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10 01, 2023

SB 559 (see companion bill AB 571)

An Act relating to: allowing discounts for prompt payment of health care fees. This bill specifies that discounts for prompt payment do not violate prohibitions on reducing certain fees for health care services. Under current state law, a health care provider is prohibited from reducing or offering to reduce coinsurance or a deductible of an individual covered under a health insurance policy that is required under the terms of the policy, unless paying the amount would be an undue financial hardship to the individual. This bill specifies as exempt from that and any other [...]

SB 559 (see companion bill AB 571)
10 01, 2023

SB 716 (see companion bill AB 745)

An Act relating to: prohibiting step therapy protocols for certain cancer drugs. This bill prohibits an insurer, pharmacy benefit manager, or utilization review organization from requiring a step therapy protocol for a drug that is prescribed for metastatic cancer or a cancer-associated condition and the use of the drug is approved by the federal Food and Drug Administration, consistent with best practices for the treatment of metastatic cancer or the cancer-associated condition, and supported by peer-reviewed publications that are based on evidence-based research.

SB 716 (see companion bill AB 745)
10 01, 2023

AB 972 (see companion bill SB 972)

An relating to: prior authorization for coverage of physical therapy and other services under health plans. Under the bill, every health plan, when requested to reauthorize coverage, must issue a decision on reauthorization of coverage of a service for which prior authorization was previously obtained within 48 hours or prior authorization is assumed to be granted. Health plans are prohibited under the bill from requiring prior authorization for the first 12 physical therapy visits with no duration of care limitation or for any nonpharmacologic management of pain provided through care related to physical therapy [...]

AB 972 (see companion bill SB 972)
10 01, 2023

SB 972 (see companion bill AB 972)

An relating to: prior authorization for coverage of physical therapy and other services under health plans. Under the bill, every health plan, when requested to reauthorize coverage, must issue a decision on reauthorization of coverage of a service for which prior authorization was previously obtained within 48 hours or prior authorization is assumed to be granted. Health plans are prohibited under the bill from requiring prior authorization for the first 12 physical therapy visits with no duration of care limitation or for any nonpharmacologic management of pain provided through care related to physical therapy [...]

SB 972 (see companion bill AB 972)
10 01, 2023

SB 552 (see companion bill AB 559)

An Act relating to: eliminating cost sharing for prescription drugs under the Medical Assistance program. Under current law, certain persons who receive health services under the Medical Assistance program, also known in this state as BadgerCare, are required to contribute a cost sharing payment to the cost of certain health services. This bill eliminates all cost sharing payments for prescription drugs under the Medical Assistance program.

SB 552 (see companion bill AB 559)
10 01, 2023

SB 129

The bill prohibits, until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or June 30, 2021, whichever is earlier, a defined network plan, including a health maintenance organization, or preferred provider plan from requiring an enrollee of the plan to pay more for a service, treatment, or supply provided by an out-of-network provider than if the service, treatment, or supply is provided by an in-network provider. This prohibition applies to any service, treatment, or supply that is related to the diagnosis of or treatment [...]

SB 129
10 01, 2023

AB 1

The bill prohibits, until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier, a defined network plan, including a health maintenance organization, or preferred provider plan from requiring an enrollee of the plan to pay more for a service, treatment, or supply provided by an out-of-network provider than if the service, treatment, or supply is provided by an in-network provider. This prohibition applies to any service, treatment, or supply that is related to the diagnosis of or [...]

AB 1
10 01, 2023

AB 34 (see companion bill SB 40)

An Act relating to: coverage of individuals with preexisting conditions and benefit limits under health plans. Every individual health benefit plan must accept every individual in this state who applies for coverage and every group health benefit plan must accept every employer in this state that applies for coverage, regardless of whether any individual or employee has a preexisting condition. A health benefit plan offered on the individual or small employer market or a self-insured governmental health plan may not vary premium rates for a specific plan on any basis except age, tobacco use, [...]

AB 34 (see companion bill SB 40)
10 01, 2023

SB 40 (see companion bill AB 34)

An Act relating to: coverage of individuals with preexisting conditions and benefit limits under health plans. Every individual health benefit plan must accept every individual in this state who applies for coverage and every group health benefit plan must accept every employer in this state that applies for coverage, regardless of whether any individual or employee has a preexisting condition. A health benefit plan offered on the individual or small employer market or a self-insured governmental health plan may not vary premium rates for a specific plan on any basis except age, tobacco use, [...]

SB 40 (see companion bill AB 34)
10 01, 2023

AB 184 (see companion bill SB 215)

An Act relating to: application of prescription drug payments to health insurance cost-sharing requirements. This bill requires health insurance policies that offer prescription drug benefits, self-insured health plans, and pharmacy benefit managers acting on behalf of policies or plans to apply amounts paid by or on behalf of a person covered underthe policy or plan for prescription drugs to any calculation of an out-of-pocket maximum amount or to any cost-sharing requirement of the policy or plan. This requirement applies regardless of whether a claim is submitted to the policy or plan to pay for [...]

AB 184 (see companion bill SB 215)
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