In addition the complaint review, the OCI in a cooperative effort of the Commissioner met with representatives from the insurance industry. Since November 2004, four public working meetings have been held to discuss each section of the proposed rule. Each public meeting was attended by the Commissioner and his staff and representatives from the Wisconsin Association of Life and Health Insurer, Council for Affordable Healthcare and Wisconsin Association of Provider Networks as well as representatives from no less than seven (7) domestic and non-domestic health insurers. Additional work groups comprised of representative from industry and the Office met two additional times to work on the ancillary provider language and criteria for preferred provider plans. Participants in the open meetings were invited to comment and make recommendations or specific modifications to the proposed rule. Candid discussion provided both Commissioner and the industry opportunity to voice support or concerns over each section of the rule. The public working meetings also gave both industry and the Commissioner the opportunity to share its respective views of the marketplace. Discussion often focused on how proposed and revised language affects the industry and its ability to function in the marketplace with the guiding statutory requirements and consumer concerns as reflected in complaints received by the OCI to maintain the proper balance in the proposed regulations. At each meeting revisions that had previously been discussed were reviewed, comment invited with extensive dialogue from both industry and OCI. At the end of the last working public meeting held May 9, 2005, the Commissioner invited written comment on the entire proposed rule. The comment period was intended to provide industry with time to reflect on the proposed rule and offer specific thoughtful revisions or recommendations and then permit the Commissioner time to review the suggested revisions and recommendations prior to issuing the Notice of Hearing for the rule. The culmination of those meeting, including written comments received throughout the last year, is reflected in this proposed rule.

9. Any analysis and supporting documentation that OCI used in support of OCI's determination of the rule's effect on small businesses under s. 227.114:

This rule may have an effect on only one (1) regulated small business as defined in s. 227.114 (1), Wis. Stats., that is an LSHO and authorized to only write 10% of its premium as a preferred provider plan. OCI maintains a database of all licensed insurers in Wisconsin. Included with the information required to be submitted to OCI, the database includes information submitted by the companies related to premium revenue and employment. In an examination of this database, OCI identified only one insurer with annual premium volume of less than $5 million that would be affected by this proposed rule.

This one insurer would incur a one-time expense associated with filing new policy forms, modifying provider contracts and implementing remedial action plan procedures related to quality problems. It is possible that the one insurer might need to minimally modify its computer system to the extent necessary to incorporate emergency medical care rendered by nonparticipating providers. These one-time expenses are not considered to be of significant cost and therefore will not have a significant economic impact on the one insurer.

Further, the proposed rule has a delayed applicability date for new policies to January 1, 2007 and renewing policies to January 1, 2008. The significantly delayed applicability will allow the insurer to spread any cost that it may incur over time thus reducing any effect the rule might have on the one insurer. The delay will also give the insurer ample time to make necessary modifications to forms or contracts also minimizing any affect of the rule on the small business insurer.

10. If these changes may have a significant fiscal effect on the private sector, the anticipated costs that will be incurred by private sector in complying with the rule:

This rule is not expected to have a significant fiscal effect on the private sector regulated by OCI. The majority of insurers offering defined network plans, including health maintenance organizations and most preferred provider plans currently offer insurance coverage that complies with the minimum standards proposed in the amendments to ch. Ins 9, Wis. Adm. Code. The proposed rule does not prohibit or require insurers offering preferred provider plans to redesign any existing plan. Insurers may continue selling and servicing policies that contain coinsurance, deductibles or other cost-sharing methods, however those plans may be required to include disclosure notices that will need to be filed with the Office prior to use. In addition insurers offering defined network, preferred provider plans will be required to submit to the OCI emergency medical care coverage language that is compliant with the regulation.

Insurers offering preferred provider plans will likely need to incur a one-time expense to modify existing contracts with participating providers through an addendum to comply with advance notice to enrollees regarding providers' plan status when elective procedures are scheduled. Additionally, the insurers may need to file updated forms and implement remedial action plans to address quality problems. It is possible that insurers might need to minimally modify existing computer systems for payment of emergency medical care services provided by nonparticipating providers.

Insurers may find a cost saving resulting from the rule through the receipt of fewer complaints from enrollees, employers and providers, and use fewer resources investigating and responding to complaints and grievances, and in preparing and documenting files for external review. Further, with significantly delayed applicability dates, insurers will have ample time to make necessary modifications including sufficient time to file any necessary form filings thereby reducing any possible effect of the proposed rule.

11. A description of the Effect on Small Business:

This rule may effect one small business regulated by the Office but should not have a significant economic impact . OCI identified one insurer that is an LSHO authorized to write no more than 10% of its premium from preferred provider business that had annual premium volume of less than $5 million, however the effect would not have a significant economic impact on that insurer for the reasons stated in above.

The insurer that may be affected by the proposed rule will incur a one-time expense related to the filing of compliant policy forms, modifying provider contracts and implementing a remedial action plan procedure related to quality problems. The proposed rule also includes a significantly delayed applicability date allowing the one insurer ample time for necessary modifications and to spread any associated costs over time thus limiting any effect the rule might have.

12. Agency contact person:

A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the WEB sites at: http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, OCI Services Section, at:

Phone: (608) 264-8110

Email: Inger.Williams@OCI.State.WI.US

Address: 125 South Webster St – 2nd Floor Madison WI 53702

Mail: PO Box 7873, Madison WI 53707-7873

13. Place where comments are to be submitted and deadline for submission:

The deadline for submitting comments is 4:00 p.m. on the 14th day after the date for the hearing stated in the Notice of Hearing.

Mailing address:

Julie E. Walsh

Legal Unit - OCI Rule Comment for Rule INS 9

Office of the Commissioner of Insurance

PO Box 7873

Madison WI 53707-7873

Street address:

Julie E. Walsh

Legal Unit - OCI Rule Comment for Rule INS 9

Office of the Commissioner of Insurance

125 South Webster St – 2nd Floor

Madison WI 53702

WEB Site: http://oci.wi.gov/ocirules.htm

Notice is hereby further given that pursuant to s. 227.114, Stats., the proposed rule may have an affect on small businesses. The initial regulatory flexibility analysis is as follows:

a. Types of small businesses affected:

There is only one (1) regulated small business that may be affected by this rule that is a Limited Service Health Organization (LSHO) authorized to write no more than 10% of its premium from preferred provider plan business. The proposed rule would not have a significant economic impact on that one insurer as the one-time expense for filing updated forms, modifying provider contracts and implementing a procedure for remedial action plan related to quality problems are not considered significant. The one insurer might also need to minimally modify its computer system to incorporate coverage for emergency medical care from nonparticipating providers, but this would not considered to be a significant expense.

The affected insurer will have until January 1, 2007 for newly issued policies and until January 1, 2008 for renewing policies to comply with the proposed regulatory requirements. This delay will allow the insurer to spread any incurred cost over time thus reducing any potential financial effect of the rule and will permit more than sufficient time to modify forms and implement procedures necessary to comply with the proposed rule without being overly burdensome to the insurer.

b. Description of reporting and bookkeeping procedures required:

To the extent that the one LSHO small business provides a preferred provider plan, it will be required to comply with the preferred provider plan requirements and will incur a one-time expense associated with filing new policy forms, modifying provider contracts and implementing remedial action plan procedures related to quality problems. It is possible that the one insurer might also need to minimally modify its computer system for services rendered by nonparticipating providers for emergency medical care. The one insurer will have ample time within which to comply with the regulations due to significantly delayed applicability of the proposed rule.

c. Description of professional skills required:

The proposed rule does not impose additional professional skill requirements that it does not already possess.

The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266-7843 or at email address Eileen.Mallow@oci.state.wi.us

A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the OCI internet WEB site at http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, Services Section, OCI, at: Inger.Williams@OCI.State.WI.US, (608) 264-8110, 125 South Webster Street – 2nd Floor, Madison WI or PO Box 7873, Madison WI 53707-7873.

NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Marriage and Family Therapy, Professional Counseling and Social Work Examining Board in ss. 15.08 (5) (b), 227.11 (2) and 457.14, Wis. Stats., and interpreting s. 457.10 (3), 457.11 and 457.14, Wis. Stats., the Marriage and Family Therapist Section will hold a public hearing at the time and place indicated below to consider an order to amend ss. MPSW 16.03 and 17.01, relating to supervised clinical practice and temporary licenses issued by the Marriage and Family Therapist Section.

Date:   August 1, 2005

Time:   9:30 A.M.

Location:   1400 East Washington Avenue

  Room 179A

  Madison, Wisconsin

Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Department of Regulation and Licensing, Office of Legal Counsel, P.O. Box 8935, Madison, Wisconsin 53708, or by email to pamela.haack@drl.state.wi.us. Written comments must be received on or before August 11, 2005 to be included in the record of rule-making proceedings.

Statutes interpreted: Sections 457.10 (3), 457.11 and 457.14, Stats.

Statutory authority: Sections 15.08 (5) (b), 227.11 (2) and 457.03 (1), Stats.

Explanation of agency authority: The Marriage and Family Therapist Section has the authority under s. 457.03, Stats., to establish minimum standards for supervised clinical training. Those standards are set forth with specificity in s. MPSW 16.03. They currently require one hour of face-to-face supervision for each 10 hours of supervised practice. The use of the term “supervised practice" has been confusing for applicants. As a result, the term “client contact" is being substituted to better clarify what is actually needed and should therefore remedy any confusion.

The Marriage and Family Therapist Section has the authority under s. 457.14, Stats., to issue temporary certificates and temporary licenses. More specifically, s. MPSW 17.01 provides that a temporary marriage and family therapist license is valid for nine months or until the applicant's examination scores are released, whichever occurs first. It also provides for a renewal of the temporary license, not to exceed nine months. This proposal puts fewer restrictions on the renewal provisions for the temporary license thereby accommodating the practical realities that applicants typically face while attempting to obtain their permanent license.

Related statute or rule: There are no other statutes or rules.

Plain language analysis:

SECTION 1. The rules currently require one hour of face-to-face supervision for each 10 hours of supervised practice. The use of the term “supervised practice" has been confusing for applicants. Section MPSW 16.03 is amended to substitute “supervised practice" with “client contact" to better clarify that supervisees must receive the minimum one hour of face-to-face supervision for each 10 client contact hours.

SECTION 2. The rules currently provide that a marriage and family therapist temporary license is valid for nine months or until the applicant's examination scores are released, whichever occurs first and also provides for a renewal not to exceed nine months. Section MPSW 17.01 is amended to grant one renewal of the temporary license, and to permit a holder of a temporary license to place it “on hold."

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact report:

The department finds that this rule has no significant fiscal effect on the private sector.

The proposed rule will have no impact on the department's funds.

Pursuant to s. 227.114 (1) (a), Stats., these proposed rules will have no significant economic impact on a substantial number of small businesses. The Department's Small Business Regulatory Review Coordinator may be contacted by email at christopher.klein@drl.state.wi.us, or by calling (608) 266-8608.

Pamela Haack, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 171, P.O. Box 8935, Madison, Wisconsin 53708-8935. Telephone: (608) 266-0495. Email: pamela.haack@drl. state.wi.us.

Comments may be submitted to Pamela Haack, Department of Regulation and Licensing, 1400 East Washington Avenue, Room 171, P.O. Box 8935, Madison, Wisconsin 53708-8935.

Email: pamela.haack@drl.state.wi.us. Comments must be received on or before August 11, 2005, to be included in the record of rule-making proceedings.

TEXT OF RULE

SECTION 1. MPSW 16.03 is amended to read:

MPSW 16.03 Supervised clinical practice. The person whose practice is being supervised shall receive a minimum of one hour of face-to-face supervision for each 10 client contact hours of supervised practice. Practice of marriage and family therapy which occurs as part of the requirements for obtaining a master's or doctoral degree in marriage and family therapy or a substantially related field shall not be considered to fulfill any part of the postgraduate supervised practice requirement. Only those individuals who hold a valid marriage and family therapist training certificate may begin accumulating hours towards their postgraduate supervised practice requirements.

SECTION 2. MPSW 17.01 is amended to read:

MPSW 17.01 Temporary license. The marriage and family therapist section may issue a temporary license permitting a person who has completed the educational and supervised practice requirements for eligibility for a license as a marriage and family therapist upon payment of the fee for the temporary license and application for the next available examination to use the title “marriage and family therapist" and to practice marriage and family therapy. The temporary license is valid for a period not to exceed 9 months from the date of its issuance, or the date on which examination scores are released, whichever comes sooner. The marriage and family therapists section may grant one renewal of the temporary license in cases of hardship, for a period not to exceed 9 months or the date of the release of scores from the next available examination after the date of renewal of the temporary license, whichever occurs sooner. A person who fails the licensure examination shall immediately return the temporary license to the marriage and family therapists section. The marriage and family therapists section may not grant or renew a temporary license to an applicant who has failed the licensure examination and it may be renewed once upon receipt of a written request and any required renewal fee. If a temporary license is returned to the department prior to its expiration along with a written request that it be placed on hold, the temporary license may later be reissued to the holder for the remainder of the 9 month period.

NOTICE IS HEREBY GIVEN that pursuant to ss. 29.014 and 227.11 (2) (a), Stats., interpreting ss. 29.014 and 29.041, Stats., the Department of Natural Resources will hold public hearings on revisions to ch. NR 10, Wis. Adm. Code, relating to the 2005 migratory game bird seasons. The proposed order establishes the season length and bag limits for the 2005 Wisconsin migratory game bird seasons. Under international treaty and federal laws, migratory game bird seasons are closed unless opened annually via the U.S. Fish and Wildlife Service regulations process. The public hearings will be held after the U.S. Fish and Wildlife Service's final draft framework is available.