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150.84(4) (4)“Health maintenance organization" has the meaning given in s. 609.01 (2).
150.84(5) (5)“Preferred provider plan" has the meaning given in s. 609.01 (4).
150.85 150.85 Certificate of public advantage.
150.85(1)(1)Authority. A health care provider may negotiate and voluntarily enter into a cooperative agreement with another health care provider in this state. The requirements of ch. 133 apply to the negotiations and cooperative agreement unless the parties to the agreement hold a certificate of public advantage for the agreement that is issued by the department and is in effect under this section.
150.85(2) (2)Application. Parties to a cooperative agreement may file an application with the department for a certificate of public advantage governing the cooperative agreement. The application shall include a signed, written copy of the cooperative agreement, and shall describe the nature and scope of the cooperation contemplated under the agreement and any consideration that passes to a party under the agreement.
150.85(3) (3)Procedure for department review.
150.85(3)(a)(a) The department shall review and approve or deny the application in accordance with the standards set forth in sub. (4) within 30 days after receiving the application. Unless the department issues a denial of the certificate of public advantage, the application is approved.
150.85(3)(b) (b) If the department denies the application for a certificate of public advantage, the department shall issue the denial to the applicants in writing, including a statement of the basis for the denial and notice of the opportunity for a hearing under s. 227.44. If the applicant desires to contest the denial of an application, it shall, within 10 days after receipt of the notice of denial, send a written request for hearing under s. 227.44 to the division of hearings and appeals in the department of administration and so notify the department of health services.
150.85(4) (4)Standards for certification.
150.85(4)(a) (a) The department shall issue a certificate of public advantage for a cooperative agreement if it determines all of the following:
150.85(4)(a)1. 1. That the benefits likely to result from the agreement substantially outweigh any disadvantages attributable to a reduction in competition likely to result.
150.85(4)(a)2. 2. That any reduction in competition likely to result from the agreement is reasonably necessary to obtain the benefits likely to result.
150.85(4)(b) (b) In order to determine that the criterion under par. (a) 1. is met, the department shall find that at least one of the following is likely to result from the cooperative agreement:
150.85(4)(b)1. 1. The quality of health care provided to residents of the state will be enhanced.
150.85(4)(b)2. 2. A hospital, if any, and health care facilities that customarily serve the communities in the area likely affected by the cooperative agreement will be preserved.
150.85(4)(b)3. 3. Services provided by the parties to the cooperative agreement will gain cost efficiency.
150.85(4)(b)4. 4. The utilization of health care resources and equipment in the area likely affected by the cooperative agreement will improve.
150.85(4)(b)5. 5. Duplication of health care resources in the area likely affected by the cooperative agreement will be avoided.
150.85(4)(c) (c) In order to determine that the criterion under par. (a) 2. is met, the department shall consider all of the following:
150.85(4)(c)1. 1. The likely adverse impact, if any, on the ability of health maintenance organizations, preferred provider plans, persons performing utilization review or other health care payers to negotiate optimal payment and service arrangements with hospitals and other health care providers.
150.85(4)(c)2. 2. Whether any reduction in competition among physicians, allied health professionals or other health care providers is likely to result directly or indirectly from the cooperative agreement.
150.85(4)(c)3. 3. Whether any arrangements that are less restrictive as to competition could likely achieve substantially the same benefits or a more favorable balance of benefits over disadvantages than that likely to be achieved from reducing competition.
150.85(5) (5)Certificate revocation.
150.85(5)(a) (a) If the department determines that the benefits resulting from or likely to result from a cooperative agreement under a certificate of public advantage no longer outweigh any disadvantages attributable to any actual or potential reduction in competition resulting from the agreement, the department may revoke the certificate of public advantage governing the agreement and, if revoked, shall so notify the holders of the certificate. A holder of a certificate of public advantage whose certificate is revoked by the department may contest the revocation by sending a written request for hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1), within 10 days after receipt of the notice of revocation.
150.85(5)(b) (b) If a party to a cooperative agreement that is issued a certificate of public advantage terminates its participation in the agreement, the party shall file a notice of termination with the department within 30 days after the termination takes effect. If all parties to the cooperative agreement terminate their participation in the agreement, the department shall revoke the certificate of public advantage for the agreement.
150.85(6) (6)Record keeping. The department shall maintain a file of all cooperative agreements for which certificates of public advantage are issued and that remain in effect.
150.85 History History: 1991 a. 250; 1995 a. 27 s. 9126 (19); 2007 a. 20 s. 9121 (6) (a).
150.85 Annotation Antitrust Immunity for Health Care Providers. Bosack. 80 MLR 245 (1997).
150.86 150.86 Judicial review. A denial by the department under s. 150.85 (3) (b) of an application for a certificate of public advantage and a revocation by the department under s. 150.85 (5) (a) of a certificate of public advantage is subject to judicial review under ch. 227.
150.86 History History: 1991 a. 250.
subch. VI of ch. 150 SUBCHAPTER VI
MORATORIUM ON CONSTRUCTION
OF HOSPITAL BEDS
150.93 150.93 Moratorium on construction of hospital beds.
150.93(1)(1)The maximum number of beds of approved hospitals in this state that may be approved by the department for occupancy is 22,516.
150.93(2) (2)Except as provided in subs. (3) and (3m), before July 1, 1996, no person may obligate for a capital expenditure or implement services, by or on behalf of a hospital, to increase the approved bed capacity of a hospital unless the person has, prior to May 12, 1992, entered into a legally enforceable contract, promise or agreement with another to so obligate or implement.
150.93(3) (3)A person may obligate for a capital expenditure, by or on behalf of a hospital, to renovate or replace on the same site existing approved beds of the hospital or to make new construction, if the renovation, replacement or new construction does not increase the approved bed capacity of the hospital.
150.93(3m) (3m)A person may obligate for a capital expenditure or implement services that increase the approved bed capacity of a hospital if the capital expenditure or services are necessitated by a transfer of beds from a public hospital that is operated by a county with a population of 750,000 or more to a private hospital and if the resulting combined total number of approved beds in the 2 hospitals does not increase.
150.93(4) (4)No person may transfer approved beds of a hospital to a facility that is associated with the hospital.
150.93(5) (5)This section does not apply to a hospital operated by the state department of veterans affairs under s. 45.50 (10).
150.93 History History: 1991 a. 250; 1995 a. 20, 27; 2005 a. 22; 2017 a. 207 s. 5.
subch. VII of ch. 150 SUBCHAPTER VII
PSYCHIATRIC OR CHEMICAL DEPENDENCY
BED LIMITATIONS
150.94 150.94 Definitions. In this subchapter:
150.94(1) (1)Notwithstanding s. 150.01 (12), “hospital" has the meaning given in s. 50.33 (2).
150.94(2) (2)“Inpatient facility" has the meaning given in s. 51.01 (10).
150.94 History History: 1991 a. 250; 1995 a. 27.
150.95 150.95 Moratorium.
150.95(1)(1)Before July 1, 1996, no person may obligate for a capital expenditure by or on behalf of a hospital, to add to the number of the licensed psychiatric or chemical dependency beds of the hospital that the department determines exist on May 12, 1992, or to establish a new hospital with psychiatric or chemical dependency beds. Before July 1, 1996, no person may convert existing hospital beds approved for occupancy to licensed psychiatric or chemical dependency beds of the hospital.
150.95(2) (2)This section does not apply to a hospital operated by the state department of veterans affairs under s. 45.50 (10).
150.95 History History: 1991 a. 250; 1995 a. 20, 27; 2005 a. 22.
150.951 150.951 Exceptions. Section 150.95 does not apply to any of the following:
150.951(1) (1)A transfer of psychiatric or chemical dependency beds from a public hospital that is operated by a county with a population of 750,000 or more and that is not an inpatient facility to a private hospital or to a public hospital that is an inpatient facility, if the resulting combined total of licensed psychiatric or chemical dependency beds in the affected hospitals does not increase.
150.951(2) (2)A transfer of psychiatric or chemical dependency beds from a hospital to a private hospital in the same county that has an existing psychiatric or chemical dependency unit or to a public hospital that is operated by the same county, if the resulting combined total of licensed psychiatric or chemical dependency beds in the affected hospitals decreases from the number that is specified in s. 150.95.
150.951 History History: 1995 a. 27, 417; 2017 a. 207 s. 5.
subch. VIII of ch. 150 SUBCHAPTER VIII
FACILITIES FOR THE INTELLECTUALLY DISABLED
AND COMMUNITY MENTAL HEALTH CENTERS
CONSTRUCTION
150.96 150.96 Definitions. In this subchapter, unless the context requires otherwise:
150.96(1) (1)“Community mental health center" means a facility providing services for the prevention or diagnosis of mental illness, or care and treatment of mentally ill patients, or rehabilitation of such persons, which services are provided principally for persons residing in a particular community in or near which the facility is situated.
150.96(2) (2)“Facility for individuals with an intellectual disability" means a facility specially designed for the diagnosis, treatment, education, training or custodial care of individuals with an intellectual disability; including facilities for training specialists and sheltered workshops for individuals with an intellectual disability, but only if such workshops are part of facilities which provide or will provide comprehensive services for individuals with an intellectual disability.
150.96(3) (3)“The federal act" means the mental retardation facilities and community mental health centers construction act of 1963 (P.L. 88-164).
150.96(4) (4)“Nonprofit facility for individuals with an intellectual disability", and “nonprofit community mental health center" mean, respectively, a facility for individuals with an intellectual disability, and a community mental health center which is owned and operated by one or more nonprofit corporations or associations no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.
150.96(5) (5)“The secretary" means the secretary of the U.S. department of health and human services or a delegate to administer the federal act.
150.96 History History: 1979 c. 177; 1981 c. 314; 1983 a. 189; 1993 a. 27 s. 237; Stats. 1993 s. 150.96; 1999 a. 83; 2011 a. 126.
150.963 150.963 Construction of facilities for the intellectually disabled and community mental health centers.
150.963(2)(2)The department shall be the sole agency of the state for all of the following purposes:
150.963(2)(a) (a) Making inventories of existing facilities, surveying the need for construction for facilities for individuals with an intellectual disability and community mental health centers, and developing programs of construction.
150.963(2)(b) (b) Developing and administering a state plan for the construction of public and other nonprofit facilities for individuals with an intellectual disability, and a state plan for the construction of public and other nonprofit community mental health centers.
150.963(3) (3)The department, in carrying out the purposes of this subchapter, may do any of the following:
150.963(3)(a) (a) Require reports, make inspections and investigations and prescribe rules that it considers necessary.
150.963(3)(b) (b) Provide methods of administration, appoint personnel, and take other action that is necessary to comply with the requirements of the federal act and regulations under the federal act.
150.963(3)(c) (c) Procure the temporary or intermittent services of experts or consultants or organizations of experts and consultants, by contract, when those services are to be performed on a part-time or fee-for-service basis and do not involve the performance of administrative duties.
150.963(3)(d) (d) To the extent that it considers desirable to effectuate the purposes of this subchapter, enter into agreements for the utilization of facilities and services of other departments, agencies and institutions, public or private.
150.963(3)(e) (e) Accept on behalf of the state and deposit with the secretary of administration any grant, gift, or contribution made to assist in meeting the cost of carrying out the purposes of this subchapter, and expend those funds for the purposes of this subchapter.
150.963(3)(f) (f) Do all other things on behalf of the state necessary to obtain full benefits under the federal act.
150.963 History History: 1979 c. 89; 1993 a. 27 s. 238; Stats. 1993 s. 150.963; 1999 a. 83; 2003 a. 33; 2011 a. 126.
150.965 150.965 Construction programs. The department is directed to develop construction programs for facilities for individuals with an intellectual disability and community mental health centers for the mentally ill, which shall be based respectively on statewide inventories of existing facilities for individuals with an intellectual disability and the mentally ill and surveys of need, and which shall provide in accordance with regulations prescribed under the federal act, for facilities which will provide adequate services for individuals with an intellectual disability and adequate community mental health services for the people residing in this state and for furnishing needed services to persons unable to pay therefor.
150.965 History History: 1993 a. 27 s. 239; Stats. 1993 s. 150.965; 1993 a. 213; 2011 a. 126.
150.967 150.967 State plans. The department shall prepare and submit to the secretary, state plans which shall include the programs for construction of facilities developed under this subchapter and which shall provide for the establishment, administration and operation of the construction activities in accordance with the requirements of the federal act and regulations under the federal act. The department shall from time to time, but not less often than annually, review the state plans and submit to the secretary any modifications of the state plans which it considers necessary and may submit to the secretary such modifications of the state plan not inconsistent with the requirements of the federal act, as it deems advisable.
150.967 History History: 1979 c. 89; 1993 a. 27 s. 240; Stats. 1993 s. 150.967.
150.97 150.97 Standards for maintenance and operation. The department shall by regulation prescribe, and shall be authorized to enforce, standards for the maintenance and operation of facilities for individuals with an intellectual disability, and community mental health centers which receive federal aid for construction under the state plans.
150.97 History History: 1993 a. 27 s. 241; Stats. 1993 s. 150.97; 2011 a. 126.
150.973 150.973 Priority of projects. The state plans shall set forth the relative need and feasibility for the several projects included in the construction programs determined in accordance with the regulations prescribed pursuant to the federal act, and shall provide for the construction insofar as financial resources are available therefor in the order of such relative need and feasibility.
150.973 History History: 1993 a. 27 s. 242; Stats. 1993 s. 150.973.
150.975 150.975 Applications. Applications for facility for individuals with an intellectual disability or community mental health center construction projects for which federal funds are requested shall be submitted to the department by the state, a political subdivision thereof or by a public or other nonprofit agency. Each application for a construction project shall conform to federal and state requirements.
150.975 History History: 1993 a. 27 s. 243; Stats. 1993 s. 150.975; 2011 a. 126.
150.977 150.977 Hearing; forwarding of applications. The department shall afford to every applicant for a construction project an opportunity for a fair hearing. If the department, after affording reasonable opportunity for development and submission of applications, finds that a project application complies with the requirements of this subchapter and is otherwise in conformity with the state plan, it shall approve the application and shall recommend and forward it to the secretary.
150.977 History History: 1979 c. 89; 1993 a. 27 s. 244; Stats. 1993 s. 150.977.
150.98 150.98 Inspection of projects. From time to time the department or its duly authorized agents shall inspect each construction project approved by the secretary, and if the inspection so warrants, the department shall certify to the secretary that work has been performed upon the project, or purchases have been made, in accordance with the approved plans and specifications, and that payment of an installment of federal funds is due to the applicant.
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