Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 17 - Health Care Liability Insurance Patients Compensation Fund › Section Ins 17.28 - Health care provider fees

Current through June 24, 2024
(1) PURPOSE. This
			 section implements s.
			 655.27(3),
			 Stats.
(2) SCOPE. This section
			 applies to fees charged to providers for participation in the fund, but does
			 not apply to fees charged for operation of the mediation system under s.
			 655.61, Stats.
(3) DEFINITIONS. In this section:
(a) "Annual fee" means the amount established
			 under sub. (6) for each class or type of provider.
(b) "Begin operation" means for a provider
			 other than a natural person to start providing health care services in this
			 state.
(bm) "Begin practice" means
			 to start practicing in this state as a medical or osteopathic physician or
			 nurse anesthetist or to become ineligible for an exemption from ch. 655,
			 Stats.
(c) "Class" means a group of
			 physicians whose specialties or types of practice are similar in their degree
			 of exposure to loss. The specialties and types of practice and the applicable
			 Insurance Services Office, Inc., codes included in each fund class are the
			 following:
1. Class 1:
Administrative Medicine
80120
Aerospace Medicine
80230
Allergy
80254
Allergy (D.O.)
84254
Cardiovascular Disease - no surgery or
						  catheterization
80255
Cardiovascular Disease - no surgery or catheterization
						  (D.O.)
84255
Dermatology - no surgery
80256
Dermatology - no surgery (D.O.)
84256
Diabetes - no surgery
80237
Endocrinology - no surgery
80238
Endocrinology - no surgery (D.O.)
84238
Family or General Practice - no surgery
80420
Family or General Practice - no surgery (D.O.)
84420
Forensic Medicine - Legal Medicine
80240
Forensic Medicine - Legal Medicine (D.O.)
84240
Gastroenterology - no surgery
80241
Gastroenterology - no surgery (D.O.)
84241
General Preventive Medicine - no surgery
80231
General Preventive Medicine - no surgery (D.O.)
84231
Geriatrics - no surgery
80243
Geriatrics - no surgery (D.O.)
84243
Gynecology - no surgery
80244
Gynecology - no surgery (D.O.)
84244
Hematology - no surgery
80245
Hematology - no surgery (D.O.)
84245
Hypnosis
80232
Infectious Diseases - no surgery
80246
Infectious Diseases - no surgery (D.O.)
84246
Internal Medicine - no surgery
80257
Internal Medicine - no surgery (D.O.)
84257
Laryngology - no surgery
80258
Manipulator (D.O.)
84801
Neoplastic Disease - no surgery
80259
Nephrology - no surgery
80260
Nephrology - no surgery (D.O.)
84260
Neurology - no surgery
80261
Neurology - no surgery (D.O.)
84261
Nuclear Medicine
80262
Nuclear Medicine (D.O.)
84262
Nutrition
80248
Occupation Medicine
80233
Occupation Medicine (D.O.)
84233
Oncology - no surgery
80302
Oncology - no surgery (D.O.)
84302
Ophthalmology - no surgery
80263
Ophthalmology - no surgery (D.O.)
84263
Osteopathy - manipulation only
84801
Otology - no surgery
80264
Otorhinolaryngology - no surgery
80265
Otorhinolaryngology - no surgery (D.O.)
84265
Pain Management - no surgery
80208
Pain Management - no surgery (D.O.)
84208
Pathology - no surgery
80266
Pathology - no surgery (D.O.)
84266
Pediatrics - no surgery
80267
Pediatrics - no surgery (D.O.)
84267
Pharmacology - Clinical
80234
Physiatry - Physical Medicine (D.O.)
84235
Physiatry - Physical Medicine &
						  Rehabilitation
80235
Physicians - no surgery
80268
Physicians - no surgery (D.O.)
84268
Psychiatry
80249
Psychiatry - (D.O.)
84249
Psychoanalysis
80250
Psychosomatic Medicine
80251
Psychosomatic Medicine (D.O.)
84251
Public Health
80236
Pulmonary Disease - no surgery
80269
Pulmonary Disease - no surgery (D.O.)
84269
Radiology - diagnostic
80253
Radiology - diagnostic (D.O.)
84253
Radiology - includes Mammography w/ Telemed
80472
Radiopaque dye
80449
Radiopaque dye (D.O.)
84449
Rheumatology - no surgery
80252
Rheumatology - no surgery (D.O.)
84252
Rhinology - no surgery
80247
Shock Therapy
80431
Shock Therapy (D.O.)
84431
Shock Therapy - insured
80162
Urgent Care - Walk-in or After Hours
80424
Urgent Care - Walk-in or After Hours (D.O.)
84424
Urology - no surgery
80121
2.
			 Class 2:
Acupuncture
80437
Acupuncture (D.O.)
84437
Anesthesiology
80151
Anesthesiology (D.O.)
84151
Angiography-Arteriography - catheterization
80422
Angiography-Arteriography - catheterization (D.O.)
84422
Broncho-Esophagology
80101
Cardiovascular Disease - minor surgery
80281
Cardiovascular Disease - minor surgery (D.O.)
84281
Colonoscopy-ERCP-Pneu or mech esoph dil (D.O.)
84443
Colonoscopy-ERCP-pneu. or mech.
80443
Dermatology - minor surgery
80282
Dermatology - minor surgery (D.O.)
84282
Diabetes - minor surgery
80271
Diabetes - minor surgery (D.O.)
84271
Emergency Medicine - No Major Surgery
80102
Emergency Medicine - No Major Surgery (DO)
84102
Employed Physician or Surgeon
80177
Employed Physician or Surgeon (D.O.)
84177
Endocrinology - minor surgery
80272
Endocrinology - minor surgery (D.O.)
84272
Family Practice - and general practice minor surgery - No
						OB
80423
Family Practice - and general practice minor surgery - No
						OB (D.O.)
84423
Family or General Practice - including OB (D.O.)
84421
Family or General Practice - including OB
80421
Gastroenterology - minor surgery
80274
Gastroenterology - minor surgery (D.O.)
84274
Geriatrics - minor surgery
80276
Geriatrics - minor surgery (D.O.)
84276
Gynecology - minor surgery
80277
Gynecology - minor surgery (D.O.)
84277
Hematology - minor surgery
80278
Hematology - minor surgery (D.O.)
84278
Hospitalist
80296
Hospitalist (D.O.)
84296
Infectious Diseases - minor surgery
80279
Intensive Care Medicine
80283
Intensive Care Medicine (D.O.)
84283
Internal Medicine - minor surgery
80284
Internal Medicine - minor surgery (D.O.)
84284
Laparoscopy
80440
Laparoscopy (D.O.)
84440
Laryngology - minor surgery
80285
Myelography-Discogram-Pneumoencephalo
80428
Myelography-Discogram-Pneumoencephalo (D.O.)
84428
Needle Biopsy
80446
Needle Biopsy (D.O.)
84446
Nephrology - minor surgery
80287
Neonatology
80804
Neonatology (D.O.)
84804
Neoplastic Disease - minor surgery
80286
Neurology - minor surgery
80288
Neurology - minor surgery (D.O.)
84288
Oncology - minor surgery
80301
Oncology - minor surgery (D.O.)
84301
Ophthalmology - minor surgery
80289
Ophthalmology - minor surgery (D.O.)
84289
Otology - minor surgery
80290
Otorhinolaryngology - minor surgery
80291
Otorhinolaryngology - minor surgery (D.O.)
84291
Pain Management - Basic procedures
80182
Pain Management - Basic procedures (D.O.)
84182
Pathology - minor surgery
80292
Pathology - minor surgery (D.O.)
84292
Pediatrics - minor surgery
80293
Pediatrics - minor surgery (D.O.)
84293
Phlebography-Lymphangeography
80434
Phlebography-Lymphangeography (D.O.)
84434
Physicians - minor surgery
80294
Physicians - minor surgery (D.O.)
84294
Radiation Therapy - lasers
80425
Radiation Therapy - lasers (D.O.)
84425
Radiation Therapy - other than lasers
80165
Radiology - diagnostic-interventional procedures
80280
Radiology - diagnostic-interventional procedures
						(D.O.)
84280
Rhinology - minor surgery
80270
Surgery - Colon & Rectal
80115
Surgery - Endocrinology
80103
Surgery - Gastroenterology
80104
Surgery - Gastroenterology (D.O.)
84104
Surgery - General Practice or Family Practice
80117
Surgery - General Practice or Family Practice
						(D.O.)
84117
Surgery - Geriatrics
80105
Surgery - Neoplastic
80107
Surgery - Nephrology
80108
Surgery - Ophthalmology
80114
Surgery - Ophthalmology (D.O.)
84114
Surgery - Urological
80145
Surgery - Urological (D.O.)
84145
3. Class 3:
4. Class 4:
(d) "Fiscal year" means each period beginning
			 each July 1 and ending each June 30.
(e) "Permanently cease operation" means for a
			 provider other than a natural person to stop providing health care services
			 with the intent not to resume providing such services in this state.
(f) "Permanently cease practice" means to
			 stop practicing as a medical or osteopathic physician or nurse anesthetist with
			 the intent not to resume that type of practice in this state.
(g) "Primary coverage" means health care
			 liability insurance meeting the requirements of subch. III of ch. 655,
			 Stats.
(h) "Provider" means a
			 health care provider, as defined in s.
			 655.001(8),
			 Stats.
(hm) "Resident" means a
			 licensed physician engaged in an approved postgraduate medical education or
			 fellowship program in any specialty specified in par. (c) 1. to 4.
(i) "Temporarily cease practice" means to
			 stop practicing in this state for any period of time because of the suspension
			 or revocation of a provider's license, or to stop practicing for at least 90
			 consecutive days for any other reason.