Amendment SA4-SSA2-SB45

SB45-SSA2-SA4,61,2 (d) Reporting. One year, 2 years, and 5 years following the completion of the material change transaction approved or conditionally approved by the department after a comprehensive review under sub. (3), and upon future intervals determined at the discretion of the department, the health care entity or any person, corporation, partnership, or other entity that acquired direct or indirect control over the health care entity shall submit reports to the department that do all of the following:

SB45-SSA2-SA4,61,4 1. Demonstrate compliance with conditions placed on the material change transaction, if any.

SB45-SSA2-SA4,61,5 2. Analyze cost trends and cost growth trends of the transacting parties.

SB45-SSA2-SA4,61,7 3. Analyze any changes or effects of the material change transaction on patient access, availability of services, workforce, quality, or equity.

SB45-SSA2-SA4,61,11 (e) Costs. The department shall be entitled to charge costs to the transacting parties for all actual, reasonable, and direct costs incurred in monitoring ongoing compliance with the terms and conditions of the sale or transfer of assets, including contractor and administrative costs.

SB45-SSA2-SA4,61,12 (6) Rules. The department may promulgate rules to implement this section.

SB45-SSA2-SA4,128 Section 128. 150.994 of the statutes is created to read:

SB45-SSA2-SA4,61,16 150.994 Corporate practice of medicine. The corporate practice of medicine is prohibited. The department shall promulgate rules to define what conduct constitutes the corporate practice of medicine for purposes of this section.

SB45-SSA2-SA4,129 Section 129. 150.996 of the statutes is created to read:

SB45-SSA2-SA4,61,23 150.996 Transparency in ownership and control of health care entities. (1) Reporting of ownership and control. Each health care entity shall report to the department on an annual basis and upon the consummation of a material change transaction involving the entity as set forth in s. 150.992, in a form and manner required by the department, all of the following information, as applicable:

SB45-SSA2-SA4,61,24 (a) Legal name of entity.

SB45-SSA2-SA4,62,1 (b) Business address of entity.

SB45-SSA2-SA4,62,2 (c) Locations of operations.

SB45-SSA2-SA4,62,4 (d) Business identification numbers of the entity, as applicable, including all of the following:

SB45-SSA2-SA4,62,5 1. Taxpayer identification number.

SB45-SSA2-SA4,62,6 2. National provider identifier.

SB45-SSA2-SA4,62,7 3. Employer identification number.

SB45-SSA2-SA4,62,8 4. Centers for Medicare and Medicaid Services certification number.

SB45-SSA2-SA4,62,9 5. National Association of Insurance Commissioners identification number.

SB45-SSA2-SA4,62,11 6. A personal identification number associated with a license issued by the commissioner of insurance.

SB45-SSA2-SA4,62,13 7. Pharmacy benefit manager identification number associated with a license or registration of the pharmacy benefit manager in this state.

SB45-SSA2-SA4,62,14 (e) Name and contact information of a representative of the entity.

SB45-SSA2-SA4,62,18 (f) The name, business address, and business identification numbers listed in par. (d) for each person or entity that, with respect to the relevant health care entity, has an ownership or investment interest, has a controlling interest, is a management services organization, or is a significant equity investor.

SB45-SSA2-SA4,62,20 (g) A current organizational chart showing the business structure of the health care entity, including all of the following:

SB45-SSA2-SA4,62,21 1. Any entity listed in par. (f).

SB45-SSA2-SA4,62,23 2. Affiliates, including entities that control or are under common control as the health care entity.

SB45-SSA2-SA4,62,24 3. Subsidiaries.

SB45-SSA2-SA4,63,2 (h) For a health care entity that is a provider organization or a health care facility, all of the following information:

SB45-SSA2-SA4,63,5 1. a. The affiliated health care providers identified by name, license type, specialty, national provider identifier, and other applicable identification number listed in par. (d).

SB45-SSA2-SA4,63,6 b. The address of the principal practice location.

SB45-SSA2-SA4,63,7 c. Whether the health care provider is employed or contracted by the entity.

SB45-SSA2-SA4,63,9 2. The name and address of affiliated health care facilities by license number, license type, and capacity in each major service area.

SB45-SSA2-SA4,63,11 (i) The names, national provider identifier, if applicable, and compensation of all of the following:

SB45-SSA2-SA4,63,13 a. The members of the governing board, board of directors, or similar governance body for the health care entity.

SB45-SSA2-SA4,63,15 b. Any entity that is owned or controlled by, affiliated with, or under common control as the health care entity.

SB45-SSA2-SA4,63,16 c. Any entity listed in par. (f).

SB45-SSA2-SA4,63,20 (j) Comprehensive financial reports of the health care entity and any ownership or control entities, including audited financial statements, cost reports, annual costs, annual receipts, realized capital gains and losses, accumulated surplus, and accumulated reserves.

SB45-SSA2-SA4,63,22 (2) Exceptions. All of the following health care entities are exempt from the reporting requirements under sub. (1):

SB45-SSA2-SA4,64,3 (a) A health care entity that is an independent provider organization, without any ownership or control entities, consisting of 2 or fewer physicians, provided that if that health care entity experiences a material change transaction under s. 150.992, the health care entity is subject to reporting under sub. (1) upon the consummation of the transaction.

SB45-SSA2-SA4,64,9 (b) A health care provider or provider organization that is owned or controlled by another health care entity, if the health care provider or provider organization is shown in the organizational chart submitted under sub. (1) (g) and the owning or controlling health care entity reports all the information required under sub. (1) on behalf of the controlled or owned entity. Health care facilities are not subject to this exception.

SB45-SSA2-SA4,64,15 (3) Rules. (a) The department shall promulgate any rules necessary to implement this section, specify the format and content of reports, and impose penalties for noncompliance. The department may require additional reporting of data or information that it determines is necessary to better protect the public’s interest in monitoring the financial conditions, organizational structure, business practices, and market share of each registered health care entity.

SB45-SSA2-SA4,64,17 (b) The department may assess administrative fees on health care entities in an amount to help defray the costs in overseeing and implementing this section.

SB45-SSA2-SA4,64,21 (4) Ownership information. (a) Information provided under this section shall be public information and may not be considered confidential, proprietary, or a trade secret, except that any individual health care provider’s taxpayer identification that is also their social security number shall be confidential.

SB45-SSA2-SA4,64,24 (b) Not later than December 31, 2028, and annually thereafter, the department shall post on its publicly available website a report with respect to the previous one-year period, including all of the following information:

SB45-SSA2-SA4,65,2 1. The number of health care entities reporting for the year, disaggregated by the business structure of each specified entity.

SB45-SSA2-SA4,65,4 2. The names, addresses, and business structure of any entities with an ownership or controlling interest in each health care entity.

SB45-SSA2-SA4,65,5 3. Any change in ownership or control for each health care entity.

SB45-SSA2-SA4,65,6 4. Any change in the tax identification number of a health care entity.

SB45-SSA2-SA4,65,10 5. As applicable, the name, address, tax identification number, and business structure of other affiliates under common control, subsidiaries, and management services entities for the health care entity, including the business type and the tax identification number of each.

SB45-SSA2-SA4,65,12 6. An analysis of trends in horizontal and vertical consolidation, disaggregated by business structure and provider type.

SB45-SSA2-SA4,65,20 (c) The department may share information reported under this section with the attorney general, other state agencies, and other state officials to reduce or avoid duplication in reporting requirements or to facilitate oversight or enforcement under state law. Any tax identification numbers that are individual social security numbers may be shared with the attorney general, other state agencies, or other state officials that agree to maintain the confidentiality of such information. The department may, in consultation with the relevant state agencies, merge similar reporting requirements where appropriate.

SB45-SSA2-SA4,66,2 (5) Enforcement. (a) Audit and inspection authority. The department is authorized to audit and inspect the records of any health care entity that has failed to submit complete information pursuant to this section or if the department has reason to question the accuracy or completeness of the information submitted pursuant this section.

SB45-SSA2-SA4,66,5 (b) Random audits. The department shall conduct annual audits of a random sample of health care entities to verify compliance with, accuracy, and completeness of the reported information pursuant to this section.

SB45-SSA2-SA4,66,8 (c) Penalty for failure to report. If a health care entity fails to provide a complete report under sub. (1), or submits a report containing false information, the entity shall be subject to all of the following civil penalties, as appropriate:

SB45-SSA2-SA4,66,12 1. Health care entities consisting of independent health care providers or provider organizations without any 3rd-party ownership or control entities, with 10 or fewer physicians or less than $10 million in annual revenue, a forfeiture of up to $50,000 for each report not provided or containing false information.

SB45-SSA2-SA4,66,14 2. For all other health care entities, a forfeiture of up to $500,000 for each report not provided or containing false information.

SB45-SSA2-SA4,130 Section 130. 250.15 (1) (b) 7. of the statutes is created to read:

SB45-SSA2-SA4,66,16 250.15 (1) (b) 7. The organizations are not health center look-alikes.

SB45-SSA2-SA4,131 Section 131. 250.15 (1) (c) of the statutes is created to read:

SB45-SSA2-SA4,66,20 250.15 (1) (c) “Health center look-alike” means a health care entity that is designated by the federal health resources and services administration as a federally qualified health center look-alike.

SB45-SSA2-SA4,132 Section 132. 250.15 (2) (d) of the statutes is amended to read:

SB45-SSA2-SA4,66,23 250.15 (2) (d) Two million two hundred fifty thousand dollars to To free and charitable clinics, $2,500,000.

SB45-SSA2-SA4,133 Section 133. 250.15 (2) (e) of the statutes is created to read:

SB45-SSA2-SA4,67,2 250.15 (2) (e) To health center look-alikes, $200,000. A grant awarded to a health center look-alike under this paragraph may not exceed $100,000.

SB45-SSA2-SA4,134 Section 134. 252.12 (2) (a) 8. (intro.) of the statutes is amended to read:

SB45-SSA2-SA4,67,15 252.12 (2) (a) 8. ‘Mike Johnson life care and early intervention services grants.’ (intro.) The department shall award not more than $4,000,000 $4,500,000 in each fiscal year in grants to applying AIDS service organizations for the provision of needs assessments; assistance in procuring financial, medical, legal, social and pastoral services; counseling and therapy; homecare services and supplies; advocacy; and case management services. These services shall include early intervention services. The department shall also award not more than $74,000 in each year from the appropriation account under s. 20.435 (5) (md) for the services under this subdivision. The state share of payment for case management services that are provided under s. 49.45 (25) (be) to recipients of medical assistance shall be paid from the appropriation account under s. 20.435 (1) (am). All of the following apply to grants awarded under this subdivision:

SB45-SSA2-SA4,135 Section 135. 253.07 (1) (a) 3. of the statutes is created to read:

SB45-SSA2-SA4,67,17 253.07 (1) (a) 3. Pregnancy termination.

SB45-SSA2-SA4,136 Section 136. 253.07 (1) (b) 3. of the statutes is created to read:

SB45-SSA2-SA4,67,19 253.07 (1) (b) 3. Pregnancy termination.

SB45-SSA2-SA4,137 Section 137. 253.07 (5) (b) (intro.) of the statutes is renumbered 253.07 (5) (b) and amended to read:

SB45-SSA2-SA4,68,2 253.07 (5) (b) Subject to par. (c), a A public entity that receives women’s health funds under this section may provide some or all of the funds to other public or private entities provided that the recipient of the funds does not do any of the following:.

SB45-SSA2-SA4,138 Section 138. 253.07 (5) (b) 1. to 3. of the statutes are repealed.

SB45-SSA2-SA4,139 Section 139. 253.07 (5) (c) of the statutes is repealed.

SB45-SSA2-SA4,140 Section 140. 253.094 of the statutes is created to read:

SB45-SSA2-SA4,68,10 253.094 Right to abortion. (1) Every individual has the fundamental right to bodily autonomy, which includes the right to access abortion. The state may not prohibit an individual from obtaining an abortion at any time during the pregnancy if an abortion is necessary in the professional judgment of the individual’s medical provider.

SB45-SSA2-SA4,68,15 (2) (a) Except as provided in sub. (1), a law or rule of this state that restricts an individual’s access to abortion is unenforceable if the law or rule does not confer any legitimate health benefit, such as by expanding an individual’s access to health care services or by, according to evidence-based research, increasing the individual’s safety.

SB45-SSA2-SA4,68,20 (b) Any person that is or may be aggrieved by the enforcement of a law or rule passed or promulgated after the effective date of this paragraph .... [LRB inserts date], that violates this subsection may bring an action in state or federal court for injunctive relief or damages against a state or local official who enforces or attempts to enforce such a law or rule.

SB45-SSA2-SA4,141 Section 141. 253.095 of the statutes is repealed.

SB45-SSA2-SA4,142 Section 142. 253.10 of the statutes is repealed and recreated to read:

SB45-SSA2-SA4,69,2 253.10 Requirements for providers of abortion care. (1) All requirements applicable to health care providers are applicable to providers of abortion care.

SB45-SSA2-SA4,143 Section 143. 253.105 of the statutes is repealed.

SB45-SSA2-SA4,144 Section 144. 253.107 (1) (b) of the statutes is amended to read:

SB45-SSA2-SA4,69,7 253.107 (1) (b) “Medical emergency” has the meaning given in s. 253.10 (2) (d) means a condition, in a physician’s reasonable medical judgment, that makes an abortion necessary.

SB45-SSA2-SA4,145 Section 145. 253.13 (6) of the statutes is created to read:

SB45-SSA2-SA4,69,14 253.13 (6) Federal recommendations; evaluation procedure. (a) Initial evaluation. 1. Subject to subd. 2., for any disorder that is added to the federal recommended uniform screening panel approved by the federal department of health and human services after January 1, 2025, and that is not included in the list of disorders under s. DHS 115.04, Wis. Adm. Code, the department shall do all of the following within 18 months after the addition of the disorder:

SB45-SSA2-SA4,69,16 a. Conduct an initial evaluation to determine whether the disorder should be included in the testing required under this section.

SB45-SSA2-SA4,69,19 b. If the department determines that the disorder should be included in the testing required under this section, commence rule making to add the disorder to the list under s. DHS 115.04, Wis. Adm. Code.

SB45-SSA2-SA4,69,24 2. This paragraph does not apply to any disorder included in the federal recommended uniform screening panel that will be added to the list of disorders under s. DHS 115.04, Wis. Adm. Code, pending promulgation of a rule for which the department has commenced rule-making procedures as of the effective date of this subdivision .... [LRB inserts date].