| 1 | 1 | | LRB-0435/1 |
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| 2 | 2 | | JPC:emw |
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| 3 | 3 | | 2023 - 2024 LEGISLATURE |
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| 4 | 4 | | 2023 ASSEMBLY BILL 790 |
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| 5 | 5 | | December 8, 2023 - Introduced by Representatives J. ANDERSON, BARE, CLANCY, |
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| 6 | 6 | | CONSIDINE, DRAKE, JACOBSON, JOERS, MADISON, MOORE OMOKUNDE, OHNSTAD, |
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| 7 | 7 | | ORTIZ-VELEZ, PALMERI, RATCLIFF, SHANKLAND, SHELTON, SNODGRASS, STUBBS |
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| 8 | 8 | | and SUBECK, cosponsored by Senators L. JOHNSON, LARSON and SPREITZER. |
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| 9 | 9 | | Referred to Committee on Insurance. |
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| 10 | 10 | | ***AUTHORS SUBJECT TO CHANGE*** |
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| 11 | 11 | | AN ACT to create 609.896 and 632.895 (16w) of the statutes; relating to: |
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| 12 | 12 | | coverage of tests and ancillary procedures for services for which health |
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| 13 | 13 | | insurance coverage is mandated. |
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| 14 | 14 | | Analysis by the Legislative Reference Bureau |
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| 15 | 15 | | This bill requires health insurance policies, known in the bill as disability |
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| 16 | 16 | | insurance policies, and governmental self-insured health plans to cover tests and |
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| 17 | 17 | | ancillary procedures needed to provide a product or service that the policy or plan is |
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| 18 | 18 | | required to cover under state law. Examples of products or services that policies and |
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| 19 | 19 | | plans are required to cover under current state law include home care, skilled |
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| 20 | 20 | | nursing care, kidney disease treatment, equipment and supplies for diabetes |
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| 21 | 21 | | treatment, mammograms, maternity coverage, lead poisoning screening, |
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| 22 | 22 | | temporomandibular disorder treatment, autism spectrum disorder treatment, |
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| 23 | 23 | | breast reconstruction, immunizations, hearing aids and cochlear implants, |
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| 24 | 24 | | colorectal cancer screening, and contraceptives. |
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| 25 | 25 | | This proposal may contain a health insurance mandate requiring a social and |
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| 26 | 26 | | financial impact report under s. 601.423, stats. |
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| 27 | 27 | | The people of the state of Wisconsin, represented in senate and assembly, do |
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| 28 | 28 | | enact as follows: |
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| 29 | 29 | | SECTION 1. 609.896 of the statutes is created to read: |
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| 33 | 33 | | 4 - 2 -2023 - 2024 Legislature LRB-0435/1 |
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| 34 | 34 | | JPC:emw |
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| 35 | 35 | | SECTION 1 ASSEMBLY BILL 790 |
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| 36 | 36 | | 609.896 Tests and ancillary procedures. Defined network plans and |
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| 37 | 37 | | preferred provider plans are subject to s. 632.895 (16w). |
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| 38 | 38 | | SECTION 2. 632.895 (16w) of the statutes is created to read: |
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| 39 | 39 | | 632.895 (16w) TESTS AND ANCILLARY PROCEDURES. (a) Every disability insurance |
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| 40 | 40 | | policy and every self-insured health plan of the state or a county, city, village, town, |
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| 41 | 41 | | or school district that is required to cover a product or service under this section shall |
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| 42 | 42 | | provide coverage of any tests or ancillary procedures necessary to provide that |
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| 43 | 43 | | product or service under this section. |
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| 44 | 44 | | (b) The coverage required under this subsection may be subject to any |
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| 45 | 45 | | limitations, exclusions, or cost-sharing provisions that apply generally under the |
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| 46 | 46 | | disability insurance policy or self-insured health plan. |
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| 47 | 47 | | (END) |
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