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SB70-AA3,61,4 13(6) Negotiation; dispute resolution. A provider or facility that is entitled to
14receive an initial payment or notice of denial under sub. (2) (c) 4. a. or (3) (c) may
15initiate, within 30 days of receiving the initial payment or notice of denial, open
16negotiations with the defined network plan, preferred provider plan, or self-insured
17governmental plan to determine a payment amount for an emergency medical
18service or other item or service for a period that terminates 30 days after initiating
19open negotiations. If the open negotiation period under this subsection terminates
20without determination of a payment amount, the provider, facility, defined network
21plan, preferred provider plan, or self-insured governmental plan may initiate,
22within the 4 days beginning on the day after the open negotiation period ends, the
23independent dispute resolution process as specified by the commissioner. If the
24independent dispute resolution decision-maker determines the payment amount,
25the party to the independent dispute resolution process whose amount was not

1selected shall pay the fees for the independent dispute resolution. If the parties to
2the independent dispute resolution reach a settlement on the payment amount, the
3parties to the independent dispute resolution shall equally divide the payment for
4the fees for the independent dispute resolution.
SB70-AA3,61,5 5(7) Continuity of care. (a) In this subsection:
SB70-AA3,61,66 1. “Continuing care patient” means an individual who is any of the following:
SB70-AA3,61,87 a. Undergoing a course of treatment for a serious and complex condition from
8a provider or facility.
SB70-AA3,61,109 b. Undergoing a course of institutional or inpatient care from a provider or
10facility.
SB70-AA3,61,1211 c. Scheduled to undergo nonelective surgery, including receipt of postoperative
12care, from a provider or facility.
SB70-AA3,61,1413 d. Pregnant and undergoing a course of treatment for the pregnancy from a
14provider or facility.
SB70-AA3,61,1615 e. Terminally ill and receiving treatment for the illness from a provider or
16facility.
SB70-AA3,61,1717 2. “Serious and complex condition” means any of the following:
SB70-AA3,61,2018 a. In the case of an acute illness, a condition that is serious enough to require
19specialized medical treatment to avoid the reasonable possibility of death or
20permanent harm.
SB70-AA3,61,2321 b. In the case of a chronic illness or condition, a condition that is
22life-threatening, degenerative, potentially disabling, or congenital and requires
23specialized medical care over a prolonged period.
SB70-AA3,62,624 (b) If an enrollee is a continuing care patient and is obtaining items or services
25from a participating provider or participating facility and the contract between the

1defined network plan, preferred provider plan, or self-insured governmental plan
2and the provider or facility is terminated because of a change in the terms of the
3participation of the provider or facility in the plan or the contract between the defined
4network plan, preferred provider plan, or self-insured governmental plan and the
5provider or facility is terminated, resulting in a loss of benefits provided under the
6plan, the plan shall do all of the following:
SB70-AA3,62,97 1. Notify each enrollee of the termination of the contract or benefits and of the
8right for the enrollee to elect to continue transitional care from the participating
9provider or participating facility under this subsection.
SB70-AA3,62,1110 2. Provide the enrollee an opportunity to notify the plan of the need for
11transitional care.
SB70-AA3,62,1812 3. Allow the enrollee to elect to continue to have the benefits provided under
13the plan under the same terms and conditions as would have applied to the item or
14service if the termination had not occurred for the course of treatment related to the
15enrollee's status as a continuing care patient beginning on the date on which the
16notice under subd. 1. is provided and ending 90 days after the date on which the
17notice under subd. 1. is provided or the date on which the enrollee is no longer a
18continuing care patient, whichever is earlier.
SB70-AA3,62,2119 (c) The provisions of s. 609.24 apply to a continuing care patient to the extent
20that s. 609.24 does not conflict with this subsection so as to limit the enrollee's rights
21under this subsection.
SB70-AA3,63,3 22(8) Rule making. The commissioner may promulgate any rules necessary to
23implement this section, including specifying the independent dispute resolution
24process under sub. (6). The commissioner may promulgate rules to modify the list
25of those items and services for which a provider may not balance bill under sub. (4)

1(c). In promulgating rules under this subsection, the commissioner may consider any
2rules promulgated by the federal department of health and human services pursuant
3to the federal No Suprises Act, 42 USC 300gg-111, et seq.
SB70-AA3,38 4Section 38. 609.24 (5) of the statutes is created to read:
SB70-AA3,63,75 609.24 (5) If an enrollee is a continuing care patient, as defined in s. 609.045
6(7) (a), and if any of the situations described under s. 609.045 (7) (b) (intro.) applies,
7all of the following apply to the enrollee's defined network plan:
SB70-AA3,63,108 (a) Subsection (1) (c) shall apply to any of the participating providers providing
9the enrollee's course of treatment under s. 609.045 (7), including the enrollee's
10primary care physician.
SB70-AA3,63,1311 (b) Subsection (1) (c) shall apply to lengthen the period in which benefits are
12provided under s. 609.045 (7) (b) 3., but shall not be applied to shorten the period in
13which benefits are provided under s. 609.045 (7) (b) 3.
SB70-AA3,63,1514 (c) Subsection (1) (d) shall not be applied in a manner that limits the enrollee's
15rights under s. 609.045 (7) (b) 3.
SB70-AA3,63,1816 (d) No plan may contract or arrange with a participating provider to provide
17notice of the termination of the participating provider's participation, pursuant to
18sub. (4).”.
SB70-AA3,63,19 19182. Page 374, line 11: after that line insert:
SB70-AA3,63,20 20 Section 39. 609.74 of the statutes is created to read:
SB70-AA3,63,22 21609.74 Coverage of infertility services. Defined network plans and
22preferred provider plans are subject to s. 632.895 (15m).
SB70-AA3,40 23Section 40. 632.895 (15m) of the statutes is created to read:
SB70-AA3,63,2424 632.895 (15m) Coverage of infertility services. (a) In this subsection:
SB70-AA3,64,6
11. “Diagnosis of and treatment for infertility” means any recommended
2procedure or medication to treat infertility at the direction of a physician that is
3consistent with established, published, or approved medical practices or professional
4guidelines from the American College of Obstetricians and Gynecologists, or its
5successor organization, or the American Society for Reproductive Medicine, or its
6successor organization.
SB70-AA3,64,87 2. “Infertility” means a disease, condition, or status characterized by any of the
8following:
SB70-AA3,64,139 a. The failure to establish a pregnancy or carry a pregnancy to a live birth after
10regular, unprotected sexual intercourse for, if the woman is under the age of 35, no
11longer than 12 months or, if the woman is 35 years of age or older, no longer than 6
12months, including any time during those 12 months or 6 months that the woman has
13a pregnancy that results in a miscarriage.
SB70-AA3,64,1514 b. An individual's inability to reproduce either as a single individual or with
15a partner without medical intervention.
SB70-AA3,64,1716 c. A physician's findings based on a patient's medical, sexual, and reproductive
17history, age, physical findings, or diagnostic testing.
SB70-AA3,64,1918 3. “Self-insured health plan" means a self-insured health plan of the state or
19a county, city, village, town, or school district.
SB70-AA3,65,220 4. “Standard fertility preservation service” means a procedure that is
21consistent with established medical practices or professional guidelines published
22by the American Society for Reproductive Medicine or its successor organization, or
23the American Society of Clinical Oncology or its successor organization, for a person
24who has a medical condition or is expected to undergo medication therapy, surgery,

1radiation, chemotherapy, or other medical treatment that is recognized by medical
2professionals to cause a risk of impairment to fertility.
SB70-AA3,65,93 (b) Subject to pars. (c) to (e), every disability insurance policy and self-insured
4health plan that provides coverage for medical or hospital expenses shall cover
5diagnosis of and treatment for infertility and standard fertility preservation
6services. Coverage required under this paragraph includes at least 4 completed
7oocyte retrievals with unlimited embryo transfers, in accordance with the guidelines
8of the American Society for Reproductive Medicine or its successor organization, and
9single embryo transfer may be used when recommended and medically appropriate.
SB70-AA3,65,1110 (c) 1. A disability insurance policy or self-insured health plan may not do any
11of the following:
SB70-AA3,65,1412 a. Impose any exclusions, limitations, or other restrictions on coverage
13required under par. (b) based on a covered individual's participation in fertility
14services provided by or to a 3rd party.
SB70-AA3,65,1815 b. Impose any exclusion, limitation, or other restriction on coverage of
16medications that are required to be covered under par. (b) that are different from
17those imposed on any other prescription medications covered under the policy or
18plan.
SB70-AA3,65,2519 c. Impose any exclusion, limitation, cost-sharing requirement, benefit
20maximum, waiting period, or other restriction on coverage that is required under
21par. (b) of diagnosis of and treatment for infertility and standard fertility
22preservation services that is different from an exclusion, limitation, cost-sharing
23requirement, benefit maximum, waiting period or other restriction imposed on
24benefits for services that are covered by the policy or plan and that are not related
25to infertility.
SB70-AA3,66,4
12. A disability insurance policy or self-insured health plan shall provide
2coverage required under par. (b) to any covered individual under the policy or plan,
3including any covered spouse or nonspouse dependent, to the same extent as other
4pregnancy-related benefits covered under the policy or plan.
SB70-AA3,66,105 (d) The commissioner, after consulting with the department of health services
6on appropriate treatment for infertility, shall promulgate any rules necessary to
7implement this subsection. Before the promulgation of rules, disability insurance
8policies and self-insured health plans are considered to comply with the coverage
9requirements of par. (b) if the coverage conforms to the standards of the American
10Society for Reproductive Medicine.
SB70-AA3,66,1211 (e) This subsection does not apply to a disability insurance policy that is a
12health benefit plan described under s. 632.745 (11) (b).
SB70-AA3,9323 13Section 9323. Initial applicability; Insurance.
SB70-AA3,66,1414 (1u) Coverage of infertility services.
SB70-AA3,66,1815 (a) For policies and plans containing provisions inconsistent with these
16sections, the treatment of ss. 609.74 and 632.895 (15m) first applies to policy or plan
17years beginning on January 1 of the year following the year in which this paragraph
18takes effect, except as provided in pars. (b ) and (c).
SB70-AA3,66,2319 (b) For policies and plans that have a term greater than one year and contain
20provisions inconsistent with these sections, the treatment of ss. 609.74 and 632.895
21(15m) first applies to policy or plan years beginning on January 1 of the year
22following the year in which the policy or plan is extended, modified, or renewed,
23whichever is later.
SB70-AA3,67,324 (c) For policies and plans that are affected by a collective bargaining agreement
25containing provisions inconsistent with these sections, the treatment of ss. 609.74

1and 632.895 (15m) first applies to policy or plan years beginning on the effective date
2of this paragraph or on the day on which the collective bargaining agreement is
3entered into, extended, modified, or renewed, whichever is later.
SB70-AA3,9423 4Section 9423. Effective dates; Insurance.
SB70-AA3,67,75 (1v) Coverage of infertility services. The treatment of ss. 609.74 and 632.895
6(15m) and Section 9323 (1u) of this act take effect on the first day of the 4th month
7beginning after publication.”.
SB70-AA3,67,8 8183. Page 374, line 11: after that line insert:
SB70-AA3,67,9 9 Section 41 . 609.713 of the statutes is created to read:
SB70-AA3,67,12 10609.713 Qualified treatment trainee coverage. Limited service health
11organizations, preferred provider plans, and defined network plans are subject to s.
12632.87 (7).
SB70-AA3,42 13Section 42 . 632.87 (7) of the statutes is created to read:
SB70-AA3,67,1414 632.87 (7) (a) In this subsection:
SB70-AA3,67,1515 1. “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp).
SB70-AA3,67,1616 2. “Qualified treatment trainee” has the meaning given in s. DHS 35.03 (17m).
SB70-AA3,67,2117 (b) No policy, plan, or contract may exclude coverage for mental health or
18behavioral health treatment or services provided by a qualified treatment trainee
19within the scope of the qualified treatment trainee's education and training if the
20policy, plan, or contract covers the mental health or behavioral health treatment or
21services when provided by another health care provider.
SB70-AA3,9323 22Section 9323. Initial applicability; Insurance.
SB70-AA3,67,2323 (1u) Qualified treatment trainee coverage.
SB70-AA3,68,4
1(a) For policies and plans containing provisions inconsistent with this section,
2the treatment of s. 632.87 (7) first applies to policy or plan years beginning on
3January 1 of the year following the year in which this paragraph takes effect, except
4as provided in par. (b).
SB70-AA3,68,95 (b) For policies and plans that are affected by a collective bargaining agreement
6containing provisions inconsistent with this section, the treatment of s. 632.87 (7)
7first applies to policy or plan years beginning on the effective date of this paragraph
8or on the day on which the collective bargaining agreement is entered into, extended,
9modified, or renewed, whichever is later.
SB70-AA3,9423 10Section 9423. Effective dates; Insurance.
SB70-AA3,68,1311 (1v) Qualified treatment trainee coverage. The treatment of s. 632.87 (7) and
12Section 9323 (1u) of this act take effect on the first day of the 4th month beginning
13after publication.”.
SB70-AA3,68,14 14184. Page 374, line 11: after that line insert:
SB70-AA3,68,15 15 Section 43. 256.08 (4) (L) of the statutes is created to read:
SB70-AA3,68,1716 256.08 (4) (L) Identify certified training programs for emergency medical
17responders.
SB70-AA3,44 18Section 44. 256.08 (5) of the statutes is created to read:
SB70-AA3,68,2219 256.08 (5) Educational standards. The department, in consultation with the
20board, may promulgate rules to establish educational standards for training
21programs for emergency medical responders and minimum examination standards
22for training programs for emergency medical responders.
SB70-AA3,45 23Section 45. 256.15 (4) (g) of the statutes is created to read:
SB70-AA3,69,4
1256.15 (4) (g) No emergency medical responder may replace an emergency
2medical technician as a member of an ambulance crew unless the emergency medical
3responder has passed the National Registry of Emergency Medical Technicians
4examination for emergency medical responders.
SB70-AA3,46 5Section 46. 256.15 (8) (b) (intro.) of the statutes is amended to read:
SB70-AA3,69,86 256.15 (8) (b) (intro.) To be eligible for initial certification as an emergency
7medical responder, except as provided in pars. (bg) and (br) and ss. 256.17 and
8256.18, an individual shall meet all of the following requirements:
SB70-AA3,47 9Section 47. 256.15 (8) (bg) of the statutes is created to read:
SB70-AA3,69,2010 256.15 (8) (bg) The department shall grant an initial certification as an
11emergency medical responder to any individual who meets the requirements under
12par. (b) 1. and 2. and successfully completes a certified training program for
13emergency medical responders identified by the department under s. 256.08 (4) (L).
14Any relevant education, training, instruction, or other experience that an applicant
15for initial certification as an emergency medical responder obtained in connection
16with any military service, as defined in s. 111.32 (12g), satisfies the completion of a
17certified training program for emergency medical responders if the applicant
18demonstrates to the satisfaction of the department that the education, training,
19instruction, or other experience obtained by the applicant is substantially equivalent
20to the certified training program for emergency medical responders.
SB70-AA3,48 21Section 48. 256.15 (8) (br) of the statutes is created to read:
SB70-AA3,69,2522 256.15 (8) (br) The department shall grant an initial certification as an
23emergency medical responder to any individual who meets the requirements under
24par. (b) 1. and 2. and passes the National Registry of Emergency Medical Technicians
25examination for emergency medical responder certification.
SB70-AA3,9419
1Section 9419. Effective dates; Health Services.
SB70-AA3,70,42 (1) Certification of emergency medical responders. The treatment of ss.
3256.08 (4) (L) and 256.15 (4) (g) and (8) (b) (intro.), (bg), and (br) takes effect on July
41, 2024.”.
SB70-AA3,70,5 5185. Page 374, line 11: after that line insert:
SB70-AA3,70,6 6 Section 49. 46.48 (33) of the statutes is created to read:
SB70-AA3,70,97 46.48 (33) Opioid antagonist funding. From the appropriation under s. 20.435
8(5) (bc), the department shall annually award up to $2,000,000 to entities for the
9purchase of opioid antagonists, as defined under s. 450.01 (13v).”.
SB70-AA3,70,10 10186. Page 374, line 11: after that line insert:
SB70-AA3,70,11 11 Section 50. 50.36 (3s) of the statutes is created to read:
SB70-AA3,70,1712 50.36 (3s) The department shall require a hospital that provides emergency
13services to have sufficient qualified personnel at all times to manage the number and
14severity of emergency department cases anticipated by the location. At all times, a
15hospital that provides emergency services shall have on-site at least one physician
16who, through education, training, and experience, specializes in emergency
17medicine.”.
SB70-AA3,70,18 18187. Page 374, line 11: after that line insert:
SB70-AA3,70,19 19 Section 51. 71.03 (9) of the statutes is created to read:
SB70-AA3,70,2220 71.03 (9) Medical Assistance coverage. (a) The department shall include the
21following questions and explanatory information on each individual income tax
22return under this section and a method for the taxpayer to respond to each question:
SB70-AA3,71,423 1. “Are you, your spouse, your dependent children, or any eligible adult child
24dependent not covered under a health insurance policy, health plan, or other health

1care coverage? `Eligible adult child dependent' means a child who is under the age
2of 26 who is a full-time student or a child who is under the age of 27 who is called
3to active duty in the national guard or armed forces reserve while enrolled as a
4full-time student.”
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