153.01 Definitions.

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153.01 Definitions. In this subchapter:

(1d)“Administrator” has the meaning given in s. 633.01

(1).

(1g)“Ambulatory surgery center” has the meaning given under 42 CFR 416.2 .

(2g)“Calculated variable” means a data element that is computed or derived from an original data item or derived using another data source.

(2m)“Data element” means an item of information from a uniform patient billing form.

(3g)“Data organization” means a nonstock corporation organized under ch. 181 that is described in section 501

(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:

(a)Represents health care consumers, insurers, administrators, and health care providers.

(b)Is formed specifically to do all of the following:

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.

2. Use the information it collects to develop and disseminate unified public reports on health care quality, safety, and efficiency.

(4)“Department” means the department of health services.

(4h)“Employer coalition” means an organization of employers formed for the purpose of purchasing health care coverage or services as a group.

(4j)“Entity” means a nonstock corporation organized under ch. 181 that is described in section 501

(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:

(a)Represents at least 70 percent of the hospitals in Wisconsin.

(b)Receives oversight with respect to services performed by the entity under this subchapter from the secretary of health services.

(4p)“Health care plan” means an insured or self-insured plan providing coverage of health care expenses or an employer coalition.

(4t)“Health care provider” has the meaning given in s. 146.81

(a)to

(p)and includes an ambulatory surgery center.

(5)“Hospital” has the meaning given under s. 50.33

(2).

(5m)“Insurer” has the meaning given under s. 632.745

(15).

(7)“Patient” means a person who receives health care services from a health care provider.

(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.

(8m)“Public health authority” means the department or a person acting under this subchapter under a grant of authority from or contract with the department.