DHS 120.03(31)(31)“Reportable price increase” means a change in a hospital’s prices that, by itself or combined with other price increases during the preceding 12 months, causes the percentage increase in the hospital’s total gross revenue from patient services for the 12 months following the change to be greater than the change in the consumer price index.
DHS 120.03(32)(32)“Sign” or “signature” means any combination of words, letters, symbols or characters that is attached to or logically associated with a record and that is used by a person for the purpose of authenticating a document, including one that has been created in or transformed into an electronic format.
DHS 120.03(33)(33)“Subacute care” means goal-oriented, comprehensive, inpatient care designed for an individual who has had an acute illness, injury or exacerbation of a disease process. It is rendered immediately after, or instead of, acute hospitalization to treat one or more specific, active, complex medical conditions or to administer one or more technically complex treatments in the context of a person’s underlying long-term conditions and overall situation. Subacute care is generally more intensive than traditional nursing facility care and less intensive than acute inpatient care.
DHS 120.03(34)(34)“Trading partner agreement” means a signed, formal arrangement between a health care provider and a qualified vendor providing the transfer of data under this chapter. The agreement specifies the acceptable data formats, the edit review and verification requirements, including procedures for processing confidential patient data and the authorized signatory for the affirmation statement.
DHS 120.03(35)(35)“Uncompensated health care services” means charity care and bad debts.
DHS 120.03(36)(36)“Uniform patient billing form” means forms consistent with federal data standards for health care payment transactions.
DHS 120.03 HistoryHistory: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 01-051: cr. (9m), Register September 2001 No. 549 eff. 10-1-01; CR 03-033: am. (13), (20) and (34) Register December 2003 No. 576, eff. 1-1-04; corrections in (9) and (21) made under s. 13.92 (4) (b) 6. and 7., Stats., Register January 2009 No. 637.
subch. II of ch. DHS 120Subchapter II — Administration
DHS 120.04DHS 120.04Assessments to fund the ch. 153, Stats., operations of the department and the board.
DHS 120.04(1)(1)Definitions. In this section:
DHS 120.04(1)(a)(a) “Net expenditure” means the excess of revenues over expenses.
DHS 120.04(1)(b)(b) “State fiscal year” means the 12-month period beginning July 1 and ending the following June 30.
DHS 120.04(2)(2)Estimate of expenditures. By October 1 of each year, the department shall estimate the total expenditures for the ch. 153, Stats., operations of the department and the board for the current state fiscal year from which it shall deduct all of the following:
DHS 120.04(2)(a)(a) The estimated total amount of monies related to this chapter the department will receive from user fees, gifts, grants, bequests, devises and federal funds for that state fiscal year.
DHS 120.04(2)(b)(b) The unencumbered remaining balances of the total amount of monies received through assessments, user fees, gifts, grants, bequests, devises and federal funds from the prior state fiscal year related to this chapter.
DHS 120.04(2)(c)(c) The estimated total amount to be received for purposes of administration of this chapter under s. 20.435 (1) (hi), Stats., during the fiscal year and the unencumbered remaining balance of the amount received for purposes of administration of this chapter under s. 20.435 (1) (hg), Stats., for the fiscal year.
DHS 120.04(3)(3)Calculation of assessments.
DHS 120.04(3)(a)(a) Health care providers.
DHS 120.04(3)(a)1.1. The department shall annually assess health care providers a fee in order to fund the operations of the department and the board as authorized in s. 153.60, Stats. The department shall calculate net expenditures and resulting assessments separately for hospitals, as a group, freestanding ambulatory surgery centers, as a group, and each type of health care provider, as a group, based on the collection, analysis and dissemination of information related to each group.
DHS 120.04(3)(a)2.2. The assessment for an individual hospital shall be based on the hospital’s proportion of the reported gross private-pay patient revenue for all hospitals for its most recently concluded fiscal year, which is that year ending at least 120 days prior to July 1.
DHS 120.04(3)(a)2m.2m. The assessment for a hospital emergency department shall be based on the hospital’s proportion of the reported total number of emergency visits for general medical surgical and critical access hospitals. The assessment period shall cover the hospital’s most recently concluded fiscal year, which is that year ending at least 120 days prior to July 1.
DHS 120.04(3)(a)3.3. The assessment for an individual freestanding ambulatory surgery center shall be based on the freestanding ambulatory surgery center’s proportion of the number of reported surgical procedures for all freestanding ambulatory surgery centers for the most recently concluded calendar year.
DHS 120.04(3)(a)4.4. The board shall approve assessment amounts for health care provider classes other than hospitals and freestanding ambulatory surgery centers prior to assessment. The amounts shall equal the quotient of the total amount to be paid by the provider group divided by the number of providers licensed by and practicing in Wisconsin.
DHS 120.04(3)(a)5.5. No health care provider that is not a facility may be assessed under this section an amount exceeding $75 per year.
DHS 120.04(3)(b)(b) Health care plans.
DHS 120.04(3)(b)1.1. The department shall, by October 1 of each year, estimate the total amount of expenditures related to the collection, database development and maintenance and generation of public data files and standard reports for health care plans that voluntarily agree to supply data to the department.
DHS 120.04(3)(b)2.2. The department shall divide the expenditure estimate derived in subd. 1. by the total number of enrollees in health care plans that have, by October 1 of each year, notified the department that the health care plan is going to voluntarily supply data to the department under s. DHS 120.15.
DHS 120.04(3)(b)3.3. The department shall annually assess each health care plan that has voluntarily agreed to supply data to the department a fee proportionate to the amount estimated in subd. 1. equivalent to the health care plan’s contribution to the total number of enrollees determined under subd. 2.
DHS 120.04(4)(4)Payment of assessments.