LRB-0436/1
JPC:cdc
2023 - 2024 LEGISLATURE
December 8, 2023 - Introduced by Representatives J. Anderson, C. Anderson,
Clancy, Drake, Emerson, Jacobson, Joers, Madison, Moore Omokunde,
Ortiz-Velez, Palmeri, Shankland, Shelton, Snodgrass, Stubbs and Subeck,
cosponsored by Senators Larson, Smith and Spreitzer. Referred to
Committee on Insurance.
AB789,1,2
1An Act to create 609.047 of the statutes;
relating to: provider directories for
2certain health plans.
Analysis by the Legislative Reference Bureau
This bill requires a defined network plan or preferred provider plan to make
available a current directory of health care providers in the plan's network of
providers to anyone considering enrollment in the plan and to the plan's enrollees at
least annually. Defined network plans and preferred provider plans are types of
managed care organizations that provide health care benefits to their enrollees. The
bill requires the plan to maintain a current provider directory on its website, to
ensure that the directory on the site is updated at least quarterly, and to ensure that
the public may view the provider directory on the site without creating or accessing
an account or entering a policy or contract number. A plan is also required by the bill
to provide information in each electronic and print directory on providers for each of
the plan's covered services, to prominently indicate in each electronic and print
directory which providers are accepting new patients at the time the directory is
updated, and to accommodate with each electronic and print directory the
communication needs of persons with disabilities and persons with limited English
proficiency.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB789,1
1Section
1. 609.047 of the statutes is created to read:
AB789,2,5
2609.047 Network directories. (1) A defined network plan or a preferred
3provider plan shall make available a current provider directory of all providers in the
4plan's network to enrollees no less frequently than annually and to persons
5considering enrollment in the plan.
AB789,2,11
6(2) A defined network plan or preferred provider plan shall maintain a current
7provider directory on the plan's website and shall ensure that the directory on the
8website is updated no less frequently than quarterly. The defined network plan or
9preferred provider plan shall ensure that the public is able to view the website
10provider directory through a clearly identifiable link or tab without creating or
11accessing an account or entering a policy or contract number.
AB789,2,13
12(3) A defined network plan or preferred provider plan shall provide a print copy
13of the provider directory to an enrollee or prospective enrollee upon request.
AB789,2,15
14(4) A defined network plan or preferred provider plan shall do all of the
15following, regardless of whether the directory is electronic or in print:
AB789,2,1716
(a) Provide information in each directory on providers for each of the plan's
17covered services.
AB789,2,1918
(b) Prominently indicate in each directory which providers are accepting new
19patients at the time the directory is updated.
AB789,2,2120
(c) Accommodate the communication needs of persons with disabilities and
21persons with limited proficiency in English.
