AB43: Bill Text

AB43,,8998 9. Require a disability insurance policy or self-insured health plan to apply to emergency department services that are essential health benefits provided by an emergency department provider that is not in the provider network of the policy or plan the same copayment amount or coinsurance rate that applies if those services are provided by a provider that is in the provider network of the policy or plan.

AB43,,8999 (d) The commissioner shall periodically update, by rule, the essential health benefits under this subsection to address any gaps in access to coverage.

AB43,,9000 (e) If an essential health benefit is also subject to mandated coverage elsewhere under this section and the coverage requirements are not identical, the disability insurance policy or self-insured health plan shall provide coverage under whichever subsection provides the insured or plan participant with more comprehensive coverage of the medical condition, item, or service.

AB43,,9001 (f) Nothing in this subsection or rules promulgated under this subsection prohibits a disability insurance policy or a self-insured health plan from providing benefits in excess of the essential health benefit coverage required under this subsection.

AB43,,9002 (g) This subsection does not apply to any disability insurance policy that is described in s. 632.745 (11) (b) 1. to 12.

AB43,3107 Section 3107. 632.895 (15m) of the statutes is created to read:

AB43,,9004 632.895 (15m) Coverage of infertility services. (a) In this subsection:

AB43,,9005 1. “Diagnosis of and treatment for infertility” means any recommended procedure or medication to treat infertility at the direction of a physician that is consistent with established, published, or approved medical practices or professional guidelines from the American College of Obstetricians and Gynecologists, or its successor organization, or the American Society for Reproductive Medicine, or its successor organization.

AB43,,9006 2. “Infertility” means a disease, condition, or status characterized by any of the following:

AB43,,9007 a. The failure to establish a pregnancy or carry a pregnancy to a live birth after regular, unprotected sexual intercourse for, if the woman is under the age of 35, no longer than 12 months or, if the woman is 35 years of age or older, no longer than 6 months, including any time during those 12 months or 6 months that the woman has a pregnancy that results in a miscarriage.

AB43,,9008 b. An individual’s inability to reproduce either as a single individual or with a partner without medical intervention.

AB43,,9009 c. A physician’s findings based on a patient’s medical, sexual, and reproductive history, age, physical findings, or diagnostic testing.

AB43,,9010 3. “Self-insured health plan” means a self-insured health plan of the state or a county, city, village, town, or school district.

AB43,,9011 4. “Standard fertility preservation service” means a procedure that is consistent with established medical practices or professional guidelines published by the American Society for Reproductive Medicine or its successor organization, or the American Society of Clinical Oncology or its successor organization, for a person who has a medical condition or is expected to undergo medication therapy, surgery, radiation, chemotherapy, or other medical treatment that is recognized by medical professionals to cause a risk of impairment to fertility.

AB43,,9012 (b) Subject to pars. (c) to (e), every disability insurance policy and self-insured health plan that provides coverage for medical or hospital expenses shall cover diagnosis of and treatment for infertility and standard fertility preservation services. Coverage required under this paragraph includes at least 4 completed oocyte retrievals with unlimited embryo transfers, in accordance with the guidelines of the American Society for Reproductive Medicine or its successor organization, and single embryo transfer may be used when recommended and medically appropriate.

AB43,,9013 (c) 1. A disability insurance policy or self-insured health plan may not do any of the following:

AB43,,9014 a. Impose any exclusions, limitations, or other restrictions on coverage required under par. (b) based on a covered individual’s participation in fertility services provided by or to a 3rd party.

AB43,,9015 b. Impose any exclusion, limitation, or other restriction on coverage of medications that are required to be covered under par. (b) that are different from those imposed on any other prescription medications covered under the policy or plan.

AB43,,9016 c. Impose any exclusion, limitation, cost-sharing requirement, benefit maximum, waiting period, or other restriction on coverage that is required under par. (b) of diagnosis of and treatment for infertility and standard fertility preservation services that is different from an exclusion, limitation, cost-sharing requirement, benefit maximum, waiting period or other restriction imposed on benefits for services that are covered by the policy or plan and that are not related to infertility.

AB43,,9017 2. A disability insurance policy or self-insured health plan shall provide coverage required under par. (b) to any covered individual under the policy or plan, including any covered spouse or nonspouse dependent, to the same extent as other pregnancy-related benefits covered under the policy or plan.

AB43,,9018 (d) The commissioner, after consulting with the department of health services on appropriate treatment for infertility, shall promulgate any rules necessary to implement this subsection. Before the promulgation of rules, disability insurance policies and self-insured health plans are considered to comply with the coverage requirements of par. (b) if the coverage conforms to the standards of the American Society for Reproductive Medicine.

AB43,,9019 (e) This subsection does not apply to a disability insurance policy that is a health benefit plan described under s. 632.745 (11) (b).

AB43,3108 Section 3108. 632.895 (16m) (b) of the statutes is amended to read:

AB43,,9021 632.895 (16m) (b) The coverage required under this subsection may be subject to any limitations, or exclusions, or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan. The coverage required under this subsection may not be subject to any deductibles, copayments, or coinsurance.

AB43,3109 Section 3109. 632.895 (17) (b) 2. of the statutes is amended to read:

AB43,,9023 632.895 (17) (b) 2. Outpatient consultations, examinations, procedures, and medical services that are necessary to prescribe, administer, maintain, or remove a contraceptive, if covered for any other drug benefits under the policy or plan sterilization procedures, and patient education and counseling for all females with reproductive capacity.

AB43,3110 Section 3110. 632.895 (17) (c) of the statutes is amended to read:

AB43,,9025 632.895 (17) (c) Coverage under par. (b) may be subject only to the exclusions, and limitations, or cost-sharing provisions that apply generally to the coverage of outpatient health care services, preventive treatments and services, or prescription drugs and devices that is provided under the policy or self-insured health plan. A disability insurance policy or self-insured health plan may not apply a deductible or impose a copayment or coinsurance to at least one of each type of contraceptive method approved by the federal food and drug administration for which coverage is required under this subsection. The disability insurance policy or self-insured health plan may apply reasonable medical management to a method of contraception to limit coverage under this subsection that is provided without being subject to a deductible, copayment, or coinsurance to prescription drugs without a brand name. The disability insurance policy or self-insured health plan may apply a deductible or impose a copayment or coinsurance for coverage of a contraceptive that is prescribed for a medical need if the services for the medical need would otherwise be subject to a deductible, copayment, or coinsurance.

AB43,3111 Section 3111. 632.897 (11) (a) of the statutes is amended to read:

AB43,,9027 632.897 (11) (a) Notwithstanding subs. (2) to (10), the commissioner may promulgate rules establishing standards requiring insurers to provide continuation of coverage for any individual covered at any time under a group policy who is a terminated insured or an eligible individual under any federal program that provides for a federal premium subsidy for individuals covered under continuation of coverage under a group policy, including rules governing election or extension of election periods, notice, rates, premiums, premium payment, application of preexisting condition exclusions, election of alternative coverage, and status as an eligible individual, as defined in s. 149.10 (2t), 2011 stats.

AB43,3112 Section 3112. 655.001 (1) of the statutes is renumbered 655.001 (1r).

AB43,3113 Section 3113. 655.001 (1g) of the statutes is created to read:

AB43,,9030 655.001 (1g) “Advanced practice registered nurse” means an individual who is licensed under s. 441.09, who has qualified to practice independently in his or her recognized role under s. 441.09 (3m) (b), and who practices advanced practice registered nursing, as defined under s. 441.001 (1c), outside of a collaborative relationship with a physician or dentist, as described under s. 441.09 (3m) (a) 1., or other employment relationship. “Advanced practice registered nurse” does not include an individual who only engages in the practice of a certified nurse-midwife, as defined under s. 441.001 (3c).

AB43,3114 Section 3114. 655.001 (7t) of the statutes is amended to read:

AB43,,9032 655.001 (7t) “Health care practitioner” means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist advanced practice registered nurse.

AB43,3115 Section 3115. 655.001 (9) of the statutes is repealed.

AB43,3116 Section 3116. 655.002 (1) (a) of the statutes is amended to read:

AB43,,9035 655.002 (1) (a) A physician or a nurse anesthetist an advanced practice registered nurse for whom this state is a principal place of practice and who practices his or her profession in this state more than 240 hours in a fiscal year.

AB43,3117 Section 3117. 655.002 (1) (b) of the statutes is amended to read:

AB43,,9037 655.002 (1) (b) A physician or a nurse anesthetist an advanced practice registered nurse for whom Michigan is a principal place of practice, if all of the following apply:

AB43,,9038 1. The physician or nurse anesthetist advanced practice registered nurse is a resident of this state.

AB43,,9039 2. The physician or nurse anesthetist advanced practice registered nurse practices his or her profession in this state or in Michigan or a combination of both more than 240 hours in a fiscal year.

AB43,,9040 3. The physician or nurse anesthetist advanced practice registered nurse performs more procedures in a Michigan hospital than in any other hospital. In this subdivision, “Michigan hospital” means a hospital located in Michigan that is an affiliate of a corporation organized under the laws of this state that maintains its principal office and a hospital in this state.

AB43,3118 Section 3118. 655.002 (1) (c) of the statutes is amended to read:

AB43,,9042 655.002 (1) (c) A physician or nurse anesthetist an advanced practice registered nurse who is exempt under s. 655.003 (1) or (3), but who practices his or her profession outside the scope of the exemption and who fulfills the requirements under par. (a) in relation to that practice outside the scope of the exemption. For a physician or a nurse anesthetist an advanced practice registered nurse who is subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is outside the scope of the exemption under s. 655.003 (1) or (3).

AB43,3119 Section 3119. 655.002 (1) (d) of the statutes is amended to read:

AB43,,9044 655.002 (1) (d) A partnership comprised of physicians or nurse anesthetists advanced practice registered nurses and organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists advanced practice registered nurses.

AB43,3120 Section 3120. 655.002 (1) (e) of the statutes is amended to read:

AB43,,9046 655.002 (1) (e) A corporation organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists advanced practice registered nurses.

AB43,3121 Section 3121. 655.002 (1) (em) of the statutes is amended to read:

AB43,,9048 655.002 (1) (em) Any organization or enterprise not specified under par. (d) or (e) that is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists advanced practice registered nurses.

AB43,3122 Section 3122. 655.002 (2) (a) of the statutes is amended to read:

AB43,,9050 655.002 (2) (a) A physician or nurse anesthetist advanced practice registered nurse for whom this state is a principal place of practice but who practices his or her profession fewer than 241 hours in a fiscal year, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession.

AB43,3123 Section 3123. 655.002 (2) (b) of the statutes is amended to read:

AB43,,9052 655.002 (2) (b) Except as provided in sub. (1) (b), a physician or nurse anesthetist advanced practice registered nurse for whom this state is not a principal place of practice, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession in this state. For a health care provider who elects to be subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is in this state and that is outside the scope of an exemption under s. 655.003 (1) or (3).

AB43,3124 Section 3124. 655.003 (1) of the statutes is amended to read:

AB43,,9054 655.003 (1) A physician or a nurse anesthetist an advanced practice registered nurse who is a state, county or municipal employee, or federal employee or contractor covered under the federal tort claims act, as amended, and who is acting within the scope of his or her employment or contractual duties.

AB43,3125 Section 3125. 655.003 (3) of the statutes is amended to read:

AB43,,9056 655.003 (3) Except for a physician or nurse anesthetist an advanced practice registered nurse who meets the criteria under s. 146.89 (5) (a), a physician or a nurse anesthetist an advanced practice registered nurse who provides professional services under the conditions described in s. 146.89, with respect to those professional services provided by the physician or nurse anesthetist advanced practice registered nurse for which he or she is covered by s. 165.25 and considered an agent of the department, as provided in s. 165.25 (6) (b).

AB43,3126 Section 3126. 655.005 (2) (a) of the statutes is amended to read:

AB43,,9058 655.005 (2) (a) An employee of a health care provider if the employee is a physician or a nurse anesthetist an advanced practice registered nurse or is a health care practitioner who is providing health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist advanced practice registered nurse.

AB43,3127 Section 3127. 655.005 (2) (b) of the statutes is amended to read:

AB43,,9060 655.005 (2) (b) A service corporation organized under s. 180.1903 by health care professionals, as defined under s. 180.1901 (1m), if the board of governors determines that it is not the primary purpose of the service corporation to provide the medical services of physicians or nurse anesthetists advanced practice registered nurses. The board of governors may not determine under this paragraph that it is not the primary purpose of a service corporation to provide the medical services of physicians or nurse anesthetists advanced practice registered nurses unless more than 50 percent of the shareholders of the service corporation are neither physicians nor nurse anesthetists advanced practice registered nurses.

AB43,3128 Section 3128. 655.23 (5m) of the statutes is amended to read:

AB43,,9062 655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of a physician or nurse anesthetist an advanced practice registered nurse and his or her corporation, partnership, or other organization or enterprise under s. 655.002 (1) (d), (e), or (em).

AB43,3129 Section 3129. 655.27 (3) (a) 4. of the statutes is amended to read:

AB43,,9064 655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e), (em), or (f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or nurse anesthetist an advanced practice registered nurse.

AB43,3130 Section 3130. 655.27 (3) (b) 2m. of the statutes is amended to read:

AB43,,9066 655.27 (3) (b) 2m. In addition to the fees and payment classifications described under subds. 1. and 2., the commissioner, after approval by the board of governors, may establish a separate payment classification for physicians satisfying s. 655.002 (1) (b) and a separate fee for nurse anesthetists advanced practice registered nurses satisfying s. 655.002 (1) (b) which take into account the loss experience of health care providers for whom Michigan is a principal place of practice.

AB43,3131 Section 3131. 655.275 (2) of the statutes is amended to read:

AB43,,9068 655.275 (2) Appointment. The board of governors shall appoint the members of the council. Section 15.09, except s. 15.09 (4) and (8), does not apply to the council. The board of governors shall designate the chairperson, who shall be a physician, the vice chairperson, and the secretary of the council and the terms to be served by council members. The council shall consist of 5 or 7 persons, not more than 3 of whom are physicians who are licensed and in good standing to practice medicine in this state and one of whom is a nurse anesthetist an advanced practice registered nurse who is licensed and in good standing to practice nursing in this state. The chairperson or another peer review council member designated by the chairperson shall serve as an ex officio nonvoting member of the medical examining board and may attend meetings of the medical examining board, as appropriate.

AB43,3132 Section 3132. 655.275 (5) (b) 2. of the statutes is amended to read:

AB43,,9070 655.275 (5) (b) 2. If a claim was paid for damages arising out of the rendering of care by a nurse anesthetist an advanced practice registered nurse, with at least one nurse anesthetist advanced practice registered nurse.

AB43,3133 Section 3133. 700.19 (2) of the statutes is amended to read:

AB43,,9072 700.19 (2) Husband and wife Spouses. If persons named as owners in a document of title, transferees in an instrument of transfer, or buyers in a bill of sale are described in the document, instrument, or bill of sale as husband and wife married to each other, or are in fact husband and wife married to each other, they are joint tenants, unless the intent to create a tenancy in common is expressed in the document, instrument, or bill of sale. This subsection applies to property acquired before January 1, 1986, and, if ch. 766 does not apply when the property is acquired, to property acquired on or after January 1, 1986.

AB43,3134 Section 3134. 704.05 (2) of the statutes is amended to read:

AB43,,9074 704.05 (2) Possession of tenant and access by landlord. Until the expiration date specified in the lease, or the termination of a periodic tenancy or tenancy at will, and so long as the tenant is not in default, the tenant has the right to exclusive possession of the premises, except as hereafter provided. The landlord may upon advance notice and at reasonable times inspect the premises, allow a city, village, town, or county inspector access for an inspection, make repairs, and show the premises to prospective tenants or purchasers; and if the tenant is absent from the premises and the landlord reasonably believes that entry is necessary to preserve or protect the premises, the landlord may enter without notice and with such force as appears necessary.

AB43,3135 Section 3135. 704.07 (2) (bm) 1. of the statutes is repealed.

AB43,3136 Section 3136. 704.07 (2) (bm) 3. of the statutes is amended to read:

AB43,,9077 704.07 (2) (bm) 3. The violation presents a significant threat to the prospective tenant’s health or safety.

AB43,3137 Section 3137. 704.07 (5) of the statutes is repealed.

AB43,3138 Section 3138. 705.01 (4) of the statutes is amended to read:

AB43,,9080 705.01 (4) “Joint account” means an account, other than a marital account, payable on request to one or more of 2 or more parties whether or not mention is made of any right of survivorship. “Joint account” also means any account established with the right of survivorship on or after January 1, 1986, by 2 parties who claim to be husband and wife married to each other, which is payable on request to either or both of the parties.

AB43,3139 Section 3139. 705.01 (4m) of the statutes is amended to read:

AB43,,9082 705.01 (4m) “Marital account” means an account established without the right of survivorship on or after January 1, 1986, by 2 parties who claim to be husband and wife married to each other, which is payable on request to either or both of the parties and which is designated as a marital account. An account established by those parties with the right of survivorship under s. 766.58 (3) (f) or 766.60 is a joint account.

AB43,3140 Section 3140. 706.09 (1) (e) of the statutes is amended to read:

AB43,,9084 706.09 (1) (e) Marital interests. Homestead of the spouse of any transferor of an interest in real estate, if the recorded conveyance purporting to transfer the homestead states that the person executing it is single, unmarried, or widowed a surviving spouse or fails to indicate the marital status of the transferor, and if the conveyance has, in either case, appeared of record for 5 years. This paragraph does not apply to the interest of a married person who is described of record as a holder in joint tenancy or of marital property with that transferor.

AB43,3141 Section 3141. 753.06 (4) (c) of the statutes is amended to read:

AB43,,9086 753.06 (4) (c) Manitowoc County. The circuit has 3 4 branches.