DHS 120.14 NoteNote: Section 71.55 (10), Stats., was repealed by 2003 Wis. Act 33. DHS 120.14(3)(a)11.11. Current names and addresses of facilities at which the physician has been granted privileges. DHS 120.14(3)(a)12.12. The usual and customary charges for office visits, routine tests and diagnostic workups, preventive measures and frequently occurring procedures, as specified by the department. DHS 120.14(3)(b)1.1. 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. DHS 120.14(3)(b)2.2. 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. DHS 120.14 NoteNote: 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.
DHS 120.14(3)(c)(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. DHS 120.14(3)(d)(d) Data adjustment methods. There shall be no adjustment methods for data submitted under this subsection. DHS 120.14(3)(e)(e) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this subsection. DHS 120.14 HistoryHistory: 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 120.15DHS 120.15 Data to be submitted by other classes of health care providers. DHS 120.15(1)(1) Applicability. This section applies to all of the following classes of health care providers: DHS 120.15(2)(a)(a) In this subsection, “board” means the certifying body for a medical specialty. DHS 120.15(2)(b)(b) For each of the providers specified in sub. (1), the department shall collect all of the following types of workforce and practice information: DHS 120.15(2)(b)1.1. Name of the provider and address or addresses of main practice or employment. DHS 120.15(2)(b)3.3. License or certification status, if applicable, including date of initial licensure or certification, credential suspensions or revocations. DHS 120.15(2)(b)4.4. Specialty, board certification and recertification information, if applicable. DHS 120.15(2)(b)6.6. 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. DHS 120.15(2)(b)7.7. 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. DHS 120.15 NoteNote: Section 71.55 (10), Stats., was repealed by 2003 Wis. Act 33. DHS 120.15(2)(b)8.8. Current names and addresses of facilities at which the provider has been granted privileges, if applicable. DHS 120.15(2)(b)9.9. The usual and customary charges for office visits, routine tests and preventive measures and frequently occurring procedures, as specified by the department. DHS 120.15(2)(b)10.10. Participation in health maintenance organizations, preferred provider organizations and independent practice arrangements. DHS 120.15(2)(c)(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. DHS 120.15(2)(d)(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. DHS 120.15(3)(a)(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. DHS 120.15(3)(b)(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. DHS 120.15 NoteNote: 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 120.15(4)(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. DHS 120.15(5)(5) Data adjustment methods. There shall be no adjustment methods for data submitted under this section. DHS 120.15(6)(6) Waiver from data submission requirements. There shall be no waivers from the data submission requirements under this section. DHS 120.15 NoteNote: 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. DHS 120.15 HistoryHistory: 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 120.16DHS 120.16 Data to be submitted by health care plans. DHS 120.16(1)(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. DHS 120.16(2)(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: DHS 120.16(2)(a)(a) Financial data. Information regarding the financial status of the health care plan secured under the authority of the commissioner of insurance. DHS 120.16(2)(b)(b) Market conduct. Information regarding the conduct of the health care plan in the marketplace secured under the authority of the commissioner of insurance. DHS 120.16(2)(c)(c) Quality indicators. Measures of quality of care provided by the health care plan from the office of the commissioner of insurance. DHS 120.16 NoteNote: Quality indicators include Health Plan Employer Data and Information (HEDIS) measures and Consumer Assessment of Health Plans (CAHPS) patient satisfaction measures.
DHS 120.16(2)(d)(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. DHS 120.16(3)(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. DHS 120.16(4)(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. DHS 120.16(5)(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. DHS 120.16 HistoryHistory: Cr. Register, December, 2000, No. 540, eff. 1-1-01. DHS 120.20(1)(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. DHS 120.20(2)(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. DHS 120.20(3)(a)(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. DHS 120.20 HistoryHistory: 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 120.21DHS 120.21 Guide to Wisconsin hospitals. DHS 120.21(1)(1) Data sources. The guide to Wisconsin hospitals shall be based on data derived from all of the following sources: DHS 120.21(2)(a)(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. DHS 120.21(2)(b)(b) Hospital information. The guide shall present and interpret all of the following information for all Wisconsin hospitals individually and in the aggregate:
