ExEcuTIvE BRANCH: GENERAL EXECUTIVE FUNCTIONS


  Agency Responsibility: The Hospital Rate-Setting Commission sets the rates
that each hospital
in Wisconsin may charge its private pay patients. Rates charged to Medicare,
Medical Assis-
tance and General Relief patients, however, are not set by the commission.
The state Legisla-
ture, in creating the commission, instructed it to reduce the rate of hospital
cost increases while
preserving the quality of health care in the state and taking into account
the financial viability of
economically and efficiently operated hospitals. Each hospital seeking to
increase the total reve-
nue it receives from private pay patients must submit a rate request to the
commission for its
review and approval. The commission inspects each item that may increase
the cost of hospital
care and demands justification for that expense from the hospital. In addition,
the commission
sets the rates each hospital may charge private pay patients for specific
billable items. The com-
mission can prosecute hospitals that fail to comply with rates it has set.
  As a check on the quality of health care provided in Wisconsin hospitals,
the commission is
responsible for implementing an all-patient utilization review program throughout
the state.
This program will evaluate the medical necessity or appropriateness of care
regarding hospital
admissions, length of stay and ancillary services. The commission also reviews
the financial
feasibility of hospital capital expenditure review projects for the Department
of Health and So-
cial Services to use when deciding whether to approve these projects.


                                             HOSPITAL RATE-SETTING COMMISSION


         I                      I                      I                
   l
     Administrative            Rate                 Financial           
Consumer and
       Support                Setting                Audits             
Business Affairs

                                                            HOSPITAL RATE-SETTING



                            SENTENCING COMMISSION
Sentencing Commission: DONALD HANAWAY (Attorney General), TiMOTHY CULLEN
(secretary of
  health and social services), MARY WILBURN (chairperson, Parole Board),
RICHARD J. PHELPS
  (state public defender) (ex officio members); VIvI L. DILWEG, MARVIN C.
HOLZ, MICHAEL B.
  TORPHY, JR., JON P. WILCOX (judges nominated by Chief Justice, Supreme
Court, appointed
  by Governor); KRISTEN KOEFFLER (nominee of Senate Majority Leader), REPRESENTATIVE
  DAVID M. TRAvis (nominee of Speaker of Assembly), GERALD PETERS (nominee
of Senate
  Minority Leader), REPRESENTATIVE DAVID T. PROSSER, JR. (nominee of Assembly
Minority


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