Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB1197 Compare Versions

Only one version of the bill is available at this time.

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3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 1197
5	5	April 9, 2024 - Introduced by Representatives BARE, JACOBSON, C. ANDERSON,
6	6	CLANCY, CONLEY, CONSIDINE, EMERSON, MADISON, MOORE OMOKUNDE, PALMERI,
7	7	RATCLIFF, SHELTON, SNODGRASS, STUBBS and SINICKI, cosponsored by Senators
8	8	ROYS, LARSON, SPREITZER and AGARD. Referred to Committee on Insurance.
9	9	*AUTHORS SUBJECT TO CHANGE*
10	10	AN ACT to create 609.803 and 632.895 (13m) of the statutes; relating to:
11	11	coverage of tests for sexually transmitted diseases by health insurance policies
12	12	and plans.
13	13	Analysis by the Legislative Reference Bureau
14	14	This bill requires health insurance policies and self-insured governmental
15	15	health plans to cover home test kits for sexually transmitted diseases, including any
16	16	laboratory costs for processing the kits. Under the bill, a home test kit must be a test
17	17	recommended by the federal Centers for Disease Control and Prevention guidelines
18	18	or the U.S. Preventive Services Task Force and must have been given a waiver of a
19	19	specific federal law, been approved or cleared by the federal Food and Drug
20	20	Administration, or been developed by a laboratory in accordance with established
21	21	regulations and quality standards. The policies and plans are required to cover the
22	22	home test kit if the use of the kit is determined to be medically necessary or
23	23	appropriate and is ordered by a health care provider or furnished through a standing
24	24	order. Health insurance policies are referred to in the statutes as disability
25	25	insurance policies.
26	26	This proposal may contain a health insurance mandate requiring a social and
27	27	financial impact report under s. 601.423, stats.
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30	30	3 - 2 -2023 - 2024 Legislature LRB-5036/1
31	31	JPC:skw
32	32	ASSEMBLY BILL 1197
33	33	For further information see the state fiscal estimate, which will be printed as
34	34	an appendix to this bill.
35	35	The people of the state of Wisconsin, represented in senate and assembly, do
36	36	enact as follows:
37	37	SECTION 1. 609.803 of the statutes is created to read:
38	38	609.803 Coverage of sexually transmitted disease testing. Preferred
39	39	provider plans and defined network plans are subject to s. 632.895 (13m).
40	40	SECTION 2. 632.895 (13m) of the statutes is created to read:
41	41	632.895 (13m) SEXUALLY TRANSMITTED DISEASE TESTS. (a) In this subsection,
42	42	“home test kit” means a product used as a test recommended by the federal centers
43	43	for disease control and prevention guidelines or the U.S. preventive services task
44	44	force and that satisfies all of the following:
45	45	1. The product allows individuals to self-collect specimens for sexually
46	46	transmitted diseases, including HIV, outside of a clinical setting.
47	47	2. The product has been given a waiver of the federal clinical laboratory
48	48	improvement amendments, has been approved or cleared by the federal food and
49	49	drug administration, or has been developed by a laboratory in accordance with
50	50	established regulations and quality standards.
51	51	(b) Every disability insurance policy and every self-insured health plan of the
52	52	state, or a county, city, village, town, or school district, that provides coverage of
53	53	primary care or preventive services shall provide coverage of a home test kit,
54	54	including any laboratory costs of processing the home test kit, if the home test kit
55	55	meets all of the following criteria:
56	56	1. The use of the home test kit is determined to be medically necessary or
57	57	appropriate.
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79	79	LRB-5036/1
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81	81	SECTION 2
82	82	ASSEMBLY BILL 1197
83	83	2. The home test kit is ordered directly by a health care provider or furnished
84	84	through a standing order for patient use based on clinical guidelines and individual
85	85	patient needs.
86	86	SECTION 3.0Initial applicability.
87	87	(1) For policies and plans containing provisions inconsistent with this act, this
88	88	act first applies to policy or plan years beginning on the effective date of this
89	89	subsection, except as provided in sub. (2).
90	90	(2) For policies and plans that are affected by a collective bargaining agreement
91	91	containing provisions inconsistent with this act, this act first applies to policy or plan
92	92	years beginning on the effective date of this subsection or on the day on which the
93	93	collective bargaining agreement is newly established, extended, modified, or
94	94	renewed, whichever is later.
95	95	SECTION 4.0Effective date.
96	96	(1) This act takes effect on the first day of the 4th month beginning after
97	97	publication.
98	98	(END)
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