Chapter UWS 24

Chapter UWS 24

HEALTH CARE PROVIDER LOAN ASSISTANCE PROGRAM

UWS 24.01   Purpose.

UWS 24.02   Definitions.

UWS 24.025   Medical assistance and badger care requirements for dental hygienists.

UWS 24.03   Priorities among eligible applicants.

UWS 24.04   Application process.

UWS 24.05   Breach of agreement.

UWS 24.06   Penalties for breach of agreement.

UWS 24.07   Waiver of penalties.

UWS 24.08   Suspension.

Ch. UWS 24 Note Note: Chapter Comm 128 as it existed on June 30, 1998 was repealed and new chapter Comm 128 was created effective July 1, 1998. Chapter Comm 128 was renumbered chapter UWS 24 under s. 13.92 (4) (b) 1., Stats., Register October 2011 No. 670.

UWS 24.01 UWS 24.01 Purpose. The purpose of this chapter is to establish the procedures under which health care providers may apply for assistance under this chapter; to establish priorities among eligible applicants in the event that the number of applicants exceeds available funding; and to establish penalties for breach of an agreement, including circumstances under which those penalties may be waived.

UWS 24.01 History History: Cr. Register, June, 1998, No. 510, eff. 6-1-98.

UWS 24.02 UWS 24.02 Definitions. In this chapter:

UWS 24.02(1g) (1g) “Board of Regents” means the Board of Regents of the University of Wisconsin System.

UWS 24.02(1r) (1r) “Dental health shortage area” has the meaning contained in s. 36.61 (1) (ag), Stats.

UWS 24.02(2) (2) “Dental hygienist” has the meaning contained in s. 36.61 (1) (aj), Stats.

UWS 24.02(4) (4) “Educational loan” means a health education assistance loan, a plus loan, a national direct student loan, a stafford loan, a health professions student loan, a supplemental loan for students, a guaranteed student loan from a state education financial aid office, a university sponsored student loan, a trust fund loan, a scholastic loan, a foundation loan or any other loan that the Board of Regents determines is exclusively for educational purposes, and that was obtained by the health care provider from a public or private lending institution for education related to the health care provider’s field of practice.

UWS 24.02(5) (5) “Eligible practice area” has the meaning contained in s. 36.61 (1) (am), Stats.

UWS 24.02(6) (6) “Health care provider” has the meaning contained in s. 36.61 (1) (b), Stats.

UWS 24.02(7) (7) “Nurse-midwife” means a person who practices nurse-midwifery in accordance with s. 441.15, Stats.

UWS 24.02(8) (8) “Nurse practitioner” means a person who meets the requirements of s. 632.895 (8) (a) 3., Stats., or who is licensed as a registered nurse under ch. 441, Stats., or the laws of another state and who satisfies any of the following:

UWS 24.02(8)(a) (a) Is certified as a primary care nurse practitioner or clinical nurse specialist by the american nurses’ credentialing center, the national certification corporation, the national certification board of pediatric nurse practitioners and nurses, the american academy of nurse practitioners, or by another certifying body approved by the american board of nursing specialties.

UWS 24.02(8)(b) (b) Has completed an educational program approved by one of the certifying bodies listed in par. (a) and who is eligible, or who upon completion of the minimum time-in-practice requirement will be eligible, to take the professional certification examination as an advanced practice nurse.

UWS 24.02(9) (9) “Physician assistant” has the meaning contained in s. 448.01 (6), Stats.

UWS 24.02(10) (10) “Primary care” means basic health care services including general assessment, treatment, and management of common acute and chronic medical conditions, health promotion and disease prevention, and prenatal care and delivery services.

UWS 24.02 History History: Cr. Register, June, 1998, No. 510, eff. 6-1-98; CR 01-157: renum. (1) to (8) to be (3) to (10), cr. (1) and (2), Register, June 2002 No. 558, eff. 7-1-02; correction in (1g), (1r), (2), (4), (5), (6) made under s. 13.92 (4) (b) 6., 7., Stats., (1), (3) renumbered to be (1r), (1g) under s. 13.92 (4) (b) 1., Stats., Register October 2011 No. 670; 2015 Wis. Act 330 s. 20: am. (1g), (4) Register April 2016 No. 724, eff. 5-1-16.

UWS 24.025 UWS 24.025 Medical assistance and badger care requirements for dental hygienists.

UWS 24.025(1) (1) In addition to conforming to s. UWS 24.02 (1r), the dental hygienist’s employer shall agree to the following:

UWS 24.025(1)(a) (a) In year 1 of the dental hygienist’s agreement with the Board of Regents, his or her employer shall provide dental services to at least 50 unduplicated medical assistance or badger care recipients, not to fall below a minimum of $8,000 in claims paid.

UWS 24.025(1)(b) (b) In year 2 of the dental hygienist’s agreement with the Board of Regents, his or her employer shall provide dental services to at least 70 unduplicated medical assistance or badger care recipients, not to fall below a minimum of $11,000 in claims paid.

UWS 24.025(1)(c) (c) In year 3 of the dental hygienist’s agreement with the Board of Regents, his or her employer shall provide dental services to at least 90 unduplicated medical assistance or badger care recipients, not to fall below a minimum of $15,000 in claims paid.

UWS 24.025(2) (2) In this section, ”unduplicated” means that a recipient may only be counted once for the year regardless of the number of visits during the year.

UWS 24.025(3) (3) The Board of Regents may waive the requirements of sub. (1) on a case-by-case and year-to-year basis upon an administrative review that shows the employer for whom the dental hygienist works made a significant effort to achieve the targets contained in sub. (1) and that the employer has credible plans, as determined by the Board of Regents, to meet the following year’s targets, if applicable. If, in the opinion of the Board of Regents, the employer did not make a significant effort nor has credible plans to meet future targets as established in sub. (1), the dental hygienist may be required to repay any monies paid to the hygienist by the Board of Regents without additional penalties and may not receive additional loan assistance for subsequent periods.

UWS 24.025 History History: CR 01-157: cr. Register June 2002 No. 558, eff. 7-1-02; correction in (1), (3) made under s. 13.92 (4) (b) 6., 7., Stats., Register October 2011 No. 670; 2015 Wis. Act 330 s. 20: am. (1) (a) to (c), (3) Register April 2016 No. 724, eff. 5-1-16.

UWS 24.03 UWS 24.03 Priorities among eligible applicants.

UWS 24.03(1) (1) Any health care provider who practices in an eligible practice area and who provides primary or dental care is eligible for educational loan repayment as provided in s. 36.61 (4), Stats.

UWS 24.03(2) (2) If the cost of repaying the educational loans of all eligible applicants, when added to the cost of educational loan repayments scheduled under existing agreements, exceeds the total amount in the appropriations under s. 20.285 (1) (jc) and (ks), Stats., the Board of Regents shall establish priorities among eligible applicants based upon the following considerations:

UWS 24.03 Note Note: Section 20.285 (1) (jc) and (ks) were repealed by 2011 Wis. Act 32.

UWS 24.03(2)(a) (a) Extremely high need for medical or dental care. The degree to which there is an extremely high need for medical or dental care in the eligible practice area in which the eligible applicant proposes to practice.

UWS 24.03(2)(b) (b) Health care provider retention. The likelihood that an eligible applicant will remain in the eligible practice area in which he or she desires to practice after the loan repayment period.

UWS 24.03(2)(c) (c) Per capita income. The per capita income of the eligible practice area in which an eligible applicant desires to practice.

UWS 24.03(2)(d) (d) Financial support for health care provider recruitment and retention. The financial or other support for health care provider recruitment and retention provided by individuals, organizations or local governments in the eligible practice area in which an eligible applicant desires to practice.

UWS 24.03(2)(e) (e) Geographic distribution. The geographical distribution of the health care providers who have entered into loan repayment agreements under this section and the geographical location of the eligible practice area in which an eligible applicant desires to practice.

UWS 24.03(2)(f) (f) Length of service. The degree to which the medical or dental provider is new to the eligible practice area.

UWS 24.03(2)(g) (g) Loan balance. The educational loan balance of the eligible applicant.

UWS 24.03(2)(h) (h) Provision of medical assistance and badger care services. If already in practice, the degree to which the dental hygienist provides medical assistance and badger care services in the dental practice.

UWS 24.03 History History: Cr. Register, June, 1998, No. 510, eff. 6-1-98; CR 01-157: am. (1), (2) (intro.), (a) and (f), cr. (2) (h), Register June 2002 No. 558, eff. 7-1-02; correction in (1), (2) (intro.) made under s. 13.92 (4) (b) 6., 7., Stats., Register October 2011 No. 670; 2015 Wis. Act 330 s. 20: am. (2) Register April 2016 No. 724, eff. 5-1-16.

UWS 24.04 UWS 24.04 Application process.

UWS 24.04(1) (1) Applications shall be in such form as the Board of Regents may require and shall contain the following information:

UWS 24.04(1)(a) (a) Evidence of health or dental care professional educational program attendance.

UWS 24.04(1)(b) (b) Evidence of licensure or certification as a nurse-midwife, nurse practitioner, dental hygienist or physician assistant.

UWS 24.04(1)(c) (c) Evidence of educational loan indebtedness and educational loan outstanding balance.

UWS 24.04(1)(d) (d) The location of the applicant’s current or proposed practice.

UWS 24.04(1)(e) (e) Evidence that the provider practices or will practice primary care in an eligible practice area.

UWS 24.04(1)(f) (f) The length of time the health care provider has practiced in the eligible practice area.

UWS 24.04(1)(g) (g) Information about the likelihood that the applicant will remain in the eligible practice area after the loan repayment period.

UWS 24.04(1)(h) (h) Any other information the Board of Regents may require to make a determination in accordance with the provisions of s. 36.61, Stats., and this chapter.

UWS 24.04(2) (2) The Board of Regents shall prepare application materials that it may update as necessary.

UWS 24.04 History History: Cr. Register, June, 1998, No. 510, eff. 6-1-98; CR 01-157: am. (1) (a) and (b), Register June 2002 No. 558, eff. 7-1-02; correction in (1) (intro.), (h), (2) made under s. 13.92 (4) (b) 6., 7., Stats., Register October 2011 No. 670; 2015 Wis. Act 330 s. 20: am. (1) (intro.), (h), (2) Register April 2016 No. 724, eff. 5-1-16.

UWS 24.05 UWS 24.05 Breach of agreement.

UWS 24.05(1) (1) The following actions, if taken by a provider who has entered into an agreement with the Board of Regents under the state health care provider loan repayment program for repayment of loans entirely from state funds, after July 1, 1998, shall constitute a breach of that agreement:

UWS 24.05(1)(a) (a) No longer practicing at an eligible clinic.

UWS 24.05(1)(b) (b) Reducing hours below the minimum required by the Board of Regents.

UWS 24.05(1)(c) (c) Failing to treat medicare or medicaid patients.

UWS 24.05(1)(d) (d) Failing to apply funds received from the Board of Regents to repayment of eligible loans.

UWS 24.05(1)(e) (e) Failing to timely supply documentation required by the Board of Regents.

UWS 24.05(1)(f) (f) Failing to work at least 45 weeks per year.

UWS 24.05(1)(g) (g) Failing to meet the additional requirements outlined for dental hygienists in s. UWS 24.025.

UWS 24.05(2) (2) The following actions, if taken by a provider who has entered into an agreement with the Board of Regents under the expanded loan assistance program under s. 36.61 (3) (a), Stats., shall constitute a breach of that agreement:

UWS 24.05(2)(a) (a) No longer practicing at an eligible clinic.

UWS 24.05(2)(b) (b) Reducing hours below the minimum required by the Board of Regents.

UWS 24.05(2)(c) (c) Failing to take medicare assignment.

UWS 24.05(2)(d) (d) Failing to treat medicaid patients.

UWS 24.05(2)(e) (e) Failing to apply funds received from the Board of Regents to repayment of eligible loans.

UWS 24.05(2)(f) (f) Failing to timely supply documentation required by the Board of Regents.

UWS 24.05(2)(g) (g) Failing to work at least 45 weeks per year.

UWS 24.05(2)(h) (h) Failing to use a sliding fee scale or comparable method of determining payment arrangements for patients who are not eligible for medicare or medical assistance and who are unable to pay the customary fee for the health care provider’s services. Sliding fee scales may vary from clinic to clinic but, at a minimum, shall address persons with incomes below 200% of the federal poverty level.

UWS 24.05 History History: Cr. Register, June, 1998, No. 510, eff. 6-1-98; CR 01-157: cr. (1) (g), am. (2) (h), Register June 2002 No. 558, eff. 7-1-02; correction in (1) (intro.), (b), (d), (e), (g), (2) (intro.), (b), (e), (f) made under s. 13.92 (4) (b) 6., 7., Stats., Register October 2011 No. 670; 2015 Wis. Act 330 s. 20: am. (1) (intro.), (b), (d), (e), (2) (intro.), (b), (e), (f) Register April 2016 No. 724, eff. 5-1-16.