Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB584 Compare Versions

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

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1	1	LRB-0437/1
2	2	JPC:cdc
3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 584
5	5	October 31, 2023 - Introduced by Representatives J . ANDERSON, BILLINGS,
6	6	SHANKLAND, C. ANDERSON, BARE, CABRERA, CONSIDINE, DONOVAN, EMERSON,
7	7	JOERS, MOORE OMOKUNDE, ORTIZ-VELEZ, PALMERI, RATCLIFF, SHELTON, STUBBS,
8	8	SUBECK, SINICKI, CLANCY and JACOBSON, cosponsored by Senators PFAFF,
9	9	CARPENTER, HESSELBEIN, L. JOHNSON, LARSON, ROYS, SMITH and SPREITZER.
10	10	Referred to Committee on Insurance.
11	11	*AUTHORS SUBJECT TO CHANGE*
12	12	AN ACT to renumber and amend 632.895 (6); to amend 609.83 and 632.895 (6)
13	13	(title); and to create 632.895 (6) (b) of the statutes; relating to: cost-sharing
14	14	cap on insulin.
15	15	Analysis by the Legislative Reference Bureau
16	16	This bill prohibits every health insurance policy and governmental
17	17	self-insured health plan that cover insulin and impose cost sharing on prescription
18	18	drugs from imposing cost sharing on insulin in an amount that exceeds $35 for a
19	19	one-month supply. Current law requires every health insurance policy that provides
20	20	coverage of expenses incurred for treatment of diabetes to provide coverage for
21	21	specified expenses and items, including insulin. The required coverage under
22	22	current law for certain diabetes treatments other than insulin infusion pumps is
23	23	subject to the same exclusions, limitations, deductibles, and coinsurance provisions
24	24	of the policy as other covered expenses. The bill's cost-sharing limitation on insulin
25	25	supersedes the specification that the exclusions, limitations, deductibles, and
26	26	coinsurance are the same as for other 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:
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33	33	3 - 2 -2023 - 2024 Legislature LRB-0437/1
34	34	JPC:cdc
35	35	SECTION 1 ASSEMBLY BILL 584
36	36	SECTION 1. 609.83 of the statutes is amended to read:
37	37	609.83 Coverage of drugs and devices. Limited service health
38	38	organizations, preferred provider plans, and defined network plans are subject to ss.
39	39	632.853, 632.861, and 632.895 (6) (b), (16t), and (16v).
40	40	SECTION 2. 632.895 (6) (title) of the statutes is amended to read:
41	41	632.895 (6) (title) EQUIPMENT AND SUPPLIES FOR TREATMENT OF DIABETES; INSULIN.
42	42	SECTION 3. 632.895 (6) of the statutes is renumbered 632.895 (6) (a) and
43	43	amended to read:
44	44	632.895 (6) (a) Every disability insurance policy which that provides coverage
45	45	of expenses incurred for treatment of diabetes shall provide coverage for expenses
46	46	incurred by the installation and use of an insulin infusion pump, coverage for all
47	47	other equipment and supplies, including insulin or any other prescription
48	48	medication, used in the treatment of diabetes, and coverage of diabetic
49	49	self-management education programs. Coverage Except as provided in par. (b),
50	50	coverage required under this subsection shall be subject to the same exclusions,
51	51	limitations, deductibles, and coinsurance provisions of the policy as other covered
52	52	expenses, except that insulin infusion pump coverage may be limited to the purchase
53	53	of one pump per year and the insurer may require the insured to use a pump for 30
54	54	days before purchase.
55	55	SECTION 4. 632.895 (6) (b) of the statutes is created to read:
56	56	632.895 (6) (b) 1. In this paragraph:
57	57	a. “Cost sharing” means the total of any deductible, copayment, or coinsurance
58	58	amounts imposed on a person covered under a policy or plan.
59	59	b. “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
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84	84	LRB-0437/1
85	85	JPC:cdc
86	86	SECTION 4
87	87	ASSEMBLY BILL 584
88	88	2. Every disability insurance policy and self-insured health plan that cover
89	89	insulin and impose cost sharing on prescription drugs may not impose cost sharing
90	90	on insulin in an amount that exceeds $35 for a one-month supply of insulin.
91	91	3. Nothing in this paragraph prohibits a disability insurance policy or
92	92	self-insured health plan from imposing cost sharing on insulin in an amount less
93	93	than the amount specified under subd. 2. Nothing in this paragraph requires a
94	94	disability insurance policy or self-insured health plan to impose any cost sharing on
95	95	insulin.
96	96	SECTION 5.0Effective date.
97	97	(1) This act takes effect on the first day of the 4th month beginning after
98	98	publication.
99	99	(END)
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