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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 1197
April 9, 2024 - Introduced by Representatives BARE, JACOBSON, C. ANDERSON,
CLANCY, CONLEY, CONSIDINE, EMERSON, MADISON, MOORE OMOKUNDE, PALMERI,
RATCLIFF, SHELTON, SNODGRASS, STUBBS and SINICKI, cosponsored by Senators
ROYS, LARSON, SPREITZER and AGARD. Referred to Committee on Insurance.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to create 609.803 and 632.895 (13m) of the statutes; relating to:
coverage of tests for sexually transmitted diseases by health insurance policies
and plans.
Analysis by the Legislative Reference Bureau
This bill requires health insurance policies and self-insured governmental
health plans to cover home test kits for sexually transmitted diseases, including any
laboratory costs for processing the kits. Under the bill, a home test kit must be a test
recommended by the federal Centers for Disease Control and Prevention guidelines
or the U.S. Preventive Services Task Force and must have been given a waiver of a
specific federal law, been approved or cleared by the federal Food and Drug
Administration, or been developed by a laboratory in accordance with established
regulations and quality standards. The policies and plans are required to cover the
home test kit if the use of the kit is determined to be medically necessary or
appropriate and is ordered by a health care provider or furnished through a standing
order. Health insurance policies are referred to in the statutes as disability
insurance policies.
This proposal may contain a health insurance mandate requiring a social and
financial impact report under s. 601.423, stats.
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ASSEMBLY BILL 1197
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SECTION 1. 609.803 of the statutes is created to read:
609.803 Coverage of sexually transmitted disease testing. Preferred
provider plans and defined network plans are subject to s. 632.895 (13m).
SECTION 2. 632.895 (13m) of the statutes is created to read:
632.895 (13m) SEXUALLY TRANSMITTED DISEASE TESTS. (a) In this subsection,
“home test kit” means a product used as a test recommended by the federal centers
for disease control and prevention guidelines or the U.S. preventive services task
force and that satisfies all of the following:
1. The product allows individuals to self-collect specimens for sexually
transmitted diseases, including HIV, outside of a clinical setting.
2. The product has been given a waiver of the federal clinical laboratory
improvement amendments, has been approved or cleared by the federal food and
drug administration, or has been developed by a laboratory in accordance with
established regulations and quality standards.
(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
primary care or preventive services shall provide coverage of a home test kit,
including any laboratory costs of processing the home test kit, if the home test kit
meets all of the following criteria:
1. The use of the home test kit is determined to be medically necessary or
appropriate.
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SECTION 2
ASSEMBLY BILL 1197
2. The home test kit is ordered directly by a health care provider or furnished
through a standing order for patient use based on clinical guidelines and individual
patient needs.
SECTION 3.0Initial applicability.
(1) For policies and plans containing provisions inconsistent with this act, this
act first applies to policy or plan years beginning on the effective date of this
subsection, except as provided in sub. (2).
(2) For policies and plans that are affected by a collective bargaining agreement
containing provisions inconsistent with this act, this act first applies to policy or plan
years beginning on the effective date of this subsection 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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