CHAPTER 153
HEALTH CARE INFORMATION
153.05 Collection and dissemination of health care and related information.
153.08 Hospital rate increases or charges in excess of rates.
153.10 Health care data reports.
153.20 Uncompensated health care services report.
153.22 Patient-level data utilization, charge, and quality report.
153.45 Release of data by department.
153.455 Data organization; contract contingency.
153.46 Release of data by entity.
153.50 Protection of patient confidentiality.
153.55 Protection of confidentiality.
153.60 Assessments to fund operations of department.
153.65 Provision of special information; user fees.
153.86 Immunity from liability.
153.01
153.01
Definitions. In this chapter:
153.01(2g)
(2g) "Calculated variable" means a data element that is computed or derived from an original data item or derived using another data source.
153.01(2m)
(2m) "Data element" means an item of information from a uniform patient billing form.
153.01(3g)
(3g) "Data organization" means a nonstock corporation organized under
ch. 181 that is described in section
501 (c) (3) of the Internal Revenue Code, is exempt from federal income tax under section
501 (a) of the Internal Revenue Code, and, in its capacity as a public health authority, does all of the following:
153.01(3g)(a)
(a) Represents health care consumers, insurers, administrators, and health care providers.
153.01(3g)(b)
(b) Is formed specifically to do all of the following:
153.01(3g)(b)1.
1. Create a centralized claims repository for this state with credible and useful data elements for the purposes of quality improvement, health care provider performance comparisons, ready understandability, and consumer decision making.
153.01(3g)(b)2.
2. Use the information it collects to develop and disseminate unified public reports on health care quality, safety, and efficiency.
153.01(4)
(4) "Department" means the department of health services.
153.01(4h)
(4h) "Employer coalition" means an organization of employers formed for the purpose of purchasing health care coverage or services as a group.
153.01(4j)
(4j) "Entity" means a nonstock corporation organized under
ch. 181 that is described in section
501 (c) (6) of the Internal Revenue Code and is exempt from federal income tax under section
501 (a) of the Internal Revenue Code, and that does all of the following:
153.01(4j)(a)
(a) Represents at least 70% of the hospitals in Wisconsin.
153.01(4j)(b)
(b) Receives oversight with respect to services performed by the entity under this chapter from the secretary of health services.
153.01(4p)
(4p) "Health care plan" means an insured or self-insured plan providing coverage of health care expenses or an employer coalition.
153.01(4t)
(4t) "Health care provider" has the meaning given in
s. 146.81 (1) and includes an ambulatory surgery center.
153.01(7)
(7) "Patient" means a person who receives health care services from a health care provider.
153.01(8)
(8) "Payer" means a 3rd-party payer, including an insurer, federal, state or local government or another who is responsible for payment of a hospital charge.
153.01(8m)
(8m) "Public health authority" means the department or a person acting under this chapter under a grant of authority from or contract with the department.
153.05
153.05
Collection and dissemination of health care and related information. 153.05(1)
(1) In order to provide to health care providers, insurers, consumers, governmental agencies and others information concerning health care providers and uncompensated health care services, and in order to provide information to assist in peer review for the purpose of quality assurance:
153.05(1)(a)
(a) Subject to
s. 153.455, the department shall collect from health care providers other than hospitals and ambulatory surgery centers, analyze, and disseminate health care information, as adjusted for case mix and severity, in language that is understandable to laypersons.
153.05(1)(b)
(b) The entity under contract under
sub. (2m) (a) shall collect from hospitals and ambulatory surgery centers the health care information required of hospitals and ambulatory surgery centers by the department under ch.
153, 2001 stats., and the rules promulgated under ch.
153, 2001 stats., including, by the date that is 18 months after the date of the contract under
sub. (2m) (a), outpatient hospital-based services. The entity shall analyze and disseminate that health care information, as adjusted for case mix and severity, in the manner required under this chapter, under ch.
153, 2001 stats., and under the rules promulgated under ch.
153, 2001 stats., and in language that is understandable to laypersons.
153.05(1)(c)
(c) Subject to
s. 153.455 (1) to
(3), the data organization under contract under
sub. (2r) may request health care claims information from insurers and administrators. The data organization shall analyze and publicly report the health care claims information with respect to the cost, quality, and effectiveness of health care, in language that is understandable by lay persons, and shall develop and maintain a centralized data repository. The data organization shall provide to the department, without charge, health care claims information collected by and reports produced by the data organization that the department requests. If
s. 153.455 (4) applies, the department may request health care claims information, which may be voluntarily provided by insurers and administrators, and may perform or contract for the performance of the other duties specified for the data organization under this paragraph.
153.05(2m)(a)(a) Notwithstanding
s. 16.75 (1),
(2), and
(3m), by the 2nd month after July 26, 2003, the department of administration shall, from the appropriation under
s. 20.505 (1) (im), contract with an entity to perform services under this chapter that are specified for the entity with respect to the collection, analysis, and dissemination of health care information of hospitals and ambulatory surgery centers. The department of administration may not, by this contract, require from the entity any collection, analysis, or dissemination of health care information of hospitals and ambulatory surgery centers that is in addition to that required under this chapter.
153.05(2m)(b)
(b) Biennially, the group specified under
s. 153.01 (4j) (b) shall review the entity's performance, including the timeliness and quality of the reports generated by the entity. If the group is dissatisfied with the entity's performance, the group may recommend to the department of administration that that department use a competitive request-for-proposal process to solicit offers from other organizations for performance of the services. If no organization responds to the request for proposal, the department of health services shall perform the services specified for the entity with respect to the collection, analysis, and dissemination of health care information of hospitals and ambulatory surgery centers under this chapter.
153.05(2m)(c)
(c) By April 1, annually, the secretary of health services shall submit to the chief clerk of each house of the legislature for distribution to the legislature under
s. 13.172 (2), a report concerning the content and number of reports and currency of information and reports generated in the previous calendar year by the entity under contract under
s. 153.05 (2m).
153.05(2r)
(2r) Notwithstanding
s. 16.75 (1),
(2), and
(3m), from the appropriation account under
s. 20.515 (1) (ut) the department of employee trust funds may expend up to $150,000, and from the appropriation accounts under
s. 20.435 (1) (hg) and
(hi) the department of health services, in its capacity as a public health authority, may expend moneys, to contract with a data organization to perform services under this chapter that are specified for the data organization under
sub. (1) (c) or, if
s. 153.455 (4) applies, for the department of health services to perform or contract for the performance of these services. As a condition of the contract under this subsection, all of the following apply:
153.05 Note
NOTE: Sub. (2r) (intro.) is shown as affected by 2 acts of the 2007 Wisconsin legislature and as merged by the legislative reference bureau under s. 13.92 (2) (i).
153.05(2r)(a)
(a) At least during the period of the contract, the data organization shall include as voting members of the board of directors of the data organization the secretary of health services and the secretary of employee trust funds, or their designees.
153.05(2r)(b)
(b) The data organization shall provide matching funds, which may include in-kind contributions, as specified in the contract.
153.05(2r)(c)
(c) Termination of funding and of services of the data organization under the contract or modification of the contract is subject to a determination made under
s. 153.455 (3).
153.05(2s)
(2s) Annually, the department of health services and the department of employee trust funds shall jointly prepare and submit under
s. 13.172 (3) to standing committees of the legislature with jurisdiction over health issues a report on the activities of the data organization under this chapter.
