Header:
WISCONSIN ADMINISTRATIVE CODE
DEPARTMENT OF HEALTH SERVICES
CHAPTER DHS 120 HEALTH CARE INFORMATION
SUBCHAPTER III -- DATA COLLECTION AND SUBMISSION
Date:
02/18/2014
Document:
DHS 120.15 Data to be submitted by other classes of health care providers
(1) APPLICABILITY. This section applies to all of the following classes of health care providers:
(a) Dentists licensed under ch. 447, Stats.
(b) Chiropractors licensed under ch. 446, Stats.
(c) Podiatrists licensed under ch. 448, Stats.
(2) DATA TO BE COLLECTED. (a) In this subsection, "board" means the certifying body for a medical specialty.
(b) For each of the providers specified in sub. (1), the department shall collect all of the following types of work-force and practice information:
1. Name of the provider and address or addresses of main practice or employment.
2. Date of birth.
3. License or certification status, if applicable, including date of initial licensure or certification, credential suspen-sions or revocations.
4. Specialty, board certification and recertification information, if applicable.
5. Post-secondary education and training.
6. Whether the provider renders services to medicare and medical assistance patients and, if applicable, whether the provider has signed a medicare participation agreement indicating that she or he accepts assignment on all medi-care patients.
7. Whether the provider participates in a voluntary partnercare program specified under s. 71.55 (10), Stats., un-der which assignment is accepted for low-income elderly.
Note: Section 71.55 (10), Stats., was repealed by 2003 Wis. Act 33.
8. Current names and addresses of facilities at which the provider has been granted privileges, if applicable.
9. The usual and customary charges for office visits, routine tests and preventive measures and frequently occur-ring procedures, as specified by the department.
10. Participation in health maintenance organizations, preferred provider organizations and independent practice arrangements.
11. Practice name, location, phone number and hours spent at location.
12. Type of degree or certification.
13. Date degree or certification granted.
14. Date, state and county of most recent residency.
(c) If the data specified in par. (b) is not available from the department of safety and professional services, or is not available for the desired time interval or in the required format, the department shall require the health care provider to submit that information directly to the department or its designee in a format prescribed by the department.
(d) The department shall consult with each applicable health care provider group specified in sub. (1), through a technical advisory committee or trade association, before the department collects data directly from members of that health care provider group.
(3) DATA SUBMISSION PROCEDURES. (a) The department shall require that information specified in sub. (2) be submitted to the department at least once every 3 years according to a schedule developed by the department. The department may require that the requested information be submitted on an annual or biennial basis according to a schedule developed by the department.
(b) The department may grant an extension of a deadline specified in par. (a) for submission of health care pro-vider information only when the health care provider adequately justifies to the department the health care provider's need for additional time. In this paragraph, "adequate justification" means a delay due to a labor strike, fire, natural disaster or catastrophic computer failure. A health care provider desiring an extension shall submit a request for an extension in writing to the department at least 10 calendar days prior to the date that the data are due. The depart-ment may grant an extension for up to 30 calendar days. Health care providers who have been granted an extension by the department shall submit their data directly to the department.
Note: Health care providers who are required to send their information directly to the department should use the following address: Bureau of Health Information and Policy, P. O. Box 2659, Madison, Wisconsin 53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street, Madison, Wisconsin.
(4) DATA VERIFICATION, REVIEW AND COMMENT PROCEDURES. Health care providers specified in sub. (1) shall verify or correct information contained on their survey. The department shall verify questionable data by contacting the applicable health care provider.
(5) DATA ADJUSTMENT METHODS. There shall be no adjustment methods for data submitted under this section.
(6) WAIVER FROM DATA SUBMISSION REQUIREMENTS. There shall be no waivers from the data submission re-quirements under this section.
Note: With the exception of s. DHS 120.15, under s. 153.78 (2), Stats., and s. DHS 120.10 (3) (b), the department may assess fines on health care providers that do not submit the data specified in this subchapter on a timely basis. Health care providers may be subject to a fine of $ 100 per day per type of data that has not been submitted to the Department under this subchapter.
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