Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB789 Compare Versions

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

Old	New	Differences
1	1	LRB-0436/1
2	2	JPC:cdc
3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 789
5	5	December 8, 2023 - Introduced by Representatives J. ANDERSON, C. ANDERSON,
6	6	CLANCY, DRAKE, EMERSON, JACOBSON, JOERS, MADISON, MOORE OMOKUNDE,
7	7	ORTIZ-VELEZ, PALMERI, SHANKLAND, SHELTON, SNODGRASS, STUBBS and SUBECK,
8	8	cosponsored by Senators LARSON, SMITH and SPREITZER. Referred to
9	9	Committee on Insurance.
10	10	*AUTHORS SUBJECT TO CHANGE*
11	11	AN ACT to create 609.047 of the statutes; relating to: provider directories for
12	12	certain health plans.
13	13	Analysis by the Legislative Reference Bureau
14	14	This bill requires a defined network plan or preferred provider plan to make
15	15	available a current directory of health care providers in the plan's network of
16	16	providers to anyone considering enrollment in the plan and to the plan's enrollees at
17	17	least annually. Defined network plans and preferred provider plans are types of
18	18	managed care organizations that provide health care benefits to their enrollees. The
19	19	bill requires the plan to maintain a current provider directory on its website, to
20	20	ensure that the directory on the site is updated at least quarterly, and to ensure that
21	21	the public may view the provider directory on the site without creating or accessing
22	22	an account or entering a policy or contract number. A plan is also required by the bill
23	23	to provide information in each electronic and print directory on providers for each of
24	24	the plan's covered services, to prominently indicate in each electronic and print
25	25	directory which providers are accepting new patients at the time the directory is
26	26	updated, and to accommodate with each electronic and print directory the
27	27	communication needs of persons with disabilities and persons with limited English
28	28	proficiency.
29	29	The people of the state of Wisconsin, represented in senate and assembly, do
30	30	enact as follows:
31	31	1
32	32	2 - 2 -2023 - 2024 Legislature LRB-0436/1
33	33	JPC:cdc
34	34	SECTION 1 ASSEMBLY BILL 789
35	35	SECTION 1. 609.047 of the statutes is created to read:
36	36	609.047 Network directories. (1) A defined network plan or a preferred
37	37	provider plan shall make available a current provider directory of all providers in the
38	38	plan's network to enrollees no less frequently than annually and to persons
39	39	considering enrollment in the plan.
40	40	(2) A defined network plan or preferred provider plan shall maintain a current
41	41	provider directory on the plan's website and shall ensure that the directory on the
42	42	website is updated no less frequently than quarterly. The defined network plan or
43	43	preferred provider plan shall ensure that the public is able to view the website
44	44	provider directory through a clearly identifiable link or tab without creating or
45	45	accessing an account or entering a policy or contract number.
46	46	(3) A defined network plan or preferred provider plan shall provide a print copy
47	47	of the provider directory to an enrollee or prospective enrollee upon request.
48	48	(4) A defined network plan or preferred provider plan shall do all of the
49	49	following, regardless of whether the directory is electronic or in print:
50	50	(a) Provide information in each directory on providers for each of the plan's
51	51	covered services.
52	52	(b) Prominently indicate in each directory which providers are accepting new
53	53	patients at the time the directory is updated.
54	54	(c) Accommodate the communication needs of persons with disabilities and
55	55	persons with limited proficiency in English.
56	56	(END)
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