Summary of factual data and analytical methodologies
The department relied on requirements set forth in s. 49.46 (bh), Stats. Analysis and supporting documents used to determine effect on small business
The department published a solicitation in the Administrative Register from September 18, 2023 to October 16, 2023, in which it requested comments on the economic impact of the proposed rule.
Effect on small business
The proposed rule is anticipated to have moderate economic impact on small businesses.
Agency contact person
Statement on quality of agency data
The data used by the Department to prepare these proposed rules and analysis comply with s. 227.14 (2m), Stats. Place where comments are to be submitted and deadline for submission
Comments may be submitted to the agency contact person that is listed above until the deadline given in the upcoming notice of public hearing. The notice of public hearing and deadline for submitting comments will be published in the Wisconsin Administrative Register and to the department’s website, at https://www.dhs.wisconsin.gov/rules/permanent.htm. Comments may also be submitted through the Wisconsin Administrative Rules Website, at: https://docs.legis.wisconsin.gov/code/chr/active. RULE TEXT
SECTION 1. DHS 105.155 is created to read:
DHS 105.155 Pharmacists.
(1) For MA certification, a pharmacist must be licensed under s. 450.03, Stats. (2) When a pharmacist performs services under a delegation agreement in accordance with s. 450.033, Stats., all of the following shall be documented and available for review by the department: (a) The name and license number of any physician who is delegating services to the pharmacist.
(b) The name and license number of the pharmacist who is entering into the agreement.
(c) The specific timeframe, not to exceed three years, for which the agreement is in effect.
(d) The patient or groups of patients eligible to receive delegated services under the agreement, including any patient inclusion or exclusion criteria.
(e) The delegated services that the pharmacist may perform.
(f) The process for the physician or designee of the physician to monitor compliance with the delegation agreement by the pharmacist.
(g) The process for how the delegated services provided by the pharmacist will be documented or included in the patient’s health record.
(h) The signature and date of any physician delegating services.
(i) The signature and date of the pharmacist entering into the agreement.
SECTION 2. DHS 107.067 is created to read:
DHS 107.067 Pharmacist Services.
(1) Covered services. Pharmacist services covered by the MA program are any medically necessary services provided to a recipient, that are delivered by a licensed pharmacist when one of the following apply:
(a) The services are provided within the scope of the pharmacist’s license.
(b) The services are covered under this chapter and are performed in accordance with s. 450.033, Stats. (2) Other limitations. Services covered under sub. (1) shall be performed by a pharmacist licensed under s. 450.03, Stats. SECTION 3. DHS 107.08 (4) (d) (intro) and 1. to 14. are amended to read:
DHS 107.08 (4) (d) The following professional services are not covered as part of a hospital inpatient claim but shall be billed by an appropriately certified MA provider;:
1. Services of physicians, including pathologists, radiologists and the professional-billed component of laboratory and radiology or imaging services, except that services by physician intern and residents services are included as hospital services;.
2. Services of psychiatrists and psychologists, except when performing group therapy and medication management, including services provided to a hospital inpatient when billed by a hospital, clinic or other mental health or AODA provider;.
3. Services of podiatrists;.
4. Services of physician assistants;.
5. Services of nurse midwives, nurse practitioners and independent nurses when functioning as independent providers;.
6. Services of certified registered nurse anesthetists;.
7. Services of anesthesia assistants;.
8. Services of chiropractors;.
9. Services of dentists;.
10. Services of optometrists;.
11. Services of hearing aid dealers [or instrument specialists] ;.
12. Services of audiologists;.
13. Any of the following provided on the date of discharge for home use;:
a. Drugs;.
b. Durable medical equipment;.
c. Disposable medical supplies;.
14. Specialized medical vehicle transportation; and.
SECTION 4. DHS 107.08 (4) (d) 12m. is created to read:
DHS 107.08 (4) (d) 12m. Services of pharmacists.
SECTION 5. DHS 107.10 (1) is are amended to read:
DHS 107.10 (1) Covered services. Drugs and drug products covered by MA include legend and non-legend drugs and supplies listed in the Wisconsin medicaid drug index which are prescribed by a physician licensed under s. 448.04, Stats., by a dentist licensed under s. 447.05, Stats., by a podiatrist licensed under s. 448.04, Stats., by an optometrist licensed under ch. 449, Stats., by an advanced practice nurse prescriber licensed under s. 441.16, Stats., or when a physician delegates the prescribing of drugs to a licensed pharmacist in accordance with s. DHS 107.067, or to a nurse practitioner or toa physician's assistant certified under s. 448.04, Stats., and the requirements under s. N 6.03 for nurse practitioners and under s. Med 8.07 for physician assistants are met. SECTION 6. DHS 107.10 (1) (Note 2) is repealed.
SECTION 5. Effective date. This rule shall take effect on the first day of the month following publication in the Wisconsin Administrative Register, as provided in s. 227.22 (2) (intro.), Stats.
