Ins 17.28(6)(L)
(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:
Ins 17.28(6)(L)1.a.a. If the total number of shareholders and employed physicians and nurse anesthetists is from 2 to 10
$ 51
Ins 17.28(6)(L)1.b.
b. If the total number of shareholders and employed physicians and nurse anesthetists is from 11 to 100
$ 503
Ins 17.28(6)(L)1.c.
c. If the total number of shareholders and employed physicians or nurse anesthetists exceeds 100
$1,252
Ins 17.28(6)(L)2.
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
Ins 17.28(6)(m)
(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:
Ins 17.28(6)(m)1.a.a. If the total number of employed physicians and nurse anesthetists is from 1 to 10
$ 51
Ins 17.28(6)(m)1.b.
b. If the total number of employed physicians and nurse anesthetists is from 11 to 100
$ 503
Ins 17.28(6)(m)1.c.
c. If the total number of employed physicians or nurse anesthetists exceeds 100
$1,252
Ins 17.28(6)(m)2.
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
Ins 17.28(6)(n)1.
1. Per 100 outpatient visits during the last calendar year for which totals are available
$0.11
Ins 17.28(6)(n)2.
2. 2.5% of the total annual fees assessed against all of the employed physicians.
Ins 17.28(6)(n)3.
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
Ins 17.28(6)(o)
(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
Ins 17.28(6)(p)
(p) For an entity affiliated with a hospital, the greater of $100 or whichever of the following applies:
Ins 17.28(6)(p)1.
1. 7.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has occurrence coverage.
Ins 17.28(6)(p)2.
2. 10.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has claims-made coverage.
Ins 17.28(6)(q)
(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:
Ins 17.28(6)(q)1.a.a. If the total number of employed physicians and nurse anesthetists is from 1 to 10
$ 51
Ins 17.28(6)(q)1.b.
b. If the total number of employed physicians and nurse anesthetists is from 11 to 100
$ 503
Ins 17.28(6)(q)1.c.
c. If the total number of employed physicians or nurse anesthetists exceeds 100
$ 1,252
Ins 17.28(6)(q)2.
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
Ins 17.28(6d)(a)
(a) A corporation organized and operated in this state of which 50% or more of its shareholders are physicians or nurse anesthetists is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists.
Ins 17.28(6d)(b)
(b) Conclusively that a corporation organized and operated in this state of which less than 50% of its shareholders are physicians or nurse anesthetists is not organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists.
Ins 17.28 Note
Note: A person who disputes the application of this presumption to the person may be entitled to a hearing on the issue in accordance with s.
227.42, Stats.
Ins 17.28(6e)(a)(a) The fund shall calculate the total amount of fees for all medical college of Wisconsin affiliated hospitals, inc., and UW hospital and clinics, residents on a full-time-equivalent basis, taking into consideration the proportion of time spent by the residents in practice which is not covered by the fund, including practice in federal, state, county and municipal facilities, as determined and documented by the medical college of Wisconsin affiliated hospitals, inc., and UW hospital and clinics, respectively.
Ins 17.28(6e)(b)
(b) Notwithstanding sub.
(4) (h), the fund's initial bill for each fiscal year shall be the amount the medical college of Wisconsin affiliated hospitals, inc., estimates will be due for the next fiscal year for all its residents. At the end of the fiscal year, the fund shall adjust the fee to reflect the residents' actual exposure during the fiscal year, as determined by the medical college of Wisconsin affiliated hospitals, inc., and shall bill the medical college of Wisconsin affiliated hospitals, inc., for the balance due, if any, plus accrued interest, as calculated under sub.
(4) (j) 2., from the beginning of the fiscal year. The fund shall refund the amount of an overpayment, if any.
Ins 17.28(6m)(a)
(a) The fund may require any provider to report, at the times and in the manner prescribed by the fund, any information necessary for the determination of a fee specified under sub.
(6).
Ins 17.28(6m)(b)
(b) For purposes of sub.
(6) (k) to
(m), a partnership or corporation shall report the number of partners, shareholders and employed physicians and nurse anesthetists on July 1 of the previous fiscal year.
Ins 17.28(6s)(a)
(a) This subsection implements s.
655.27 (3) (bg) 1., Stats., requiring the establishment of an automatic increase in a provider's fund fee based on loss and expense experience.
