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1. Name of the physician and address or addresses of main practice or employment.
2. Active status information.
3. License or certification status, including date of initial licensure or certification, credential suspensions or revocations.
4. Medical education and training information.
5. Specialty, board certification and recertification information.
6. Teaching focus information, if applicable.
7. Practice information, including practice name, location, phone number, hours spent at location and provision of obstetrical, pediatric or prenatal care.
8. Whether the physician renders services to medicare and medical assistance patients and, if applicable, whether the physician has signed a medicare participation agreement indicating that she or he accepts assignment on all medicare patients.
9. Whether the physician participates in a voluntary partnercare program specified under s. 71.55 (10), Stats., under which assignment is accepted for low-income elderly.
Note: Section 71.55 (10), Stats., was repealed by 2003 Wis. Act 33.
10. Date, state and county of most recent residency.
11. Current names and addresses of facilities at which the physician has been granted privileges.
12. The usual and customary charges for office visits, routine tests and diagnostic workups, preventive measures and frequently occurring procedures, as specified by the department.
13. Health plan affiliations.
(b) Data submission procedures.
1. Physicians shall return the survey to the department within 30 days of receiving it. Receipt of data is presumed within 5 days of the date the notice was mailed.
2. The department may grant an extension of a deadline specified in subd. 1. for submission of information only when the physician adequately justifies to the department the physician’s need for additional time. In this subdivision, “adequate justification’’ means a delay due to a labor strike, fire, natural disaster or catastrophic computer failure. A physician desiring an extension shall submit a request for an extension in writing to the department at least 10 calendar days prior to the date that the data are due. The department may grant an extension for up to 30 calendar days. Physicians who have been granted an extension by the department shall submit their data directly to the department.
Note: Physicians 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.
(c) Data verification, review and comment procedures. Physicians shall verify or correct information contained on their survey. The department shall verify questionable information by contacting the applicable physician.
(d) Data adjustment methods. There shall be no adjustment methods for data submitted under this subsection.
(e) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this subsection.
History: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 01-051: am. (1) (b) 4. a., Register September 2001 No. 549 eff. 10-1-01; CR 03-033: am. (1) (b) 1., 2., 4. b., 5. and 6. (intro.), (c) 2. (intro.), 4. b., 5. (intro.) and b., (e) 1. and 4., renum. (1) (c) 3. to be (1) (c) 4m. and am., r. (1) (c) 4. c. Register December 2003 No. 576, eff. 1-1-04.
DHS 120.15Data to be submitted by other classes of health care providers.
(1)Applicability. This section applies to all of the following classes of health care providers:
(a) Dentists licensed under ch. 447, Stats.
(b) Chiropractors licensed under ch. 446, Stats.
(c) Podiatrists licensed under ch. 448, Stats.
(2)Data to be collected.
(a) In this subsection, “board” means the certifying body for a medical specialty.
(b) For each of the providers specified in sub. (1), the department shall collect all of the following types of workforce and practice information:
1. Name of the provider and address or addresses of main practice or employment.
2. Date of birth.
3. License or certification status, if applicable, including date of initial licensure or certification, credential suspensions or revocations.
4. Specialty, board certification and recertification information, if applicable.
5. Post-secondary education and training.
6. Whether the provider renders services to medicare and medical assistance patients and, if applicable, whether the provider has signed a medicare participation agreement indicating that she or he accepts assignment on all medicare patients.
7. Whether the provider participates in a voluntary partnercare program specified under s. 71.55 (10), Stats., under which assignment is accepted for low-income elderly.
Note: Section 71.55 (10), Stats., was repealed by 2003 Wis. Act 33.
8. Current names and addresses of facilities at which the provider has been granted privileges, if applicable.
9. The usual and customary charges for office visits, routine tests and preventive measures and frequently occurring procedures, as specified by the department.
10. Participation in health maintenance organizations, preferred provider organizations and independent practice arrangements.
11. Practice name, location, phone number and hours spent at location.
12. Type of degree or certification.
13. Date degree or certification granted.
14. Date, state and county of most recent residency.
(c) If the data specified in par. (b) is not available from the department of safety and professional services, or is not available for the desired time interval or in the required format, the department shall require the health care provider to submit that information directly to the department or its designee in a format prescribed by the department.
(d) The department shall consult with each applicable health care provider group specified in sub. (1), through a technical advisory committee or trade association, before the department collects data directly from members of that health care provider group.
(3)Data submission procedures.
(a) The department shall require that information specified in sub. (2) be submitted to the department at least once every 3 years according to a schedule developed by the department. The department may require that the requested information be submitted on an annual or biennial basis according to a schedule developed by the department.
(b) The department may grant an extension of a deadline specified in par. (a) for submission of health care provider information only when the health care provider adequately justifies to the department the health care provider’s need for additional time. In this paragraph, “adequate justification” means a delay due to a labor strike, fire, natural disaster or catastrophic computer failure. A health care provider desiring an extension shall submit a request for an extension in writing to the department at least 10 calendar days prior to the date that the data are due. The department may grant an extension for up to 30 calendar days. Health care providers who have been granted an extension by the department shall submit their data directly to the department.
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.
(4)Data verification, review and comment procedures. Health care providers specified in sub. (1) shall verify or correct information contained on their survey. The department shall verify questionable data by contacting the applicable health care provider.
(5)Data adjustment methods. There shall be no adjustment methods for data submitted under this section.
(6)Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this section.
Note: With the exception of s. DHS 120.15, under s. 153.78 (2), Stats., and s. DHS 120.10 (3) (b), the department may assess fines on health care providers that do not submit the data specified in this subchapter on a timely basis. Health care providers may be subject to a fine of $100 per day per type of data that has not been submitted to the Department under this subchapter.
History: Cr. Register, December, 2000, No. 540, eff. 1-1-01; correction in (2) (c) made under s. 13.92 (4) (b) 6., Stats., Register February 2012 No. 674.
DHS 120.16Data to be submitted by health care plans.
(1)Applicability. This section applies to health care plans that either voluntarily submit health care plan data directly to the department or submit it to the department through the data collection of other state agencies.
(2)Data to be collected. The department shall collect all of the following types of data from each participating health care plan or through a designated state agency:
(a) Financial data. Information regarding the financial status of the health care plan secured under the authority of the commissioner of insurance.
(b) Market conduct. Information regarding the conduct of the health care plan in the marketplace secured under the authority of the commissioner of insurance.
(c) Quality indicators. Measures of quality of care provided by the health care plan from the office of the commissioner of insurance.
Note: Quality indicators include Health Plan Employer Data and Information (HEDIS) measures and Consumer Assessment of Health Plans (CAHPS) patient satisfaction measures.
(d) Grievances and complaints data. Measures of grievances and complaints filed by enrollees of the health care plan from the office of the commissioner of insurance and the department of employee trust funds.
(3)Data submission procedures. State agencies specified in sub. (2) shall forward to the department information specified in sub. (2) in electronic files on an annual basis. The information shall be in a format that has been agreed upon by the department and the state agencies.
(4)Data verification, review and comment procedures. Each of the state agencies specified in sub. (2) shall verify that the information provided to the department has been reviewed and meets the agency’s standards for release to the public.
(5)Data adjustment methods. The department shall include caveats regarding the information the department releases to the public, when needed, to assist consumers in understanding the differences in populations served by the health care plans. Caveats may include references to large populations, such as commercial, medical assistance or medicare populations.
History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.
Subchapter IV — Standard Reports
DHS 120.20General provisions.
(1)Standard reports. The department shall prepare the paper reports listed in this subsection and shall make these paper reports available to the public at a charge that meets the department’s cost of printing, copying and mailing a report to the requester. The department shall make electronic copies of the reports available from the department’s website at no charge.
(a) Hospital rate increase report.
(b) Patient-level data utilization, charge and quality report.
(c) Guide to Wisconsin hospitals report.
(d) Uncompensated health care services report.
(e) Consumer guide.
(f) Hospital quality indicators.
Note: The Department’s web address is: http://www.dhs.wisconsin.gov
(2)Prohibition on early release of reports. If the department releases drafts of any of the standard reports to health care providers for comment, health care providers or subsequent holders of the drafts may not release these reports or data elements from the reports.
(3)Open records applicability.
(a) Except as prohibited under par. (b), the data used to compile the reports under this chapter are not subject to inspection, copying or receipt as specified in the open records provisions under s. 19.35 (1), Stats. When the department completes the reports and distributes them to the governor and legislature the reports shall be publicly available.
(b) Data collected under ss. DHS 120.11 to 120.16 shall not be subject to inspection, copying or receipt as specified in the open record provisions under s. 19.35 (1), Stats.
History: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 03-033: am. (3) (b) Register December 2003 No. 576, eff. 1-1-04.
DHS 120.21Guide to Wisconsin hospitals.
(1)Data sources. The guide to Wisconsin hospitals shall be based on data derived from all of the following sources:
(a) The annual hospital fiscal year survey.
(b) The annual survey of hospitals.
(2)Contents.
(a) General. The guide to Wisconsin hospitals shall present descriptive financial, utilization and staffing information about individual Wisconsin hospitals, as well as summary and trend information for selected aggregate data.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.