AB50-ASA2-AA8,171,7546.48 (33) Diaper bank grants. The department may distribute not more 6than $500,000 in each fiscal year as grants to diaper banks to provide diapers to 7families in need. AB50-ASA2-AA8,171,139(1) Diaper bank grants. In the schedule under s. 20.005 (3) for the 10appropriation to the department of health services under s. 20.435 (1) (b), the dollar 11amount for fiscal year 2025-26 is increased by $500,000 and the dollar amount for 12fiscal year 2026-27 is increased by $500,000 to provide grants to diaper banks 13under s. 46.48 (33).”. AB50-ASA2-AA8,171,1716601.31 (1) (nv) For issuing or renewing a license as a pharmaceutical 17representative under s. 632.863, an amount to be set by the commissioner by rule. AB50-ASA2-AA8,171,2019632.863 Pharmaceutical representatives. (1) Definitions. In this 20section: AB50-ASA2-AA8,171,2321(a) “Health care professional” means a physician or other health care 22practitioner who is licensed to provide health care services or to prescribe 23pharmaceutical or biologic products. AB50-ASA2-AA8,172,2
1(b) “Pharmaceutical” means a medication that may legally be dispensed only 2with a valid prescription from a health care professional. AB50-ASA2-AA8,172,53(c) “Pharmaceutical representative” means an individual who markets or 4promotes pharmaceuticals to health care professionals on behalf of a 5pharmaceutical manufacturer for compensation. AB50-ASA2-AA8,172,136(2) Licensure. Beginning on the first day of the 12th month beginning after 7the effective date of this subsection .... [LRB inserts date], no individual may act as 8a pharmaceutical representative in this state without being licensed by the 9commissioner as a pharmaceutical representative under this subsection. In order 10to obtain a license under this subsection, the individual shall apply to the 11commissioner in the form and manner prescribed by the commissioner and shall 12pay the fee under s. 601.31 (1) (nv). The term of a license issued under this 13subsection is one year, and the license is renewable. AB50-ASA2-AA8,172,1614(3) Display of license. A pharmaceutical representative licensed under sub. 15(2) shall display the pharmaceutical representative’s license during each visit with 16a health care professional. AB50-ASA2-AA8,172,2017(4) Enforcement. (a) Any individual who violates this section or any rules 18promulgated under this section shall be fined not less than $1,000 nor more than 19$3,000 for each offense. Each day of continued violation constitutes a separate 20offense. AB50-ASA2-AA8,173,221(b) The commissioner may suspend or revoke the license of a pharmaceutical 22representative who violates this section or any rules promulgated under this 23section. A suspended or revoked license under this paragraph may not be
1reinstated until the pharmaceutical representative remedies all violations related 2to the suspension or revocation and pays all assessed penalties and fees. AB50-ASA2-AA8,173,53(5) Rules. The commissioner shall promulgate rules to implement this 4section, including rules that require pharmaceutical representatives to complete 5continuing educational coursework as a condition of licensure.”. AB50-ASA2-AA8,173,108601.31 (1) (mv) For initial issuance or renewal of a license as a pharmacy 9benefit management broker or consultant under s. 628.495, amounts set by the 10commissioner by rule. AB50-ASA2-AA8,173,1412628.495 Pharmacy benefit management broker and consultant 13licenses. (1) Definition. In this section, “pharmacy benefit manager” has the 14meaning given in s. 632.865 (1) (c). AB50-ASA2-AA8,173,1915(2) License required. Beginning on the first day of the 12th month 16beginning after the effective date of this subsection .... [LRB inserts date], no 17individual may act as a pharmacy benefit management broker or consultant and no 18individual may act to procure the services of a pharmacy benefit manager on behalf 19of a client without being licensed by the commissioner under this section. AB50-ASA2-AA8,173,2220(3) Rules. The commissioner may promulgate rules to establish criteria and 21procedures for initial licensure and renewal of licensure and to implement licensure 22under this section.”. AB50-ASA2-AA8,174,52632.865 (2m) Fiduciary duty and disclosures to health benefit plan 3sponsors. (a) A pharmacy benefit manager owes a fiduciary duty to the health 4benefit plan sponsor to act according to the health benefit plan sponsor’s 5instructions and in the best interests of the health benefit plan sponsor. AB50-ASA2-AA8,174,96(b) A pharmacy benefit manager shall annually provide, no later than the 7date and using the method prescribed by the commissioner by rule, the health 8benefit plan sponsor all of the following information from the previous calendar 9year: AB50-ASA2-AA8,174,11101. The indirect profit received by the pharmacy benefit manager from owning 11any interest in a pharmacy or service provider. AB50-ASA2-AA8,174,13122. Any payment made by the pharmacy benefit manager to a consultant or 13broker who works on behalf of the health benefit plan sponsor. AB50-ASA2-AA8,174,17143. From the amounts received from all drug manufacturers, the amounts 15retained by the pharmacy benefit manager, and not passed through to the health 16benefit plan sponsor, that are related to the health benefit plan sponsor’s claims or 17bona fide service fees. AB50-ASA2-AA8,174,22184. The amounts, including pharmacy access and audit recovery fees, received 19from all pharmacies that are in the pharmacy benefit manager’s network or have a 20contract to be in the network and, from these amounts, the amount retained by the 21pharmacy benefit manager and not passed through to the health benefit plan 22sponsor.”. AB50-ASA2-AA8,175,32609.74 Coverage of infertility services. Defined network plans and 3preferred provider plans are subject to s. 632.895 (15m). AB50-ASA2-AA8,175,55632.895 (15m) Coverage of infertility services. (a) In this subsection: AB50-ASA2-AA8,175,1161. “Diagnosis of and treatment for infertility” means any recommended 7procedure or medication to treat infertility at the direction of a physician that is 8consistent with established, published, or approved medical practices or 9professional guidelines from the American College of Obstetricians and 10Gynecologists, or its successor organization, or the American Society for 11Reproductive Medicine, or its successor organization. AB50-ASA2-AA8,175,13122. “Infertility” means a disease, condition, or status characterized by any of 13the following: AB50-ASA2-AA8,175,1814a. The failure to establish a pregnancy or carry a pregnancy to a live birth 15after regular, unprotected sexual intercourse for, if the woman is under the age of 1635, no longer than 12 months or, if the woman is 35 years of age or older, no longer 17than 6 months, including any time during those 12 months or 6 months that the 18woman has a pregnancy that results in a miscarriage. AB50-ASA2-AA8,175,2019b. An individual’s inability to reproduce either as a single individual or with a 20partner without medical intervention. AB50-ASA2-AA8,175,2221c. A physician’s findings based on a patient’s medical, sexual, and 22reproductive history, age, physical findings, or diagnostic testing. AB50-ASA2-AA8,176,2
13. “Self-insured health plan” means a self-insured health plan of the state or 2a county, city, village, town, or school district. AB50-ASA2-AA8,176,934. “Standard fertility preservation service” means a procedure that is 4consistent with established medical practices or professional guidelines published 5by the American Society for Reproductive Medicine, or its successor organization, or 6the American Society of Clinical Oncology, or its successor organization, for a 7person who has a medical condition or is expected to undergo medication therapy, 8surgery, radiation, chemotherapy, or other medical treatment that is recognized by 9medical professionals to cause a risk of impairment to fertility. AB50-ASA2-AA8,176,1710(b) Subject to pars. (c) to (e), every disability insurance policy and self-insured 11health plan that provides coverage for medical or hospital expenses shall cover 12diagnosis of and treatment for infertility and standard fertility preservation 13services. Coverage required under this paragraph includes at least 4 completed 14oocyte retrievals with unlimited embryo transfers, in accordance with the 15guidelines of the American Society for Reproductive Medicine, or its successor 16organization, and single embryo transfer when recommended and medically 17appropriate. AB50-ASA2-AA8,176,1918(c) 1. A disability insurance policy or self-insured health plan may not do any 19of the following: AB50-ASA2-AA8,176,2220a. Impose any exclusion, limitation, or other restriction on coverage required 21under par. (b) based on a covered individual’s participation in fertility services 22provided by or to a 3rd party. AB50-ASA2-AA8,177,323b. Impose any exclusion, limitation, or other restriction on coverage of
1medications that are required to be covered under par. (b) that are different from 2those imposed on any other prescription medications covered under the policy or 3plan. AB50-ASA2-AA8,177,104c. Impose any exclusion, limitation, cost-sharing requirement, benefit 5maximum, waiting period, or other restriction on coverage that is required under 6par. (b) of diagnosis of and treatment for infertility and standard fertility 7preservation services that is different from an exclusion, limitation, cost-sharing 8requirement, benefit maximum, waiting period, or other restriction imposed on 9benefits for services that are covered by the policy or plan and that are not related to 10infertility. AB50-ASA2-AA8,177,14112. A disability insurance policy or self-insured health plan shall provide 12coverage required under par. (b) to any covered individual under the policy or plan, 13including any covered spouse or nonspouse dependent, to the same extent as other 14pregnancy-related benefits covered under the policy or plan. AB50-ASA2-AA8,177,2015(d) The commissioner, after consulting with the department of health services 16on appropriate treatment for infertility, shall promulgate any rules necessary to 17implement this subsection. Before the promulgation of rules, disability insurance 18policies and self-insured health plans are considered to comply with the coverage 19requirements of par. (b) if the coverage conforms to the standards of the American 20Society for Reproductive Medicine. AB50-ASA2-AA8,177,2221(e) This subsection does not apply to a disability insurance policy that is 22described under s. 632.745 (11) (b) 1. to 12. AB50-ASA2-AA8,178,1
1(1) Coverage of infertility services. AB50-ASA2-AA8,178,52(a) For policies and plans containing provisions inconsistent with these 3sections, the treatment of ss. 609.74 and 632.895 (15m) first applies to policy or 4plan years beginning on January 1 of the year following the year in which this 5paragraph takes effect, except as provided in pars. (b) and (c). AB50-ASA2-AA8,178,106(b) For policies and plans that have a term greater than one year and contain 7provisions inconsistent with these sections, the treatment of ss. 609.74 and 632.895 8(15m) first applies to policy or plan years beginning on January 1 of the year 9following the year in which the policy or plan is extended, modified, or renewed, 10whichever is later. AB50-ASA2-AA8,178,1511(c) For policies and plans that are affected by a collective bargaining 12agreement containing provisions inconsistent with these sections, the treatment of 13ss. 609.74 and 632.895 (15m) first applies to policy or plan years beginning on the 14effective date of this paragraph or on the day on which the collective bargaining 15agreement is entered into, extended, modified, or renewed, whichever is later. AB50-ASA2-AA8,178,1917(1) Coverage of infertility services. The treatment of ss. 609.74 and 18632.895 (15m) and Section 9323 (1) of this act take effect on the first day of the 4th 19month beginning after publication.”. AB50-ASA2-AA8,179,522(1) MyWisconsin ID - IT security. In the schedule under s. 20.005 (3) for the 23appropriation to the department of health services under s. 20.435 (1) (a), the dollar
1amount for fiscal year 2025-26 is increased by $1,432,400 to develop the 2MyWisconsin identification account management system. In the schedule under s. 320.005 (3) for the appropriation to the department of health services under s. 420.435 (1) (a), the dollar amount for fiscal year 2026-27 is increased by $477,500 to 5develop the MyWisconsin identification account management system.”. AB50-ASA2-AA8,179,98632.895 (17) (b) 1m. Oral contraceptives that are lawfully furnished over the 9counter without a prescription. AB50-ASA2-AA8,179,1111(1) Coverage of over-the-counter oral contraceptives. AB50-ASA2-AA8,179,1512(a) For policies and plans containing provisions inconsistent with s. 632.895 13(17) (b) 1m., the treatment of s. 632.895 (17) (b) 1m. first applies to policy or plan 14years beginning on January 1 of the year following the year in which this paragraph 15takes effect, except as provided in par. (b). AB50-ASA2-AA8,179,2016(b) For policies and plans that are affected by a collective bargaining 17agreement containing provisions inconsistent with s. 632.895 (17) (b) 1m., the 18treatment of s. 632.895 (17) (b) 1m. first applies to policy or plan years beginning on 19the effective date of this paragraph or on the day on which the collective bargaining 20agreement is newly established, extended, modified, or renewed, whichever is later. AB50-ASA2-AA8,179,2422(1) Coverage of over-the-counter oral contraceptives. The treatment 23of s. 632.895 (17) (b) 1m. and Section 9323 (1) of this act take effect on the first day 24of the 4th month beginning after publication.”. AB50-ASA2-AA8,180,5346.74 Grants for mobile dental clinics. The department shall award 4grants to community health centers, as defined in s. 250.15 (1) (a), to procure and 5operate mobile dental clinics. AB50-ASA2-AA8,180,137(1) Mobile dental clinic grants. In the schedule under s. 20.005 (3) for the 8appropriation to the department of health services under s. 20.435 (4) (b), the dollar 9amount for fiscal year 2026-27 is increased by $1,898,700 to fund grants to 3 10community health centers to enable them to each procure and operate a mobile 11dental clinic, and to reflect an increase in dental services utilization under the 12Medical Assistance program under subch. IV of ch. 49 resulting from the mobile 13dental clinics.”. AB50-ASA2-AA8,180,191640.51 (8m) Every health care coverage plan offered by the group insurance 17board under sub. (7) shall comply with ss. 631.95, 632.722, 632.729, 632.746 (1) to 18(8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 19632.861, 632.867, 632.87 (4e), 632.885, 632.89, and 632.895 (11) to (17). AB50-ASA2-AA8,180,2221609.718 Dental therapist coverage. Limited service health organizations, 22preferred provider plans, and defined network plans are subject to s. 632.87 (4e). AB50-ASA2-AA8,181,5
1632.87 (1) No insurer may refuse to provide or pay for benefits for health care 2services provided by a licensed health care professional on the ground that the 3services were not rendered by a physician as defined in s. 990.01 (28), unless the 4contract clearly excludes services by such practitioners, but no contract or plan may 5exclude services in violation of sub. (2), (2m), (3), (4), (4e), (4m), (5), or (6). AB50-ASA2-AA8,181,117632.87 (4) No policy, plan or contract may exclude coverage for diagnosis and 8treatment of a condition or complaint by a licensed dentist or dental therapist 9within the scope of the dentist’s or dental therapist’s license, if the policy, plan or 10contract covers diagnosis and treatment of the condition or complaint by another 11health care provider, as defined in s. 146.81 (1) (a) to (p). AB50-ASA2-AA8,181,1413632.87 (4e) In this subsection, “dental therapist” means an individual 14licensed under s. 447.04 (1m). AB50-ASA2-AA8,181,1915(b) No policy, plan, or contract may exclude coverage for dental services, 16treatments, or procedures provided by a dental therapist within the scope of the 17dental therapist’s license if the policy, plan, or contract covers the dental services, 18treatments, or procedures when provided by another health care provider, as 19defined in s. 146.81 (1) (a) to (hp). AB50-ASA2-AA8,181,2121(1) Dental therapist coverage.
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