CR 19-119 Rule Text

The Office reviewed the actual fees and the process to ascertain return of the convenience installment fee and the amount of staff time needed to accurately identify all installment fees and add appropriate interest to the fees. Any impact to small businesses is de minimis as the installment fee was provided for the individual health care provider convenience and is still available for spreading the annual assessment over four quarterly payments.

11.     See the attached Private Sector Fiscal Analysis.

The proposed rule will not significantly impact the private sector as demonstrated in the economic impact analysis attached to the rule. Additionally, the proposed rule amending several ISO codes will result in more accurate assessments of providers based upon classification of the type of health care services provided. The resulting change in the fees should not be passed through to the general public.

12.     A description of the Effect on Small Business:

The proposed rule will not significantly impact small businesses as demonstrated in the economic impact analysis attached to the rule. Additionally, the proposed rule amending several ISO codes will result in more accurate assessments of providers, including small businesses, based upon classification of the type of health care services provided.

13.     Agency contact person:

A copy of the full text of the proposed rule changes, analysis, and fiscal estimate may be obtained from the web site under Rule-Making Information at: https://oci.wi.gov/Pages/RegulationHome.aspx

or by contacting Karyn Culver, Paralegal, at:

Phone:   [phone]

Email:   [e-mail]

Address:   125 South Webster St – 2nd Floor, Madison WI 53703-3474

Mail:   PO Box 7873, Madison, WI 53707-7873

14.     Place where comments are to be submitted and deadline for submission:

The deadline for submitting comments is 4:00 p.m. on October 14, 2019.

Mailing address:

Julie E. Walsh

Legal Unit - OCI Rule Comment for Rule Ins 1728

Office of the Commissioner of Insurance

PO Box 7873

Madison WI 53707-7873

Street address:

Julie E. Walsh

Legal Unit - OCI Rule Comment for Rule Ins 1728

Office of the Commissioner of Insurance

125 South Webster St – 2nd Floor

Madison WI 53703-3474

Email address:

Julie E. Walsh

[e-mail]

Web site: http://docs.legis.wisconsin.gov/code

 

The proposed rule changes are:

  SECTION 1. Ins 17.28 (3) (c), are amended to read:

Ins 17.28 (3) (c) 1. Class 1:

Administrative Medicine

80120

Aerospace Medicine

80230

Allergy

80254

Allergy (D.O.)

84254

Cardiovascular Disease—no surgery or catheterization

80255

Cardiovascular Disease—no surgery or catheterization (D.O.)

84255

Dermatology—no surgery

80256

Dermatology—no surgery (D.O.)

84256

Diabetes—no surgery

80237

Endocrinology—no surgery

80238

Endocrinology—no surgery (D.O.)

84238

Family or General Practice—no surgery

80420

Family or General Practice—no surgery (D.O.)

84420

Forensic Medicine—Legal Medicine

80240

Forensic Medicine—Legal Medicine (D.O.)

84240

Gastroenterology—no surgery

80241

Gastroenterology—no surgery (D.O.)

84241

General Preventive Medicine—no surgery

80231

General Preventive Medicine—no surgery (D.O.)

84231

Geriatrics—no surgery

80243

Geriatrics—no surgery (D.O.)

84243

Gynecology—no surgery

80244

Gynecology—no surgery (D.O.)

84244

Hematology—no surgery

80245

Hematology—no surgery (D.O.)

84245

Hypnosis

80232

Infectious Diseases—no surgery

80246

Infectious Diseases—no surgery (D.O.)

84246

Internal Medicine—no surgery

80257

Internal Medicine—no surgery (D.O.)

84257

Laryngology—no surgery

80258

Manipulator (D.O.)

84801

Neoplastic Disease—no surgery

80259

Nephrology—no surgery

80260

Nephrology – no surgery (D.O.)

84260

Neurology—no surgery

80261

Neurology—no surgery (D.O.)

84261

Nuclear Medicine

80262

Nuclear Medicine (D.O.)

84262

Nutrition

80248

Occupation Medicine

80233

Occupation Medicine (D.O.)

84233

Oncology – no surgery

80302

Oncology – no surgery (D.O.)

84302

Ophthalmology—no surgery

80263

Ophthalmology—no surgery (D.O.)

84263

Osteopathy—manipulation only

84801

Otology – no surgery

80264

Otorhinolaryngology—no surgery

80265

Otorhinolaryngology—no surgery (D.O.)

84265

Pain Management – no surgery

80208

Pain Management – no surgery (D.O.)

84208

Pathology—no surgery

80266

Pathology—no surgery (D.O.)

84266

Pediatrics—no surgery

80267

Pediatrics—no surgery (D.O.)

84267

Pharmacology—Clinical

80234

Physiatry—Physical Medicine (D.O.)

84235

Physiatry—Physical Medicine & Rehabilitation

80235

Physicians—no surgery

80268

Physicians—no surgery (D.O.)

84268

Psychiatry

80249

Psychiatry—(D.O.)

84249

Psychoanalysis

80250

Psychosomatic Medicine

80251

Psychosomatic Medicine (D.O.)

84251

Public Health

80236

Pulmonary Disease—no surgery

80269

Pulmonary Disease—no surgery (D.O.)

84269

Radiology—diagnostic

80253

Radiology—diagnostic (D.O.)

84253

Radiology–includes Mammography w/ Telemed

80472

Radiopaque dye

80449

Radiopaque dye (D.O.)

84449

Rheumatology—no surgery

80252

Rheumatology—no surgery (D.O.)

84252

Rhinology – no surgery

80247

Shock Therapy

80431

Shock Therapy (D.O.)

84431

Shock Therapy—insured

80162

Urgent Care—Walk-in or After Hours

80424

Urgent Care—Walk-in or After Hours (D.O.)

84424

Urology—no surgery

80121

2.

Class 2:

Acupuncture

80437

Acupuncture (D.O.)

84437

Anesthesiology

80151

Anesthesiology (D.O.)

84151

Angiography-Arteriography—catheterization

80422

Angiography-Arteriography—catheterization (D.O.)

84422

Broncho-Esophagology

80101

Cardiovascular Disease—minor surgery

80281

Cardiovascular Disease—minor surgery (D.O.)

84281

Colonoscopy-ERCP-Pneu or mech esoph dil (D.O.)

84443

Colonoscopy-ERCP-pneu. or mech.

80443

Dermatology—minor surgery

80282

Dermatology – minor surgery (D.O.)

84282

Diabetes – minor surgery

80271

Diabetes—minor surgery (D.O.)

84271

Emergency Medicine—No Major Surgery

80102

Emergency Medicine—No Major Surgery (DO)

84102

Employed Physician or Surgeon

80177

Employed Physician or Surgeon (D.O.)

84177

Endocrinology—minor surgery

80272

Endocrinology—minor surgery (D.O.)

84272

Family Practice—and general practice minor surgery—No OB

80423

Family Practice—and general practice minor surgery—No OB (D.O.)

84423

Family or General Practice—including OB

80421

Family or General Practice – including OB (D.O.)

84421

Gastroenterology—minor surgery

80274

Gastroenterology—minor surgery (D.O.)

84274

Geriatrics—minor surgery

80276

Geriatrics—minor surgery (D.O.)

84276

Gynecology—minor surgery

80277

Gynecology—minor surgery (D.O.)

84277

Hematology—minor surgery

80278

Hematology—minor surgery (D.O.)

84278

Hospitalist

80296

Hospitalist (D.O.)

84296

Infectious Diseases—minor surgery

80279

Intensive Care Medicine

80283

Intensive Care Medicine (D.O.)

84283

Internal Medicine—minor surgery

80284

Internal Medicine—minor surgery (D.O.)

84284

Laparoscopy

80440

Laparoscopy (D.O.)

84440

Laryngology—minor surgery

80285

Myelography – Discogram-Pneumoencephalo

80428

Myelography-Discogram-Pneumoencephalo (D.O.)

84428

Needle Biopsy

80446

Needle Biopsy (D.O.)

84446

Nephrology—minor surgery

80287

Neonatology

80298

80804

Neonatology (D.O.)

84298

84804

Neoplastic Disease—minor surgery

80286

Neurology—minor surgery

80288

Neurology—minor surgery (D.O.)

84288

Oncology – minor surgery

80301

Oncology – minor surgery (D.O.)

84301

Ophthalmology—minor surgery

80289

Ophthalmology—minor surgery (D.O.)

84289

Otology – minor surgery

80290

Otorhinolaryngology—minor surgery

80291

Otorhinolaryngology—minor surgery (D.O.)

84291

Pain Management – Basic procedures

80182

Pain Management – Basic procedures (D.O.)

84182

Pathology—minor surgery

80292

Pathology—minor surgery (D.O.)

84292

Pediatrics—minor surgery

80293

Pediatrics—minor surgery (D.O.)

84293

Phlebography-Lymphangeography

80434

Phlebography-Lymphangeography (D.O.)

84434

Physicians—minor surgery

80294

Physicians – minor surgery (D.O.)

84294

Radiation Therapy—lasers

80425

Radiation Therapy—lasers (D.O.)

84425

Radiation Therapy – other than lasers

80165

Radiology—diagnostic-interventional procedures

80280

Radiology—diagnostic-interventional procedures (D.O.)

84280

Rhinology – minor surgery

80270

Surgery—Colon & Rectal

80115

Surgery —Endocrinology

80103

Surgery—Gastroenterology

80104

Surgery – Gastroenterology (D.O.)

84104

Surgery—General Practice or Family Practice

80117

Surgery—General Practice or Family Practice (D.O.)

84117

Surgery—Geriatrics

80105

Surgery—Neoplastic

80107

Surgery—Nephrology

80108

Surgery—Ophthalmology

80114

Surgery—Ophthalmology (D.O.)

84114

Surgery—Urological

80145

Surgery—Urological (D.O.)

84145

3. Class 3:

Emergency Medicine—includes major surgery

80157

Emergency Medicine—includes major surgery (D.O.)

84157

Otology—surgery

80158

Pain Management – Neurology, Adv Proc

80298

Pain Management – Neurology, Adv Proc (D.O.)

84298

Radiation Therapy – employed physician

80163

Radiation Therapy – employed physician (D.O.)

84163

Shock Therapy – employed physician

80161

Shock Therapy – employed physician (D.O.)

84161

Surgery—Abdominal

80166

Surgery – Bariatrics

80476

Surgery – Bariatrics (D.O.)

84476

Surgery—Cardiac

80141

Surgery—Cardiac (D.O.)

84141

Surgery—Cardiovascular Disease

80150

Surgery—Cardiovascular Disease (D.O.)

84150

Surgery—General

80143

Surgery—General (D.O.)

84143

Surgery—Gynecology

80167

Surgery—Gynecology (D.O.)

84167

Surgery—Hand

80169

Surgery—Head & Neck

80170

Surgery – Laryngology

80106

Surgery—Orthopedic

80154

Surgery—Orthopedic (D.O.)

84154

Surgery—Otorhinolaryngology-no plastic surgery

80159

Surgery—Plastic

80156

Surgery—Plastic (D.O.)

84156

Surgery—Plastic-Otorhinolaryngology

80155

Surgery—Plastic-Otorhinolaryngology (D.O.)

84155

Surgery—Rhinology

80160

Surgery—Thoracic

80144

Surgery—Thoracic (D.O.)

84144

Surgery—Traumatic

80171

Surgery—Traumatic (D.O.)

84171

Surgery—Vascular

80146

Surgery – Vascular (D.O.)

84146

Weight Control—Bariatrics

80180

SECTION 2. Ins 17.28 (4) (f) is amended to read:

Ins 17.28 (4) (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 administrative service charges, interest or 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.

SECTION 3. EFFECTIVE DATE. This rule is effective on the first day of the month commencing after the date of publication in the Wisconsin Administrative Register in accordance with s. 227.22 (2) (intro.), Stats.

Dated at Madison, Wisconsin, this 6th day of September 2019.

  ___________________________

  Nathan D. Houdek

  Deputy Commissioner