Ins 17.285(7)(c)(c) The council shall furnish the provider with a copy of its report and recommendation to the board and with notice of the right to a hearing as provided in sub. (9).

Ins 17.285(9)(a)(a) A provider has the right to a hearing under ch. 227, Stats., and ch. Ins 5 on the council’s recommendation, if the provider requests a hearing within 30 days after receiving the notice under sub. (7) (c).

Ins 17.285(9)(am)(am) The reports of the consultant and any other documents relied on by the council in making its recommendation to the board are admissible in evidence at a hearing under this section.

Ins 17.285(9)(b)(b) Notice of the hearing examiner’s proposed decision shall inform the provider that he or she may submit to the board written objections and arguments regarding the proposed findings of fact, conclusions of law and decision within 20 days after the date of the notice.

Ins 17.285(10)(10) Final decision; judicial review. The board shall make the final decision on the imposition of a surcharge. The final decision is reviewable by the circuit court as provided under ch. 227, Stats.

Ins 17.285(11)(a)(a) A surcharge imposed on a provider’s plan premium, fund fee or both after a final decision by the board takes effect on the next billing date and remains in effect during any period of judicial review.

Ins 17.285(11)(c)(c) If judicial review results in the imposition of no surcharge or a reduced surcharge, the plan, the fund or both shall refund the excess amount collected from the provider or apply a credit to the provider’s next plan premium or fund fee bill or both.

Ins 17.285(11)(d)(d) A surcharge remains in effect for 36 months. The percentage imposed shall be reduced by 50% for the 2nd 12 months and by 75% for the 3rd 12 months, if the provider does not accumulate any additional closed claims before the expiration of the surcharge. The time periods specified in this paragraph are tolled on the date a provider stops practicing in this state and remain tolled until the provider resumes practice in this state.

Ins 17.285(11)(e)(e) If the provider accumulates additional closed claims while a surcharge is in effect, the provider is subject to the higher of the following:

Ins 17.285(11)(f)(f) If the provider is a physician who changes from one class to another class specified in s. Ins 17.25 (12m) (c) or 17.28 (6s) (c) while a surcharge is in effect, the percentage imposed by the final decision of the board shall be applied to the plan premium, fund fee or both for the physician’s new class effective on the date the class change occurs.

Ins 17.285(12)(12) Request from private insurer. If the council receives a request for a recommendation under s. 655.275 (5) (a) 3., Stats., from a private insurer, the council shall follow the procedures specified in subs. (3) to (5) and notify the private insurer and the provider of the determination it would make under sub. (5) (f) if the provider’s primary insurer were the plan. A provider is not entitled to a hearing on any determination reported under this subsection.

Ins 17.285(13)(13) Confidentiality. The final decision of the board and all information and records relating to the review procedure are the work product of the board and are confidential.

Ins 17.285(14)(14) Member and consultant compensation. Council members and consultants shall be paid $250 per meeting attended or $250 per report filed by a consultant based on the consultant’s review of a file under s. 655.275 (5) (b), Stats.

Ins 17.285 HistoryHistory: Cr. Register, February, 1988, No. 386, eff. 3-1-88; am. (2) (a) and (b), (3) (a) and (c) 2., (5) (b) (intro.), (7) (a), (8), (9) (a), (11) (f) and (14), cr. (2m) and (4) (c) 2., renum. (4) (c) to be (4) (c) 1., Register, June, 1990, No. 414, eff. 7-1-90; am. (2) (a), (b), (d) and (e), (7) (b), (11) (a), (c) to (e) (intro.) and 1., (f) and (12), renum. (3) (a), (4) (b) (intro.) and 1., (5) (d), (8) to be (3), (4) (c), (5) (e) and (7) (c) and am. (3), (4) (c) and (7) (c), r. (3) (b) and (d), (4) (b) 2., (c) (d), (6) and (11) (b), cr. (2) (cg) and (cr), (2s), (4) (b), (5) (d) and (f), (9) (am), r. and recr. (4) (a), (5) (a) to (c) and (9) (a), Register, January, 1992, No. 433, eff. 2-1-92; CR 03-039: cr. (14) Register October 2003 No. 574, eff. 11-1-03.

Ins 17.29(4)(4) Contract term. The commissioner, with the approval of the board, shall establish the term of the contract with the servicing agent. The contract shall include a provision for its cancellation if performance or delivery is not made in accordance with its terms and conditions.

Ins 17.29(5)(am)(am) Reporting to the claims committee of the board on claim files identified by that committee, at the times and in the manner specified by that committee.

Ins 17.29(5)(e)(e) Negotiating to settlement all claims made against the fund except in cases where this responsibility is retained by the claims committee of the board.