SB59,1013,10
1(c) 1. A dental therapist licensed under this chapter may provide dental
2therapy services only under the general supervision of a qualifying dentist with
3whom the dental therapist has entered into a collaborative management agreement.
4For purposes of this subdivision, general supervision of a dental therapist by a
5dentist requires that a task or procedure be performed by a dental therapist with the
6prior knowledge and consent of the dentist, but does not require the presence of the
7dentist in the office or on the premises at the time a task or procedure is being
8performed by the dental therapist and does not require prior examination or
9diagnosis of a patient by the dentist before the dental therapist provides dental
10therapy services to the patient.
SB59,1013,1711
2. A supervising dentist shall accept responsibility for all services performed
12by a dental therapist pursuant to a collaborative management agreement. If services
13needed by a patient are beyond the dental therapist's scope of practice or
14authorization under the collaborative management agreement, the dental therapist
15shall, to the extent required under the collaborative management agreement,
16consult with the supervising dentist as needed to arrange for those services to be
17provided by a dentist or another qualified health care professional.
SB59,1013,2118
(d) 1. Prior to providing any dental therapy services, a dental therapist shall
19enter into a written collaborative management agreement with a qualifying dentist
20who will serve as a supervising dentist under par. (c). The agreement must be signed
21by the dental therapist and the qualifying dentist and address all of the following:
SB59,1013,2322
a. The practice settings where services may be provided and the patient
23populations that may be served.
SB59,1014,3
1b. Any conditions or limitations on the services that may be provided by the
2dental therapist, the level of supervision required, and any circumstances requiring
3consultation prior to performing services.
SB59,1014,44
c. Age-specific and procedure-specific practice protocols.
SB59,1014,55
d. Dental record-keeping procedures.
SB59,1014,66
e. Plans for managing dental or medical emergencies.
SB59,1014,87
f. A quality assurance plan for monitoring care provided by the dental
8therapist.
SB59,1014,99
g. Protocols for administering and dispensing medications.
SB59,1014,1110
h. Criteria or protocols relating to the provision of care to patients with specific
11medical conditions, treatments, or medications.
SB59,1014,1212
i. Policies relating to supervision of dental hygienists and other staff.
SB59,1014,1513
j. A plan for the referral of patients to other dental or health care professionals
14or clinics when services needed are beyond the scope of practice or authorization of
15the dental therapist.
SB59,1014,1716
k. Whether and to what extent the dental therapist may perform services
17described in par. (b) 15.
SB59,1014,1918
2. a. A collaborative management agreement shall be limited to covering one
19qualifying dentist and one dental therapist.
SB59,1014,2120
b. A dental therapist may enter into multiple collaborative management
21agreements.
SB59,1014,2322
c. No dentist may have collaborative management agreements with more than
235 dental therapists at any time.
SB59,2050
24Section 2050
. 447.065 of the statutes is amended to read:
SB59,1015,5
1447.065 Delegation of remediable procedures and dental practices. (1) 2A dentist
or dental therapist who is licensed
to practice dentistry under this chapter
3may delegate to an individual who is not licensed under this chapter only the
4performance of remediable procedures, and only if all of the following conditions are
5met:
SB59,1015,76
(a) The unlicensed individual performs the remediable procedures in
7accordance with a treatment plan approved by the dentist
or dental therapist.
SB59,1015,98
(b) The dentist
or dental therapist is on the premises when the unlicensed
9individual performs the remediable procedures.
SB59,1015,1110
(c) The unlicensed individual's performance of the remediable procedures is
11subject to inspection by the dentist
or dental therapist.
SB59,1015,18
12(2) Subject to the requirements under s. 447.06 (2), a dentist
or dental therapist 13who is licensed
to practice dentistry under this chapter may delegate to a dental
14hygienist who is licensed to practice dental hygiene under this chapter the
15performance of remediable procedures and the administration of oral systemic
16premedications, local anesthesia, nitrous oxide inhalation analgesia, and
17subgingival sustained release chemotherapeutic agents
, to the extent the dentist or
18dental therapist has the authority to perform the activity personally.
SB59,1015,21
19(3) A dentist
or dental therapist who delegates to another individual the
20performance of any practice or remediable procedure is responsible for that
21individual's performance of that delegated practice or procedure.
SB59,2051
22Section 2051
. 447.07 (1) of the statutes is amended to read:
SB59,1016,323
447.07
(1) The examining board may, without further notice or process, limit,
24suspend, or revoke the license or certificate of any dentist
, dental therapist, or dental
25hygienist, or the registration of a mobile dentistry program registrant, who fails,
1within 60 days after the mailing of written notice to the dentist's,
dental therapist's, 2dental hygienist's, or registrant's last-known address, to renew the license,
3certificate, or registration.
SB59,2052
4Section 2052
. 447.07 (3) (intro.) of the statutes is amended to read:
SB59,1016,165
447.07
(3) (intro.) Subject to the rules promulgated under s. 440.03 (1), the
6examining board may make investigations and conduct hearings in regard to any
7alleged action of any dentist
, dental therapist, or dental hygienist, of a mobile
8dentistry program registrant, or of any other person it has reason to believe is
9engaged in or has engaged in the practice of dentistry
, dental therapy, or dental
10hygiene, or the operation of a mobile dentistry program, in this state, and may, on
11its own motion, or upon complaint in writing, reprimand any dentist
, dental
12therapist, or dental hygienist who is licensed or certified under this chapter, or any
13mobile dentistry program registrant, or deny, limit, suspend, or revoke his or her
14license or certificate, or the registration of the mobile dentistry program registrant,
15if it finds that the dentist,
dental therapist, dental hygienist, or mobile dentistry
16program registrant has done any of the following:
SB59,2053
17Section 2053
. 447.07 (3) (e) to (h) of the statutes are amended to read:
SB59,1016,2018
447.07
(3) (e) Subject to ss. 111.321, 111.322, and 111.335, been convicted of a
19crime, the circumstances of which substantially relate to the practice of dentistry
,
20dental therapy, or dental hygiene or the operation of a mobile dentistry program.
SB59,1016,2321
(f) Violated this chapter or any federal or state statute or rule that relates to
22the practice of dentistry
, dental therapy, or dental hygiene, or the operation of a
23mobile dentistry program.
SB59,1017,3
1(g) Subject to ss. 111.321, 111.322 and 111.34, practiced dentistry
, dental
2therapy, or dental hygiene while his or her ability was impaired by alcohol or other
3drugs.
SB59,1017,64
(h) Engaged in conduct that indicates a lack of knowledge of, an inability to
5apply or the negligent application of, principles or skills of dentistry
, dental therapy, 6or dental hygiene.
SB59,2054
7Section 2054
. 447.40 (intro.) of the statutes is amended to read:
SB59,1017,15
8447.40 Informed consent. (intro.) Any dentist
or dental therapist who treats
9a patient shall inform the patient about the availability of reasonable alternate
10modes of treatment and about the benefits and risks of these treatments. The
11reasonable dentist standard is the standard for informing a patient under this
12section. The reasonable dentist standard requires disclosure only of information
13that a reasonable dentist would know and disclose under the circumstances. The
14dentist's
or dental therapist's duty to inform the patient under this section does not
15require disclosure of any of the following:
SB59,2055
16Section 2055
. 447.40 (6) of the statutes is amended to read:
SB59,1017,1917
447.40
(6) Information about alternate modes of treatment for any condition
18the dentist
or dental therapist has not included in his or her diagnosis
, assessment,
19or treatment plan at the time the dentist
or dental therapist informs the patient.
SB59,2056
20Section 2056
. 448.03 (2) (a) of the statutes is amended to read:
SB59,1018,221
448.03
(2) (a) Any person lawfully practicing within the scope of a license,
22permit, registration, certificate or certification granted to practice midwifery under
23subch. XIII of ch. 440, to practice professional or practical nursing or
24nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice
25dentistry
, dental therapy, or dental hygiene under ch. 447, to practice optometry
1under ch. 449, to practice acupuncture under ch. 451 or under any other statutory
2provision, or as otherwise provided by statute.
SB59,2057
3Section 2057
. 448.21 (1) (a) of the statutes is amended to read:
SB59,1018,54
448.21
(1) (a) The practice of dentistry
, dental therapy, or dental hygiene within
5the meaning of ch. 447.
SB59,2058
6Section 2058
. 450.03 (1) (e) of the statutes is amended to read:
SB59,1018,137
450.03
(1) (e) Any person lawfully practicing within the scope of a license,
8permit, registration, certificate, or certification granted to provide home medical
9oxygen under s. 450.076, to practice professional or practical nursing or
10nurse-midwifery under ch. 441, to practice dentistry
, dental therapy, or dental
11hygiene under ch. 447, to practice medicine and surgery under ch. 448, to practice
12optometry under ch. 449 or to practice veterinary medicine under ch. 89, or as
13otherwise provided by statute.
SB59,2059
14Section 2059
. 450.10 (3) (a) 4. of the statutes is amended to read:
SB59,1018,1515
450.10
(3) (a) 4. A dentist
or dental therapist licensed under ch. 447.
SB59,2060
16Section 2060
. 452.14 (3) (n) of the statutes is amended to read:
SB59,1018,2017
452.14
(3) (n) Treated any person unequally solely because of sex, race, color,
18handicap, national origin, ancestry, marital status, lawful source of income,
status
19as a holder or nonholder of a license under s. 343.03 (3m), or status as a victim of
20domestic abuse, sexual assault, or stalking, as defined in s. 106.50 (1m) (u).
SB59,2061
21Section 2061
. 462.02 (2) (d) of the statutes is amended to read:
SB59,1018,2422
462.02
(2) (d) A dentist licensed under s. 447.04 (1),
a dental therapist licensed
23under s. 447.04 (1m), a dental hygienist licensed under s. 447.04 (2), or a person
24under the direct supervision of a dentist.
SB59,2062
25Section 2062
. 462.04 of the statutes is amended to read:
SB59,1019,9
1462.04 Prescription or order required. A person who holds a license or
2limited X-ray machine operator permit under this chapter may not use diagnostic
3X-ray equipment on humans for diagnostic purposes unless authorized to do so by
4prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed
5under s. 447.04 (1),
a dental therapist licensed under s. 447.04 (1m), a podiatrist
6licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced
7practice nurse certified under s. 441.16 (2), a physician assistant licensed under s.
8448.04 (1) (f), or, subject to s. 448.56 (7) (a), a physical therapist licensed under s.
9448.53.
SB59,2063
10Section 2063
. 463.10 (5) of the statutes is amended to read:
SB59,1019,1411
463.10
(5) Exception. Subsections (2) to (4m) do not apply to a dentist
who is
12licensed under s. 447.03 (1) or to a , dental therapist, or physician who tattoos or
13offers to tattoo a person in the course of the dentist's
, dental therapist's, or physician's
14professional practice.
SB59,2064
15Section 2064
. 463.12 (5) of the statutes is amended to read:
SB59,1019,1916
463.12
(5) Exception. Subsections (2) to (4m) do not apply to a dentist
who is
17licensed under s. 447.03 (1) or to a , dental therapist, or physician who pierces the
18body of or offers to pierce the body of a person in the course of the dentist's
, dental
19therapist's, or physician's professional practice.
SB59,2065
20Section
2065. 565.10 (17) of the statutes is created to read:
SB59,1020,221
565.10
(17) Setoff against retailer compensation. The department shall
22setoff any debt or other amount owed to the department, regardless of the origin,
23nature, or date of the debt or amount, against any compensation or payment owed
24to a lottery retailer under this chapter, whether owed by statute, rule, or contract.
25If, after the setoff, additional compensation or payment is due, the department shall
1setoff the remaining amount against all certified debts owed by the lottery retailer
2under ss. 71.93 and 71.935.
SB59,2066
3Section
2066. 565.12 (1) (intro.) of the statutes is amended to read:
SB59,1020,64
565.12
(1) (intro.) A lottery retailer contract entered into under s. 565.10 may
5be terminated or suspended for a specified period if the department finds that the
6retailer has done any of the following
before or after the contract was entered into:
SB59,2067
7Section
2067. 565.30 (5) of the statutes is amended to read:
SB59,1021,138
565.30
(5) Withholding of delinquent state taxes, child support or debts
9owed the state. The administrator shall report the name, address and social security
10number or federal income tax number of each winner of a lottery prize equal to or
11greater than $600 and the name, address and social security number or federal
12income tax number of each person to whom a lottery prize equal to or greater than
13$600 has been assigned to the department of revenue to determine whether the
14payee or assignee of the prize is delinquent in the payment of state taxes under ch.
1571, 72, 76, 77, 78 or 139 or, if applicable, in the court-ordered payment of child
16support or has a debt
owing to the state under s. 71.93 or 71.935. Upon receipt of a
17report under this subsection, the department of revenue shall
first ascertain
based
18on certifications by the department of children and families or its designee under s.
1949.855 (1) whether any person named in the report is currently delinquent in
20court-ordered payment of child support, and shall
next certify to the administrator
, 21whether any person named in the report is delinquent in court-ordered payment of
22child support
or based on certifications by the department of children and families
23under s. 49.855 (1), is delinquent in the payment of state taxes under ch. 71, 72, 76,
2477, 78 or 139
, or has a debt under s. 71.93 or 71.935. Upon this certification by the
25department of revenue or upon court order the administrator shall withhold the
1certified amount and send it to the department of revenue for remittance to the
2appropriate agency or person. The department of revenue shall charge the winner
3or assignee of the lottery prize
for the department of revenue's administrative
4expenses associated with withholding and remitting debt owed to a state agency a
5collection fee and may withhold the amount of the
administrative expenses collection
6fee from the prize payment. The
administrative expenses collection fee received or
7withheld by the department of revenue shall be credited to the appropriation under
8s. 20.566 (1) (h). In instances in which the payee or assignee of the prize is delinquent
9both in payments for state taxes and in court-ordered payments of child support, or
10is delinquent in one or both of these payments and has a debt
owing to the state under
11s. 71.93 or 71.935, the amount remitted to the appropriate agency or person shall be
12in proportion to the prize amount as is the delinquency or debt owed by the payee or
13assignee setoff under s. 71.93 (3) (a).
SB59,2068
14Section
2068. 601.31 (1) (n) of the statutes is amended to read:
SB59,1021,1815
601.31
(1) (n) For appointing, or renewing an appointment of, an agent under
16s. 628.11, $16 annually for resident agents or
$30
$40 annually for nonresident
17agents, unless the commissioner sets a higher fee by rule, to be paid at times and
18under procedures set by the commissioner.
SB59,2069
19Section 2069
. 601.83 (1) (a) of the statutes is amended to read:
SB59,1022,720
601.83
(1) (a) The commissioner shall administer a state-based reinsurance
21program known as the healthcare stability plan in accordance with the specific terms
22and conditions approved by the federal department of health and human services
23dated July 29, 2018. Before December 31, 2023, the commissioner may not request
24from the federal department of health and human services a modification,
25suspension, withdrawal, or termination of the waiver under
42 USC 18052 under
1which the healthcare stability plan under this subchapter operates unless
2legislation has been enacted specifically directing the modification, suspension,
3withdrawal, or termination. Before December 31, 2023, the commissioner may
4request renewal, without substantive change, of the waiver under
42 USC 18052 5under which the health care stability plan operates
in accordance with s. 20.940 (4) 6unless legislation has been enacted that is contrary to such a renewal request.
The
7commissioner shall comply with applicable timing in and requirements of s. 20.940.
SB59,2070
8Section
2070. 609.713 of the statutes is created to read:
SB59,1022,10
9609.713 Essential health benefits; preventive services. Defined network
10plans and preferred provider plans are subject to s. 632.895 (13m) and (14m).
SB59,2071
11Section
2071. 609.847 of the statutes is created to read:
SB59,1022,14
12609.847 Preexisting condition discrimination and certain benefit
13limits prohibited. Limited service health organizations, preferred provider plans,
14and defined network plans are subject to s. 632.728.
SB59,2072
15Section
2072. 625.12 (1) (a) of the statutes is amended to read:
SB59,1022,1716
625.12
(1) (a) Past and prospective loss and expense experience within and
17outside of this state
, except as provided in s. 632.728.
SB59,2073
18Section
2073. 625.12 (1) (e) of the statutes is amended to read:
SB59,1022,2019
625.12
(1) (e) Subject to
s.
ss. 632.365
and 632.728, all other relevant factors,
20including the judgment of technical personnel.
SB59,2074
21Section
2074. 625.12 (2) of the statutes is amended to read:
SB59,1023,522
625.12
(2) Classification.
Risks Except as provided in s. 632.728, risks may
23be classified in any reasonable way for the establishment of rates and minimum
24premiums, except that no classifications may be based on race, color, creed or
25national origin, and classifications in automobile insurance may not be based on
1physical condition or developmental disability as defined in s. 51.01 (5). Subject to
2s. ss. 632.365
and 632.728, rates thus produced may be modified for individual risks
3in accordance with rating plans or schedules that establish reasonable standards for
4measuring probable variations in hazards, expenses, or both. Rates may also be
5modified for individual risks under s. 625.13 (2).
SB59,2075
6Section
2075. 625.15 (1) of the statutes is amended to read:
SB59,1023,147
625.15
(1) Rate making. An Except as provided in s. 632.728, an insurer may
8itself establish rates and supplementary rate information for one or more market
9segments based on the factors in s. 625.12 and, if the rates are for motor vehicle
10liability insurance, subject to s. 632.365, or the insurer may use rates and
11supplementary rate information prepared by a rate service organization, with
12average expense factors determined by the rate service organization or with such
13modification for its own expense and loss experience as the credibility of that
14experience allows.
SB59,2076
15Section
2076. 628.34 (3) (a) of the statutes is amended to read:
SB59,1023,2216
628.34
(3) (a) No insurer may unfairly discriminate among policyholders by
17charging different premiums or by offering different terms of coverage except on the
18basis of classifications related to the nature and the degree of the risk covered or the
19expenses involved, subject to ss. 632.365,
632.728, 632.746 and 632.748. Rates are
20not unfairly discriminatory if they are averaged broadly among persons insured
21under a group, blanket or franchise policy, and terms are not unfairly discriminatory
22merely because they are more favorable than in a similar individual policy.
SB59,2077
23Section 2077
. 632.35 of the statutes is amended to read:
SB59,1024,3
24632.35 Prohibited rejection, cancellation and nonrenewal. No insurer
25may cancel or refuse to issue or renew an automobile insurance policy wholly or
1partially because of one or more of the following characteristics of any person: age,
2sex, residence, race, color, creed, religion, national origin, ancestry, marital status
or, 3occupation
, or status as a holder or nonholder of a license under s. 343.03 (3m).
SB59,2078
4Section
2078. 632.697 of the statutes is amended to read:
SB59,1024,13
5632.697 Benefits subject to department's right to recover. Death
6benefits payable under a life insurance policy or an annuity are subject to the right
7of the department of health services to recover under s. 46.27 (7g)
, 2017 stats.,
849.496, 49.682, or 49.849 an amount equal to the medical assistance that is
9recoverable under s. 49.496 (3) (a), an amount equal to aid under s. 49.68, 49.683,
1049.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), or an amount
11equal to long-term community support services under s. 46.27
, 2017 stats., that is
12recoverable under s. 46.27 (7g) (c) 1.
, 2017 stats., and that was paid on behalf of the
13deceased policyholder or annuitant.
SB59,2079
14Section
2079. 632.728 of the statutes is created to read:
SB59,1024,16
15632.728 Coverage of persons with preexisting conditions; guaranteed
16issue; benefit limits. (1) Definitions. In this section:
SB59,1024,1717
(a) “Health benefit plan” has the meaning given in s. 632.745 (11).
SB59,1024,1818
(b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
SB59,1024,24
19(2) Guaranteed issue. (a) Every individual health benefit plan shall accept
20every individual in this state who, and every group health benefit plan shall accept
21every employer in this state that, applies for coverage, regardless of sexual
22orientation, gender identity, or whether or not any employee or individual has a
23preexisting condition. A health benefit plan may restrict enrollment in coverage
24described in this paragraph to open or special enrollment periods.
SB59,1025,3
1(b) The commissioner shall establish a statewide open enrollment period of no
2shorter than 30 days for every individual health benefit plan to allow individuals,
3including individuals who do not have coverage, to enroll in coverage.