AB50-ASA2-AA8,182,222(a) For policies and plans containing provisions inconsistent with ss. 40.51 23(8m), 609.718, and 632.87 (1), (4), and (4e), the treatment of ss. 40.51 (8m), 609.718, 24and 632.87 (1), (4), and (4e) first applies to policy or plan years beginning on
1January 1 of the year following the year in which this paragraph takes effect, except 2as provided in par. (b). AB50-ASA2-AA8,182,83(b) For policies and plans that are affected by a collective bargaining 4agreement containing provisions inconsistent with ss. 40.51 (8m), 609.718, and 5632.87 (1), (4), and (4e), the treatment of ss. 40.51 (8m), 609.718, and 632.87 (1), (4), 6and (4e) first applies to policy or plan years beginning on the effective date of this 7paragraph or on the day on which the collective bargaining agreement is entered 8into, extended, modified, or renewed, whichever is later. AB50-ASA2-AA8,182,1210(1) Dental therapist coverage. The treatment of ss. 40.51 (8m), 609.718, 11and 632.87 (1), (4), and (4e) and Section 9323 (1) of this act take effect on the first 12day of the 4th month beginning after publication.”. AB50-ASA2-AA8,182,2015(1) Alzheimer's disease training and information grants. In the 16schedule under s. 20.005 (3) for the appropriation to the department of health 17services under s. 20.435 (1) (bg), the dollar amount for fiscal year 2025-26 is 18increased by $50,000 and the dollar amount for fiscal year 2026-27 is increased by 19$50,000 to increase funding for the Alzheimer's disease training and information 20grants.”. AB50-ASA2-AA8,183,42340.51 (8) Every health care coverage plan offered by the state under sub. (6)
1shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.722, 2632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 3632.85, 632.853, 632.855, 632.861, 632.867, 632.87 (3) to (6) (7), 632.885, 632.89, 4632.895 (5m) and (8) to (17), and 632.896. AB50-ASA2-AA8,183,9640.51 (8m) Every health care coverage plan offered by the group insurance 7board under sub. (7) shall comply with ss. 631.95, 632.722, 632.729, 632.746 (1) to 8(8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 9632.861, 632.867, 632.87 (7), 632.885, 632.89, and 632.895 (11) to (17). AB50-ASA2-AA8,183,171166.0137 (4) Self-insured health plans. If a city, including a 1st class city, 12or a village provides health care benefits under its home rule power, or if a town 13provides health care benefits, to its officers and employees on a self-insured basis, 14the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 15632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 16632.853, 632.855, 632.861, 632.867, 632.87 (4) to (6) (7), 632.885, 632.89, 632.895 17(9) to (17), 632.896, and 767.513 (4). AB50-ASA2-AA8,183,2219120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 2049.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and 21(b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.861, 632.867, 632.87 (4) to 22(6) (7), 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4). AB50-ASA2-AA8,32823Section 328. 185.983 (1) (intro.) of the statutes is amended to read: AB50-ASA2-AA8,184,724185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a
1cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 2646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 3601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 4631.95, 632.72 (2), 632.722, 632.729, 632.745 to 632.749, 632.775, 632.79, 632.795, 5632.798, 632.85, 632.853, 632.855, 632.861, 632.867, 632.87 (2) to (6) (7), 632.885, 6632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 7635, 645, and 646, but the sponsoring association shall: AB50-ASA2-AA8,184,119609.713 Qualified treatment trainee coverage. Limited service health 10organizations, preferred provider plans, and defined network plans are subject to s. 11632.87 (7). AB50-ASA2-AA8,184,1313632.87 (7) (a) In this subsection: AB50-ASA2-AA8,184,14141. “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp). AB50-ASA2-AA8,184,16152. “Qualified treatment trainee” has the meaning given in s. DHS 35.03 16(17m), Wis. Adm. Code. AB50-ASA2-AA8,184,2117(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. AB50-ASA2-AA8,184,2323(1) Qualified treatment trainee coverage. AB50-ASA2-AA8,185,424(a) For policies and plans containing provisions inconsistent with these
1sections, the treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 2(1) (intro.), 609.713, and 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). AB50-ASA2-AA8,185,105(b) For policies and plans that are affected by a collective bargaining 6agreement containing provisions inconsistent with these sections, the treatment of 7ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 8632.87 (7) first applies to policy or plan years beginning on the effective date of this 9paragraph or on the day on which the collective bargaining agreement is entered 10into, extended, modified, or renewed, whichever is later. AB50-ASA2-AA8,185,1512(1) Qualified treatment trainee coverage. The treatment of ss. 40.51 (8) 13and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 632.87 (7) and 14Section 9323 (1) of this act take effect on the first day of the 4th month beginning 15after publication.”. AB50-ASA2-AA8,185,221840.51 (8) Every health care coverage plan offered by the state under sub. (6) 19shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.722, 20632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 21632.85, 632.853, 632.855, 632.861, 632.867, 632.87 (3) to (6) and (8), 632.885, 22632.89, 632.895 (5m) and (8) to (17), and 632.896. AB50-ASA2-AA8,186,4
140.51 (8m) Every health care coverage plan offered by the group insurance 2board under sub. (7) shall comply with ss. 631.95, 632.722, 632.729, 632.746 (1) to 3(8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 4632.861, 632.867, 632.87 (8), 632.885, 632.89, and 632.895 (11) to (17). AB50-ASA2-AA8,186,12666.0137 (4) Self-insured health plans. If a city, including a 1st class city, 7or a village provides health care benefits under its home rule power, or if a town 8provides health care benefits, to its officers and employees on a self-insured basis, 9the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 10632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 11632.853, 632.855, 632.861, 632.867, 632.87 (4) to (6) and (8), 632.885, 632.89, 12632.895 (9) to (17), 632.896, and 767.513 (4). AB50-ASA2-AA8,186,1714120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 1549.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and 16(b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.861, 632.867, 632.87 (4) to 17(6) and (8), 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4). AB50-ASA2-AA8,33518Section 335. 185.983 (1) (intro.) of the statutes is amended to read: AB50-ASA2-AA8,187,219185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a 20cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 21646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 22601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 23631.95, 632.72 (2), 632.722, 632.729, 632.745 to 632.749, 632.775, 632.79, 632.795, 24632.798, 632.85, 632.853, 632.855, 632.861, 632.867, 632.87 (2) to (6) and (8),
1632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 2620, 630, 635, 645, and 646, but the sponsoring association shall: AB50-ASA2-AA8,187,64609.714 Substance abuse counselor coverage. Limited service health 5organizations, preferred provider plans, and defined network plans are subject to s. 6632.87 (8). AB50-ASA2-AA8,187,88632.87 (8) (a) In this subsection: AB50-ASA2-AA8,187,991. “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp). AB50-ASA2-AA8,187,11102. “Substance abuse counselor” means a substance abuse counselor certified 11under s. 440.88. AB50-ASA2-AA8,187,1612(b) No policy, plan, or contract may exclude coverage for alcoholism or other 13drug abuse treatment or services provided by a substance abuse counselor within 14the scope of the substance abuse counselor’s education and training if the policy, 15plan, or contract covers the alcoholism or other drug abuse treatment or services 16when provided by another health care provider. AB50-ASA2-AA8,187,1818(1) Substance abuse counselor coverage. AB50-ASA2-AA8,188,219(a) For policies and plans containing provisions inconsistent with the 20treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 21609.714, and 632.87 (8), the treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 22(2) (g), 185.983 (1) (intro.), 609.714, and 632.87 (8) first applies to policy or plan
1years beginning on January 1 of the year following the year in which this paragraph 2takes effect, except as provided in par. (b). AB50-ASA2-AA8,188,93(b) For policies and plans that are affected by a collective bargaining 4agreement containing provisions inconsistent with the treatment of ss. 40.51 (8) 5and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.714, and 632.87 (8), the 6treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 7609.714, and 632.87 (8) first applies to policy or plan years beginning on the 8effective date of this paragraph or on the day on which the collective bargaining 9agreement is newly established, extended, modified, or renewed, whichever is later. AB50-ASA2-AA8,188,1411(1) Substance abuse counselor coverage. The treatment of ss. 40.51 (8) 12and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.714, and 632.87 (8) and 13Section 9323 (1) of this act take effect on the first day of the 4th month beginning 14after publication.”. AB50-ASA2-AA8,188,211740.51 (8) Every health care coverage plan offered by the state under sub. (6) 18shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.722, 19632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 20632.85, 632.851, 632.853, 632.855, 632.861, 632.867, 632.87 (3) to (6), 632.885, 21632.89, 632.895 (5m) and (8) to (17), and 632.896. AB50-ASA2-AA8,189,32340.51 (8m) Every health care coverage plan offered by the group insurance
1board under sub. (7) shall comply with ss. 631.95, 632.722, 632.729, 632.746 (1) to 2(8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.851, 632.853, 3632.855, 632.861, 632.867, 632.885, 632.89, and 632.895 (11) to (17). AB50-ASA2-AA8,189,11566.0137 (4) Self-insured health plans. If a city, including a 1st class city, 6or a village provides health care benefits under its home rule power, or if a town 7provides health care benefits, to its officers and employees on a self-insured basis, 8the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 9632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 10632.851, 632.853, 632.855, 632.861, 632.867, 632.87 (4) to (6), 632.885, 632.89, 11632.895 (9) to (17), 632.896, and 767.513 (4). AB50-ASA2-AA8,189,1613120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 1449.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and 15(b) 2., 632.747 (3), 632.798, 632.85, 632.851, 632.853, 632.855, 632.861, 632.867, 16632.87 (4) to (6), 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4). AB50-ASA2-AA8,34217Section 342. 185.983 (1) (intro.) of the statutes is amended to read: AB50-ASA2-AA8,190,218185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a 19cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 20646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 21601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 22631.95, 632.72 (2), 632.722, 632.729, 632.745 to 632.749, 632.775, 632.79, 632.795, 23632.798, 632.85, 632.851, 632.853, 632.855, 632.861, 632.867, 632.87 (2) to (6),
1632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 2620, 630, 635, 645, and 646, but the sponsoring association shall: AB50-ASA2-AA8,190,54609.825 Coverage of emergency ambulance services. (1) In this 5section: AB50-ASA2-AA8,190,66(a) “Ambulance service provider” has the meaning given in s. 256.01 (3). AB50-ASA2-AA8,190,107(b) “Self-insured governmental plan” means a self-insured health plan of the 8state or a county, city, village, town, or school district that has a network of 9participating providers and imposes on enrollees in the self-insured health plan 10different requirements for using providers that are not participating providers. AB50-ASA2-AA8,190,1511(2) A defined network plan, preferred provider plan, or self-insured 12governmental plan that provides coverage of emergency medical services shall 13cover emergency ambulance services provided by an ambulance service provider 14that is not a participating provider at a rate that is not lower than the greatest rate 15that is any of the following: AB50-ASA2-AA8,190,1716(a) A rate that is set or approved by a local governmental entity in the 17jurisdiction in which the emergency ambulance services originated. AB50-ASA2-AA8,190,2318(b) A rate that is 400 percent of the current published rate for the provided 19emergency ambulance services established by the federal centers for medicare and 20medicaid services under title XVIII of the federal Social Security Act, 42 USC 1395 21et seq., in the same geographic area or a rate that is equivalent to the rate billed by 22the ambulance service provider for emergency ambulance services provided, 23whichever is less. AB50-ASA2-AA8,191,3
1(c) The contracted rate at which the defined network plan, preferred provider 2plan, or self-insured governmental plan would reimburse a participating 3ambulance service provider for the same emergency ambulance services. AB50-ASA2-AA8,191,94(3) No defined network plan, preferred provider plan, or self-insured 5governmental plan may impose a cost-sharing amount on an enrollee for emergency 6ambulance services provided by an ambulance service provider that is not a 7participating provider at a rate that is greater than the requirements that would 8apply if the emergency ambulance services were provided by a participating 9ambulance service provider. AB50-ASA2-AA8,191,1310(4) No ambulance service provider that receives reimbursement under this 11section may bill an enrollee for any additional amount for emergency ambulance 12services except for any copayment, coinsurance, deductible, or other cost-sharing 13responsibilities required to be paid by the enrollee. AB50-ASA2-AA8,191,1514(5) For purposes of this section, “emergency ambulance services” does not 15include air ambulance services. AB50-ASA2-AA8,191,1817632.851 Reimbursement of emergency ambulance services. (1) In this 18section: AB50-ASA2-AA8,191,1919(a) “Ambulance service provider” has the meaning given in s. 256.01 (3). AB50-ASA2-AA8,191,2320(b) “Clean claim” means a claim that has no defect of impropriety, including a 21lack of required substantiating documentation or any particular circumstance that 22requires special treatment that prevents timely payment from being made on the 23claim. AB50-ASA2-AA8,192,1
1(c) “Emergency medical responder” has the meaning given in s. 256.01 (4p). AB50-ASA2-AA8,192,32(d) “Emergency medical services practitioner” has the meaning given in s. 3256.01 (5). AB50-ASA2-AA8,192,44(e) “Firefighter” has the meaning given in s. 36.27 (3m) (a) 1m. AB50-ASA2-AA8,192,55(f) “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp). AB50-ASA2-AA8,192,66(g) “Law enforcement officer” has the meaning given in s. 165.85 (2) (c). AB50-ASA2-AA8,192,77(h) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c). AB50-ASA2-AA8,192,138(2) (a) A disability insurance policy or self-insured health plan shall, within 930 days after receipt of a clean claim for covered emergency ambulance services, 10promptly remit payment for the covered emergency ambulance services directly to 11the ambulance service provider. No disability insurance policy or self-insured 12health plan may send a payment for covered emergency ambulance services to an 13enrollee. AB50-ASA2-AA8,192,1814(b) A disability insurance policy or self-insured health plan shall respond to a 15claim for covered emergency ambulance services that is not a clean claim by sending 16a written notice, within 30 days after receipt of the claim, acknowledging the date of 17receipt of the claim and informing the ambulance service provider of one of the 18following:
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