EmR1306
Filed with LRB: June 10, 2013
Publication Date: June 12, 2013
Effective Dates: June 12, 2013 through November 8, 2013
Hearing Date: July 23, 2013
EMERGENCY ORDER AMENDING, REPEALING AND CREATING A RULE.
Office of the Commissioner of Insurance
Rule No. 042-13: To amend s. Ins 17.01 (3), and 17.28 (3) (c) and to repeal and recreate s. Ins 17.28 (6), Wis. Admin. Code.
Relating to: Injured Patients and Families Compensation Fund Annual Fund and Mediation Panel Fees, and ISO code amendments for the fiscal year beginning July 1, 2013, and affecting small business.
The statement of scope for this rule SS 042-13, was approved by the Governor on April 16, 2013, published in Register No. 688, on April 30, 2013, and approved by the Commissioner on May 10, 2013.
This emergency rule was approved by the Governor on June 4, 2013.
______________________________________________________________________________
FINDING OF EMERGENCY
The Commissioner of Insurance finds that an emergency exists and that the attached rule is necessary for the immediate preservation of the public peace, health, safety, or welfare. Facts constituting the emergency are as follows:
These changes must be in place with an effective date prior to July 1, 2013 in order for the new fiscal year assessments to be issued in accordance with s. 655.27 (3), Wis. Stats. The permanent rule-making process cannot be completed prior to the effective date of the new fee schedule. The fiscal year fund fees were established by the Board of Governors at the meeting held on December 19, 2012 and the mediation panel fees established by the Board of Governors at the meeting held on March 20, 2013.
______________________________________________________________________
ANALYSIS PREPARED BY THE OFFICE OF THE COMMISSIONER OF INSURANCE (OCI)
1. Statutes interpreted:
ss. 655.27 (3), and 655.61, Wis. Stats.
2. Statutory authority:
ss. 601.41 (3), 655.004, 655.27 (3) (b), and 655.61, Wis. Stats.
3. Explanation of OCI’s authority to promulgate the proposed rule:
The injured patients and families compensation fund (“fund”), was established by and operated under Ch. 655, Stats. The commissioner of insurance with approval of the board of governors (“board”) is required to annually set the fees for the fund and the medical mediation panel by administrative rule. The proposed fees comply with the limitation delineated in s. 655.27 (3) (br), Stats. Section 655.04, Stats., provides that the director of state courts and the commissioner may promulgate rules necessary to enable them to perform their responsibilities under this chapter. Pursuant to s. 655.27 (3) (b), Stats., the commissioner, after approval by the board, shall by rule set the fees to the fund and s. 655.61, Stats., requires the board, by rule, to set the fees charged to health care providers at a level sufficient to provide the necessary revenue to fund the medical mediation panels. Further, s. 601.41 (3), Stats., provides that the commissioner shall have rule-making authority pursuant to s. 227.11 (2), Stats.
4. Related statutes or rules:
None.
5. Plain language analysis:
This proposed rule establishes the fees that participating health care providers must pay to the fund for the fiscal year beginning July 1, 2013. These fees represent a 5% decrease from fees paid for the 2012-2013 fiscal year. The board approved these fees at its meeting on December 19, 2012, based on the recommendation of the board's actuarial and underwriting committee and reports of the fund’s actuaries.
The board is also required to promulgate by rule the annual fees for the operation of the injured patients and families compensation medical mediation system, based on the recommendation of the director of state courts. The recommendation of the director of state courts was reviewed by the board’s actuarial and underwriting committee. This rule implements the funding level approved by the board on March 20, 2013 by establishing mediation panel fees for the next fiscal year at $0 for physicians and $0 per occupied bed for hospitals, representing a decrease of $22.50 per physician and a decrease of $4.50 per occupied bed for hospitals from 2012-13 fiscal year mediation panel fees.
Finally this rule includes changes to the Insurance Services Office (ISO) code listing to address corrections to several classification specialties as well as new classification specialties. ISO codes are the numerical designation for a health care provider’s specialty and are used to classify the provider for assessment purposes. Errors identified in the ISO codes or specialty narratives for three specialties have been corrected. A third specialty had duplicate listings resulting in the exclusion of another specialty which has now been added. The Doctor of Osteopathy (D.O.) designated ISO codes have been added for two specialties previously listed only under the Doctor of Medicine (M.D.) ISO codes.
6. Summary of and comparison with any existing or proposed federal statutes and regulations:
To the fund board’s and OCI’s knowledge there is no existing or proposed federal regulation that is intended to address fund rates, administration or to fund medical mediation panel activities.
7. Comparison with rules in adjacent states:
To the fund board’s and OCI’s knowledge there are no similar rules in the adjacent states to compare this rule to as none of adjacent states have a fund created by statute where rates are directed to be established yearly by rule as is true in Wisconsin.
8. A summary of the factual data and analytical methodologies that OCI used in support of the proposed rule:
None. This rule establishes annual fund fees pursuant to the requirements of the above-noted Wisconsin statutes. The recommendation to the board regarding the fund fee and the medical mediation panel assessment is developed and reviewed annually by the fund’s actuaries and the board’s actuarial and underwriting committee. The actuarial and underwriting committee after review and discussion with the fund’s actuaries present the information and the actuaries report to the board for consideration. This proposed rule reflects the rates approved by the board at the December 19, 2012 and March 20, 2013 board meetings.
9. Analysis and supporting documentation that OCI used in support of OCI’s determination of the rule’s effect on small business or in preparation of an economic impact analysis:
This decrease in fund fees will have a positive effect on small businesses in Wisconsin, particularly those that employ physicians and other health care professionals. The mediation panel fee is assessed only on physicians and hospitals, not on corporations or other health care entities that will also benefit from the reduction to zero fees for fiscal year 2014. The fund fee decrease will affect only those small businesses that pay the fund fees and mediation panel fees on behalf of their employed physicians. The fund fee decrease will not have a significant effect nor should it negatively affect the small business’s ability to compete with other providers.
10. Effect on small business:
This rule will have little or no effect on small businesses. The decrease contained in the proposed rule will require providers to pay reduced fund fees which will decrease the operational expenses for the providers. The decrease in fees promulgated by this rule should not result in a significant fiscal effect on the private sector.
11. A copy of any comments and opinion prepared by the Board of Veterans Affairs under s. 45.03 (2m), Stats., for rules proposed by the Department of Veterans Affairs.
None.
12. 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 at: http://oci.wi.gov/ocirules.htm
or by contacting Inger Williams, OCI Services Section, at:
Phone: (608) 264-8110
Email: inger.williams@wisconsin.gov
Address: 125 South Webster St – 2nd Floor, Madison WI 53703-3474
Mail: PO Box 7873, Madison, WI 53707-7873
13. Place where comments are to be submitted and deadline for submission:
The deadline for submitting comments is 4:00 p.m. on the 14th day after the date for the hearing stated in the Notice of Hearing.
Mailing address:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 1701
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 1701
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53703-3474
Email address:
Julie E. Walsh
Julie.Walsh@wisconsin.gov
Web site: http://oci.wi.gov/ocirules.htm
______________________________________________________________________
The proposed rule changes are:
SECTION 1. Ins 17.01 (3) is amended to read:
Ins 17.01 (3) FEE
SCHEDULE. The following fee schedule shall be effective July 1, 2012 2013:
(a) For physicians-- $22.50$0.
(b) For hospitals, per
occupied bed-- $4.50$0.
SECTION 2. Ins 17.28 (3) (c) 1., 2., and 3., 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 |
|
|
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 |
|
|
|
|
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 |
|
|
Neonatology (D.O.) |
84298 |
|
|
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 |
80280 |
|
|
Radiology—diagnostic-interventional |
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 |
|
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—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 |
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 3. Ins 17.28 (6) is repealed and recreated to read:
(6) Fee schedule. The following fee schedule is in effect from July 1, 2013 to June 30, 2014:
(a) Except as provided in pars. (b) to (f) and sub. (6e), for a physician for
whom this state is a principal place of practice:
Class 1…. $1,457 Class 3….$ 5,828
Class 2…. $2,623 Class 4….$9,616
(b) For a resident acting within the scope of a residency or fellowship program:
Class 1….. $ 729 Class 3….$2,916
Class 2….. $1,312 Class 4….$4,811
(c) For a resident practicing part-time outside the scope of a residency or fellowship program:
All classes……………………………… $874
(d) For a Medical College of Wisconsin, Inc., full-time faculty member:
Class 1….. $ 583 Class 3… .$2,332
Class 2…..$1,049 Class 4… .$3,848
(e) For physicians who practice part-time:
1. For a physician who practices fewer than 500 hours during the fiscal year, limited to office practice and nursing home and house calls, and who does not practice obstetrics or surgery or assist in surgical procedures: ..$ 364
2. For a physician who practices 1040 hours or less during the fiscal year, including those who practice fewer than 500 hours during the fiscal year whose practice is not limited to office practice, nursing homes or house calls or who do practice obstetrics, surgery or assist in surgical procedures:
Class 1…..$ 874 Class 3….$3,496
Class 2…..$1,573 Class 4….$5,768
(f) For a physician for whom this state is not a principal place of practice:
Class 1…..$ 729 Class 3….$2,916
Class 2…..$1,312 Class 4….$4,811
(g) For a nurse anesthetist for whom this state is a principal place of practice: $ 358
(h) For a nurse anesthetist for whom this state is not a principal place of practice:……………………………………………………………………………………………$ 179
(i) For a hospital, all of the following fees:
1. Per occupied bed………………………………………………………………………$ 87
2. Per 100 outpatient visits during the last calendar year for which totals are available:………………………………………………………………………………………….$ 4.35
(j) For a nursing home, as described under s. 655.002 (1) (j), Stats., that is wholly owned and operated by a hospital and that has health care liability insurance separate from that of the hospital by which it is owned and operated:
Per occupied bed……………………………………………………………………….…..$ 17
(k) For a partnership comprised of physicians or nurse anesthetists, organized for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:
1. a. If the total number of partners and employed physicians and nurse anesthetists is from 2 to 10…………………………………………………………………………………………$ 51
b. If the total number of partners and employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………..$ 503
c. If the total number of partners and employed physicians and nurse anesthetists exceeds 100……………………………………………………..……………………………..…$1,252
2. The following fee for each full-time equivalent allied health care professional employed by the partnership as of the most recent completed survey submitted:
Employed Health Care Professionals Fund Fee
Nurse Practitioners……………………………………………………..………………..….$ 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
(L) For a corporation, including a service corporation, with more than one shareholder organized under ch. 180, Stats., for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:
1. a. If the total number of shareholders and employed physicians and nurse anesthetists is from 2 to 10……………………………………………………………...…….$ 51
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:
1. 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 $100 or whichever of the following applies:
1. 7.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has occurrence coverage.
2. 10.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has claims-made coverage.
(q) For an organization or enterprise not specified as a partnership or corporation that is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:
1. a. If the total number of employed physicians and nurse anesthetists is from 1 to 10………………………………………………………………………………...………………$ 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
SECTION 4. These changes may be enforced under s. Ins 17.01 (2) (d) and (e).
Dated at Madison, Wisconsin, this 7th day of June , 2013.
_________________________________________
Theodore K. Nickel
Commissioner of Insurance
Office of the Commissioner of Insurance
Fiscal Estimate
for Section Ins 17.01, 17.28 (3) (c) and (6) relating to Injured Patients and Families Compensation Fund Annual fund and Mediation Panel Fees and ISO code amendments for the fiscal year beginning July 1, 2013 and affecting small business
This rule change will have no significant effect on the private sector as this proposed rule reduces fees to participants in the fund and reduces mediation panel fees to zero. The fund is a segregated account and does not impact state funds. The rule decreases fees and therefore does not have an effect on county, city, village, town, school district, technical college district and sewerage district fiscal liabilities and revenues.
State of Wisconsin
/
OFFICE OF
THE COMMISSIONER OF INSURANCE
125 South Webster
Street · P.O. Box 7873 Madison, Wisconsin
53707-7873 Phone: (608)
266-3585 · Fax: (608)
266-9935 E-Mail:
ociinformation@wisconsin.gov Web Address:
oci.wi.gov Scott
Walker, Governor Theodore
K. Nickel,
Commissioner Wisconsin.gov
STATE OF WISCONSIN ³
³ SS
OFFICE OF THE COMMISSIONER OF INSURANCE ³
I, Theodore K. Nickel, Commissioner of Insurance and custodian of the official records, certify that the annexed emergency rule affecting Section Ins 17.01, 17.28 (3) and 17.28 (6), Wis. Adm. Code, relating to the Injured Pateints and Families Compensation Fund annual fund and mediation panel fees, and ISO code amendments for the fiscal year beginning July 1, 2013 and affecting small business, is duly approved and adopted by this Office on June 7, 2013.
I further certify that I have compared this copy with the original on file in this Office and that it is a true copy of the original, and the whole of the original.
IN TESTIMONY WHEREOF, I have hereunto set my hand at 125 South Webster Street, Madison, Wisconsin,
on June 7, 2013.
_______________________________________
Theodore K. Nickel
Commissioner of Insurance
