Chapter DHS 120

DHS 120.06(2)(c) (c) A subsidiary or affiliate of an organization in par. (a) in which a controlling interest is held and may be exercised by that organization either independently or in concert with any other organization in par. (a).

DHS 120.06(2)(d) (d) An association of any of the entities in pars. (a) to (c).

DHS 120.06(3) (3) Confidentiality. The department may grant the contractor authority to examine confidential materials and perform other specified functions. The contractor shall comply with all confidentiality requirements established under this chapter. The release of confidential information by the contractor without the department’s written consent shall constitute grounds for the department to terminate the contract and subjects the contractor to all pertinent penalties and liabilities described in this chapter.

DHS 120.06 History History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.

DHS 120.07 DHS 120.07 Training.

DHS 120.07(1) (1) General. The department shall conduct throughout the state a series of training sessions for data submitters to explain its policies and procedures and to provide assistance in implementing the requirements of ch. 153, Stats., and this chapter.

DHS 120.07(2) (2) Data submission training associated with ss. DHS 120.12 (5), (5m) and (6), 120.13 and 120.14 (1).

DHS 120.07(2)(a) (a) The department shall sponsor data submission training each time the department establishes a major change in the data submission process.

DHS 120.07(2)(b) (b) Each data submitting entity shall authorize appropriate staff to attend the department’s data submission training.

DHS 120.07(2)(c) (c) If a data submitting entity replaces its department-trained data submission designee, the data submitting entity shall either transfer the knowledge required to submit data to another designee or make arrangements with the department for the replacement designee to obtain department training.

DHS 120.07 History History: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 01-051: am. Register, September 2001 No. 549 eff. 10-1-01.

DHS 120.08 DHS 120.08 Reporting status changes required. A facility shall report to the department any of the following within 45 days after the event occurs:

DHS 120.08(1) (1) The opening of a new facility.

DHS 120.08(2) (2) The closing of the facility.

DHS 120.08(3) (3) The merger of 2 or more facilities.

DHS 120.08(4) (4) A change in the name of the facility.

DHS 120.08(5) (5) A change of the facility’s address.

DHS 120.08(6) (6) A change in the identity of the chief executive officer or chief administrative officer of the facility.

DHS 120.08(7) (7) A change in the beginning and ending dates of the facility’s fiscal year.

DHS 120.08 Note Note: Health care providers who are required to send their information directly to the department should use the following address: Bureau of Health Information and Policy, P. O. Box 2659, Madison, Wisconsin 53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street, Madison, Wisconsin.

DHS 120.08 History History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.

DHS 120.09 DHS 120.09 Notice of hospital rate increases or charges in excess of rates.

DHS 120.09(1) (1) Definitions. In this section:

DHS 120.09(1)(a) (a) “Annualized percentage” means an estimate of the percentage increase in a hospital’s gross revenue due to a price increase in charges for patient services for the 12-month period beginning with the effective date of the price increase.

DHS 120.09(1)(b) (b) “Change in the consumer price index” means the percentage difference between the consumer price index, as defined in s. 16.004 (8) (e) 1., Stats., for the 12-month period ending on December 31 of the preceding year and the consumer price index for the 12-month period ending on December 31 of the year prior to the preceding year.

DHS 120.09(1)(c) (c) “Charge element” means any service, supply or combination of services or supplies that is specified in the categories for payment under the charge revenue code of the uniform patient billing form.

DHS 120.09(1)(d) (d) “Class 1 notice” means, in accordance with s. 985.07 (1), Stats., the publication of a notice at least once in a newspaper likely to give notice to interested persons in the area where the hospital is located.

DHS 120.09(1)(e) (e) “Room and board” means the charges associated with all services provided to the patient in a private or semi-private room.

DHS 120.09(2) (2) Notice required. No sooner than 45 calendar days and no later than 30 calendar days before a hospital implements a reportable price increase, it shall publish a class 1 notice of the proposed price increase as provided in this section.

DHS 120.09(3) (3) Contents of notice.

DHS 120.09(3)(a) (a) Required format. Each notice under sub. (2) shall include a boldface heading printed in capital letters of at least 18-point type. The text of the notice shall be printed in at least 10-point type. Any numbers printed in the notice shall be expressed as numerals.

DHS 120.09(3)(b) (b) Notice of price increase. A notice under sub. (2) shall include, at a minimum, all of the following in the following order:

DHS 120.09(3)(b)1. 1. A heading entitled, “NOTICE OF PROPOSED HOSPITAL PRICE INCREASE FOR (name of hospital).”

DHS 120.09(3)(b)2. 2. The address of the hospital.

DHS 120.09(3)(b)3. 3. The beginning and ending dates of the hospital’s fiscal year.

DHS 120.09(3)(b)4. 4. The total anticipated amount of the price increase, expressed as an annualized percentage.

DHS 120.09(3)(b)5. 5. The date the price increase will take effect.

DHS 120.09(3)(b)6. 6. The effective date of the hospital’s last reportable price increase and the amount of that increase, expressed as an annualized percentage.

DHS 120.09(3)(b)6m. 6m. The effective date of any other reported price increases within one year prior to the increase in subd. 6. and the amount of each increase, expressed as an annualized percentage.

DHS 120.09(3)(b)7. 7. The name of each charge element listed in table DHS 120.09 for which the hospital proposes to increase the price. A hospital may, but need not, include any charge element for which no price increase is proposed. For each charge element listed, the hospital shall include all of the following information, formatted as follows:

DHS 120.09(3)(b)7.a. a. Current per unit price.

DHS 120.09(3)(b)7.b. b. Proposed per unit price.

DHS 120.09(3)(b)7.c. c. Amount of the price change between subd. 7. a. and b.

DHS 120.09(3)(b)7.d. d. Percentage of the price change between subd. 7. a. and b.

DHS 120.09(3)(b)8. 8. An explanation of the reason for the proposed price increase.

Table DHS 120.09

HOSPITAL CHARGE ELEMENTS

ROOM AND BOARD – PRIVATE

  General classification

  Medical/surgical/gynecology

  Obstetric

  Pediatric

  Psychiatric

  Hospice

  Detoxification

  Oncology

  Other

ROOM AND BOARD – SEMIPRIVATE TWO BED

  General classification

  Medical/surgical/gynecology

  Obstetric

  Pediatric

  Psychiatric

  Hospice

  Detoxification

  Oncology

  Other

NURSERY

  General classification

  Newborn

  Premature

  Neonatal intensive care unit

  Other

INTENSIVE CARE

  General classification

  Surgical

  Medical

  Pediatric

  Psychiatric

  Post-intensive care unit

  Burn care

  Trauma

  Other

CORONARY CARE

  General classification

  Myocardial infarction

INCREMENTAL NURSING CHARGE RATE

  General classification

  Nursery