Information Regarding Health Care Charges and Quality
Act 146 was enacted on March 9, 2010 and is effective January 1, 2011. The Act (PDF, 42 KB) specifies requirements for hospitals, insurance plans, health care providers, and the Department of Health Services (DHS) related to disclosure of information about the cost and quality of health care services. A summary memo (PDF, 41 KB) by the Wisconsin Legislative Council is available.
The final Act 146 Implementation Plan (PDF, 282 KB) is available. Appendix 2 (PDF, 155 KB) lists the five CPT services to include in the physician report for each medical condition. Appendix 3 (PDF, 46 KB) is a report template for physicians to use in preparing consumer information to comply with Act 146.
The implementation plan does not directly address requirements on hospitals and insurance plans except for those in section 5(5); nor does it refer to requirements for health care providers except for those in sections 5(2), 5(3)(b) through (f), and 5(5), which relate to the creation of a standard report for patients, and to the enforcement of Act requirements. Hospitals, insurance plans and health care providers should be alert to other requirements in the Act that are not described in this plan.
The Department of Health Services, Division of Quality Assurance (DQA) is responsible for investigating all complaints over which the Department has jurisdiction. If any individual believes that a hospital or physician has violated 2009 Wisconsin Act 146 regarding the disclosure of health care charges and quality information, that individual has the right to file a complaint. Physicians practicing individually or in associations of three or fewer physicians are exempt under the law.
The Wisconsin Department of Safety and Professional Services (formerly Regulation and Licensing) is the state agency responsible for credentialing and regulating physicians in Wisconsin. If you have a complaint that a physician is in violation of a relevant condition or rule related to the profession, you may contact the Department of Safety and Professional Services at the following link: http://dsps.wi.gov/Home or use the toll-free number 1-877-617-1565.
There are several ways to file a complaint with the Division of Quality Assurance. Refer to the options listed below:
- Contact the Division of Quality Assurance at 608-266-8481.
- File a complaint using the Online Complaint Intake System.
- Call the toll-free number: 1-800-642-6552.
The Department has developed a listserv for communications between DHS and providers. Sign up for the Act 146 listserv here.
The Act requires the Department to adjust annually the amounts that a health care provider may charge for providing copies of a patient's health care records; see current fee schedule here (PDF, 13 KB) .