Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB340 Compare Versions

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

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1	1	LRB-2930/1
2	2	JPC:cjs
3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 340
5	5	June 30, 2023 - Introduced by Representatives VINING, DRAKE, ANDRACA, BARE,
6	6	BILLINGS, CABRERA, CLANCY, CONLEY, CONSIDINE, EMERSON, GOYKE, HAYWOOD,
7	7	HONG, J. ANDERSON, JACOBSON, JOERS, MOORE OMOKUNDE, MYERS, OHNSTAD,
8	8	PALMERI, RATCLIFF, SHELTON, SINICKI, SNODGRASS, STUBBS, SHANKLAND, BALDEH,
9	9	SUBECK and RIEMER, cosponsored by Senators ROYS, L. JOHNSON, AGARD,
10	10	HESSELBEIN, LARSON, PFAFF, CARPENTER, SPREITZER, TAYLOR, SMITH and WIRCH.
11	11	Referred to Committee on Health, Aging and Long-Term Care.
12	12	*AUTHORS SUBJECT TO CHANGE*
13	13	AN ACT to create 632.895 (14m) of the statutes; relating to: coverage of
14	14	maternity and newborn care under health insurance policies and plans and
15	15	granting rule-making authority.
16	16	Analysis by the Legislative Reference Bureau
17	17	This bill requires certain health insurance policies, known in the bill as
18	18	disability insurance policies, and governmental self-insured health plans to cover
19	19	the essential health benefit of maternity and newborn care, as specified by the
20	20	commissioner of insurance by rule. The bill specifies a list of requirements that the
21	21	commissioner must follow when establishing the maternity and newborn care
22	22	benefit, including certain limitations on cost sharing. If the maternity or newborn
23	23	care benefit specified by the commissioner is also subject to its own mandated
24	24	coverage requirement under current law, the bill requires the disability insurance
25	25	policy or self-insured health plan to provide coverage under whichever requirement
26	26	provides the insured or plan participant with more comprehensive coverage.
27	27	This proposal may contain a health insurance mandate requiring a social and
28	28	financial impact report under s. 601.423, stats.
29	29	The people of the state of Wisconsin, represented in senate and assembly, do
30	30	enact as follows:
31	31	SECTION 1. 632.895 (14m) of the statutes is created to read:
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35	35	4 - 2 -2023 - 2024 Legislature LRB-2930/1
36	36	JPC:cjs
37	37	SECTION 1 ASSEMBLY BILL 340
38	38	632.895 (14m) MATERNITY AND NEWBORN CARE; ESSENTIAL HEALTH BENEFIT. (a)
39	39	In this subsection, “self-insured health plan” has the meaning given in s. 632.85 (1)
40	40	(c).
41	41	(b) On a date specified by the commissioner, by rule, every disability insurance
42	42	policy, except as provided in par. (g), and every self-insured health plan shall provide
43	43	coverage for the essential health benefit of maternity and newborn care, including
44	44	benefits, items, and services, as determined by the commissioner, by rule, subject to
45	45	par. (c).
46	46	(c) In determining the scope of maternity and newborn care benefits for which
47	47	coverage is required under par. (b), the commissioner shall do all of the following:
48	48	1. Conduct a survey of employer-sponsored coverage to determine maternity
49	49	and newborn care benefits typically covered by employers and ensure that the scope
50	50	of benefits for which coverage is required under this subsection is equal to the scope
51	51	of benefits covered under a typical disability insurance policy offered by an employer
52	52	to its employees.
53	53	2. Ensure that the maternity and newborn care benefit is provided with no or
54	54	limited cost-sharing requirements.
55	55	3. Require that disability insurance policies and self-insured health plans do
56	56	not, with regards to maternity and newborn care coverage required under par. (b),
57	57	make coverage decisions, determine reimbursement rates, establish incentive
58	58	programs, or design benefits in ways that discriminate against individuals because
59	59	of their disability or expected length of life.
60	60	(d) The commissioner shall periodically update, by rule, the maternity and
61	61	newborn care benefits under this subsection to address any gaps in access to
62	62	coverage.
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88	88	LRB-2930/1
89	89	JPC:cjs
90	90	SECTION 1
91	91	ASSEMBLY BILL 340
92	92	(e) If the maternity or newborn care benefit is also subject to mandated
93	93	coverage elsewhere under this section and the coverage requirements are not
94	94	identical, the disability insurance policy or self-insured health plan shall provide
95	95	coverage under whichever subsection provides the insured or plan participant with
96	96	more comprehensive coverage of the benefit, item, or service.
97	97	(f) Nothing in this subsection or rules promulgated under this subsection
98	98	prohibits a disability insurance policy or a self-insured health plan from providing
99	99	benefits in excess of the essential health benefit coverage required under this
100	100	subsection.
101	101	(g) This subsection does not apply to any disability insurance policy that is
102	102	described in s. 632.745 (11) (b) 1. to 12.
103	103	(END)
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