DHS 120.04(4)(c)2.a.a. A physician providing evidence of being fully retired shall be exempt from paying the assessment of the collection of claims data specified in subd. 1. The department shall consider physicians providing all medical care free of charge during retirement to be fully retired. The department shall consider physicians who are retired under the patient compensation fund to be fully retired.

DHS 120.04(4)(c)2.b.b. The department may audit its inpatient and ambulatory surgery databases to corroborate the evidence submitted by physicians. If the department audit indicates that a physician who has submitted evidence of being fully retired is actively practicing in the previous calendar quarter, the physician shall submit the claims data assessment, unless the physician can provide additional evidence that the physician’s care was provided at no charge. If the physician claims to be providing medical care at no charge, the physician shall submit additional evidence.

DHS 120.04(4)(d)(d) Health care plans. Each health care plan voluntarily submitting health care plan data shall pay the amount it has been assessed on or before December 1 of each year by check or money order payable as specified in the assessment notice. Payment of the assessment is timely if the assessment is mailed to the address specified in the assessment notice, is postmarked before midnight of December 1 of the year in which due, with postage prepaid, and is received not more than 5 days after the prescribed date for making the payment. A payment that fails to satisfy these requirements solely because of a delay or administrative error of the U.S. postal service shall be considered to be timely.

DHS 120.04 HistoryHistory: Cr. Register, December, 2000, No. 540, eff. 1-1-01; CR 01-051: am. (2) (intro.), cr. (3) (a) 2m., Register September 2001 No. 549 eff. 10-1-01; correction in (2) (c) made under s. 13.93 (2m) (b) 7., Stats., Register December 2003 No. 576; corrections in (2) (c) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 120.05(1)(1) Format. Individual health care professionals or the chief executive officer of the facility or the designee of the individual health care professional or the chief executive officer of the facility shall sign all written information or communications submitted by or on behalf of a health care provider to the department.

DHS 120.05(2)(2) Timing. All written communications, including documents, reports and information required to be submitted to the department shall be submitted by 1st class registered mail, by delivery in person or in an electronic format specified by the department. The date of submission is the date the written communication is postmarked, the date delivery in person is made, or the date on the electronic communication.

DHS 120.05 NoteNote: Send all communications, except the actual payment of assessments under s. DHS 120.04 (4), to the following address: Bureau of Health Information and Policy, P. O. Box 2659, Madison, WI 53701-2659, or deliver them to Room 372, 1 West Wilson Street, Madison, Wisconsin.

DHS 120.06(1)(a)(a) “Contractor” means a person under contract to the department to collect, process, analyze or store data for any of the purposes of this chapter.

DHS 120.06(1)(b)(b) “Major purchaser, payer or provider of health care services” means any of the following:

DHS 120.06(1)(b)1.1. A person, a trust, a multiple employer trust, a multiple employer welfare association, an employee benefit plan administrator or a labor organization that purchases health benefits, which provides health care benefits or services for more than 500 of its full-time equivalent employees, or members in the case of a labor organization, either through an insurer or by means of a self-funded program of benefits.

DHS 120.06(1)(b)2.2. An insurer that writes accident and health insurance and is among the 20 leading insurers for either group or individual accident and health insurance, as specified in the market shares table of the most recent annual Wisconsin insurance report of the state commissioner of insurance. “Major purchaser, payer or provider of health care services” does not include an insurer that writes only disability income insurance.

DHS 120.06(1)(b)3.3. A trust, a multiple employer trust, a multiple employer welfare association or an employee benefit plan administrator, including an insurer, that administers health benefits for more than 29,000 individuals.

DHS 120.06(2)(2) Eligible contractors. If the department designates a contractor for the provision of data processing services for this chapter, including the collection, analysis and dissemination of health care information, the contractor may not be one of the following types of public or private organizations:

DHS 120.06(2)(a)(a) A major purchaser, payer or provider of health care services in this state.

DHS 120.06(2)(b)(b) A subcontractor of an organization in par. (a).

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