Wisconsin Legislature: Ins 17.28 Text

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:

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:

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

(6d) Primary purpose presumption. For purposes of s. 655.002 (1) (e), Stats., and this section, it is presumed:

(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.

(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.

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.

(6e) Medical college residents’ fees.

(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.

(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.

(6m) Reporting.

(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).

(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.

(6s) Surcharge.

(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.

(b) In this subsection:

1. “Aggregate indemnity” has the meaning given under s. Ins 17.285 (2) (a).

2. “Closed claim” has the meaning given under s. Ins 17.285 (2) (b).

3. “Provider” has the meaning given under s. Ins 17.285 (2) (d).

4. “Review period” has the meaning given under s. Ins 17.285 (2) (e).

(c) The following tables shall be used in making the determinations required under s. Ins 17.285 as to the percentage increase in a provider’s fund fee: