DOA:......Lessner, BB0042 - Qualified Treatment Trainee Coverage
For 2025-2027 Budget -- Not Ready For Introduction
An Act ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
INSURANCE
Coverage of treatment or services provided by qualified treatment trainees
This bill prohibits any health insurance plan from excluding coverage for mental health or behavioral health treatment or services provided by a qualified treatment trainee within the scope of the qualified treatment trainee’s education and training if the health insurance plan covers the mental health or behavioral health treatment or services when provided by another health care provider. “Qualified treatment trainee” is defined under current law to mean either a graduate student who is enrolled in an accredited institution in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field or a person with a graduate degree from an accredited institution and course work in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field who has not yet completed the applicable supervised practice requirements described under the administrative code.
This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
Section 1. 40.51 (8) of the statutes is amended to read:
40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.722, 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.7498, 632.798, 632.83, 632.835, 632.848, 632.85, 632.851, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (3) to (6) (8), 632.871, 632.885, 632.89, 632.891, 632.895 (5m) and (8) to (17), and 632.896.
****Note: This is reconciled s. 40.51 (8). This Section has been affected by drafts with the following LRB numbers: -0863/P1, -0869/P1, -0871/P1, -0890/P1, -1562/P1, -1658/P1, -1660/P1, and -1669/P1.
Section 2. 40.51 (8m) of the statutes is amended to read:
40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.722, 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.7498, 632.798, 632.83, 632.835, 632.848, 632.85, 632.851, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (4e), (7), and (8), 632.871, 632.885, 632.89, 632.891, and 632.895 (11) to (17).
****Note: This is reconciled s. 40.51 (8m). This Section has been affected by drafts with the following LRB numbers: -0863/P1, -0865/P1, -0869/P1, -0871/P1, -0890/P1, -1562/P1, -1658/P1, -1660/P1, and -1669/P1.
Section 3. 66.0137 (4) of the statutes is amended to read:
66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.7498, 632.798, 632.848, 632.85, 632.851, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (4) to (6) (8), 632.871, 632.885, 632.89, 632.891, 632.895 (9) to (17), 632.896, and 767.513 (4).
****Note: This is reconciled s. 66.0137 (4). This Section has been affected by drafts with the following LRB numbers: -0863/P1, -0869/P1, -0871/P1, -0890/P1, -1562/P1, -1658/P1, -1660/P1, and -1669/P1.
Section 4. 120.13 (2) (g) of the statutes is amended to read:
120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.7498, 632.798, 632.848, 632.85, 632.851, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (4) to (6) (8), 632.871, 632.885, 632.89, 632.891, 632.895 (9) to (17), 632.896, and 767.513 (4).
****Note: This is reconciled s. 66.0137 (4). This Section has been affected by drafts with the following LRB numbers: -0863/P1, -0869/P1, -0871/P1, -0890/P1, -1562/P1, -1658/P1, 1660/P1, and -1669/P1.
Section 5. 185.983 (1) (intro.) of the statutes is amended to read:
185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 631.95, 632.72 (2), 632.722, 632.729, 632.745 to 632.749, 632.7498, 632.775, 632.79, 632.795, 632.798, 632.848, 632.85, 632.851, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (2) to (6) (8), 632.871, 632.885, 632.89, 632.891, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but the sponsoring association shall:
****Note: This is reconciled s. 66.0137 (4). This Section has been affected by drafts with the following LRB numbers: -0863/P1, -0869/P1, -0871/P1, -0890/P1, -1562/P1, -1658/P1, -1660/P1, and -1669/P1.
Section 6. 609.713 of the statutes is created to read:
609.713 Qualified treatment trainee coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (7).
Section 7. 632.87 (7) of the statutes is created to read:
632.87 (7) (a) In this subsection:
1. “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp).
2. “Qualified treatment trainee” has the meaning given in s. DHS 35.03 (17m), Wis. Adm. Code.
(b) No policy, plan, or contract may exclude coverage for mental health or behavioral health treatment or services provided by a qualified treatment trainee within the scope of the qualified treatment trainee’s education and training if the policy, plan, or contract covers the mental health or behavioral health treatment or services when provided by another health care provider.
Section 9323. Initial applicability; Insurance.
(1) Qualified treatment trainee coverage.
(a) For policies and plans containing provisions inconsistent with ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 632.87 (7), the treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 632.87 (7) first applies to policy or plan years beginning on January 1 of the year following the year in which this paragraph takes effect, except as provided in par. (b).
(b) For policies and plans that are affected by a collective bargaining agreement containing provisions inconsistent with ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 632.87 (7), the treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 632.87 (7) first applies to policy or plan years beginning on the effective date of this paragraph or on the day on which the collective bargaining agreement is entered into, extended, modified, or renewed, whichever is later.
Section 9423. Effective dates; Insurance.
(1) Qualified treatment trainee coverage. The treatment of ss. 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.713, and 632.87 (7) and Section 9323 (1) of this act take effect on the first day of the 4th month beginning after publication.
(end)
