginning of a fiscal year an initial bill which shall include all of the following;
Ins 17.28(4)(i)2.
2. Notice of the provider's right to pay the amount due in full or in instalments.
Ins 17.28(4)(i)3.
3. The minimum amount due if the provider elects installment payments.
Ins 17.28(4)(j)
(j) Balance billing. If a provider pays at least the minimum amount due but less than the total amount due by the due date, the fund shall calculate the remainder due by subtracting the amount paid from the amount due and shall bill the provider for the remainder on a quarterly installment basis. Each subsequent bill shall include all of the following:
Ins 17.28(4)(j)2.
2. Interest on the remainder due. The daily rate of interest shall be the average annualized rate earned by the fund on its short-term funds for the first 3 quarters of the preceding fiscal year, as determined by the state investment board, divided by 360.
Ins 17.28(4)(k)
(k) Prompt payment required. A provider shall pay at least the minimum amount due on or before each due date. If the fund receives payment later than the due date specified in the late payment notice sent to the provider by certified mail, the fund, notwithstanding par.
(n) 5., may not apply the payment retroactively to the annual fee unless the board has authorized retroactive coverage under sub.
(3s) (b).
Ins 17.28(4)(n)
(n) Application of payments. Except as provided in par.
(k), all payments to the fund shall be applied in chronological order first to previous fiscal years for which a balance is due and then to the current fiscal year. The amounts for each fiscal year shall be credited in the following order:
Ins 17.28(4)(o)
(o) Waiver of balance. The fund may waive any balance of $50 or less, if it is in the economic interest of the fund to do so.
Ins 17.28(5)(a)(a) Electronic filing. Except as provided in par.
(b), each insurer and self-insured provider required under s.
655.23 (3) (b) or
(c), Stats., to file a certificate of insurance shall file the certificate electronically in the format specified by the commissioner by the 15th day of the month following the month of original issuance or renewal or a change of class under sub.
(6).
Ins 17.28(5)(b)
(b) Exemption. An insurer or self-insured provider may file a written request for an exemption from the requirement of par.
(a). The commissioner may grant the exemption if he or she finds that compliance would constitute a financial or administrative hardship. An insurer or self-insured provider granted an exemption under this paragraph shall file a paper certificate in the format specified by the commissioner within 45 days after original issuance or renewal or a change of class under sub.
(6).
Ins 17.28(5)(c)
(c)
Late filing fee. A late fee in the amount of $100.00 per certificate shall be paid to the fund by each insurer and self-insured provider who fails to file a certificate of insurance in accordance with the requirements of this subsection. An additional $100.00 late fee shall be paid per certificate for each additional week, or portion thereof, the certificate is not in compliance with this subsection.
Ins 17.28(6)
(6) Fee schedule. The following fee schedule is in effect from July 1, 2013 to June 30, 2014:
Ins 17.28(6)(a)
(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
Ins 17.28(6)(b)
(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
Ins 17.28(6)(c)
(c) For a resident practicing part-time outside the scope of a residency or fellowship program:
All classes $874
Ins 17.28(6)(d)
(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
Ins 17.28(6)(e)1.
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
Ins 17.28(6)(e)2.
2. For a physician who practices 1,040 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
Ins 17.28(6)(f)
(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
Ins 17.28(6)(g)
(g) For a nurse anesthetist for whom this state is a principal place of practice:
$
358
Ins 17.28(6)(h)
(h) For a nurse anesthetist for whom this state is not a principal place of practice:
$
179
Ins 17.28(6)(i)2.
2. Per 100 outpatient visits during the last calendar year for which totals are available:
$ 4.35
Ins 17.28(6)(j)
(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
Ins 17.28(6)(k)
(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:
Ins 17.28(6)(k)1.a.a. If the total number of partners and employed physicians and nurse anesthetists is from 2 to 10
$ 51
Ins 17.28(6)(k)1.b.
b. If the total number of partners and employed physicians and nurse anesthetists is from 11 to 100
$ 503
Ins 17.28(6)(k)1.c.
c. If the total number of partners and employed physicians and nurse anesthetists exceeds 100
$1,252
Ins 17.28(6)(k)2.
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
