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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 1044
February 2, 2024 - Introduced by Representatives SUBECK, SHANKLAND, C.
ANDERSON, J. ANDERSON, CONLEY, CONSIDINE, DRAKE, EMERSON, JOERS,
NEUBAUER, PALMERI, RATCLIFF, SINICKI and STUBBS, cosponsored by Senators
HESSELBEIN, SPREITZER, AGARD, LARSON, PFAFF, ROYS, SMITH, TAYLOR and
WIRCH. Referred to Committee on Insurance.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to amend 609.83; and to create 632.895 (12r) of the statutes; relating
to: cost-sharing cap on epinephrine auto-injectors under health insurance
policies and plans.
Analysis by the Legislative Reference Bureau
This bill prevents every health insurance policy and every self-insured
governmental health plan that covers medically necessary epinephrine
auto-injectors from imposing cost sharing in an amount that exceeds $60 for a
twin-pack of epinephrine auto-injectors, regardless of the type of epinephrine
auto-injector. Health insurance policies are referred to in the bill as disability
insurance policies.
This proposal may contain a health insurance mandate requiring a social and
financial impact report under s. 601.423, stats.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SECTION 1. 609.83 of the statutes is amended to read:
609.83 Coverage of drugs and devices. Limited service health
organizations, preferred provider plans, and defined network plans are subject to ss.
632.853, 632.861, and 632.895 (12r), (16t), and (16v).
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SECTION 2 ASSEMBLY BILL 1044
SECTION 2. 632.895 (12r) of the statutes is created to read:
632.895 (12r) EPINEPHRINE AUTO-INJECTORS. (a) In this subsection,
“epinephrine auto-injector” means a device used for the automatic injection of
epinephrine into the human body to prevent or treat a life-threatening allergic
reaction.
(b) Every disability insurance policy, and every self-insured health plan of the
state or a county, city, village, town, or school district, that provides coverage of
medically necessary epinephrine auto-injectors may not impose cost sharing on
epinephrine auto-injectors in an amount that exceeds $60 for a twin-pack of
medically necessary epinephrine auto-injectors, regardless of the type of
epinephrine auto-injector.
(c) Nothing in this subsection prohibits a disability insurance policy or
self-insured health plan from imposing cost sharing on epinephrine auto-injectors
in an amount less than the amount specified under par. (b). Nothing in this
paragraph requires a disability insurance policy or self-insured health plan to
impose any cost sharing on epinephrine auto-injectors.
SECTION 3.0Initial applicability.
(1) EPINEPHRINE AUTO-INJECTORS.
(a) For policies and plans containing provisions inconsistent with s. 632.895
(12r), the treatment of s. 632.895 (12r) first applies to policy or plan years beginning
on January 1 of the year following the year in which this paragraph takes effect,
except as provided in par. (b).
(b) For policies and plans that are affected by a collective bargaining agreement
containing provisions inconsistent with s. 632.895 (12r), the treatment of s. 632.895
(12r) first applies to policy or plan years beginning on the effective date of this
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SECTION 3
ASSEMBLY BILL 1044
paragraph or on the day on which the collective bargaining agreement is newly
established, extended, modified, or renewed, whichever is later.
SECTION 4.0Effective date.
(1) This act takes effect on the first day of the 4th month beginning after
publication.
(END)
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