December 8, 2023 - Introduced by Representatives J. Anderson, C. Anderson, Clancy, Drake, Emerson, Jacobson, Joers, Madison, Moore Omokunde, Ortiz-Velez, Palmeri, Shankland, Shelton, Snodgrass, Stubbs and Subeck, cosponsored by Senators Larson, Smith and Spreitzer. Referred to Committee on Insurance.
AB789,,22An Act to create 609.047 of the statutes; relating to: provider directories for certain health plans. AB789,,33Analysis by the Legislative Reference Bureau This bill requires a defined network plan or preferred provider plan to make available a current directory of health care providers in the plan’s network of providers to anyone considering enrollment in the plan and to the plan’s enrollees at least annually. Defined network plans and preferred provider plans are types of managed care organizations that provide health care benefits to their enrollees. The bill requires the plan to maintain a current provider directory on its website, to ensure that the directory on the site is updated at least quarterly, and to ensure that the public may view the provider directory on the site without creating or accessing an account or entering a policy or contract number. A plan is also required by the bill to provide information in each electronic and print directory on providers for each of the plan’s covered services, to prominently indicate in each electronic and print directory which providers are accepting new patients at the time the directory is updated, and to accommodate with each electronic and print directory the communication needs of persons with disabilities and persons with limited English proficiency.
AB789,,44The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: AB789,15Section 1. 609.047 of the statutes is created to read: AB789,,66609.047 Network directories. (1) A defined network plan or a preferred provider plan shall make available a current provider directory of all providers in the plan’s network to enrollees no less frequently than annually and to persons considering enrollment in the plan. AB789,,77(2) A defined network plan or preferred provider plan shall maintain a current provider directory on the plan’s website and shall ensure that the directory on the website is updated no less frequently than quarterly. The defined network plan or preferred provider plan shall ensure that the public is able to view the website provider directory through a clearly identifiable link or tab without creating or accessing an account or entering a policy or contract number. AB789,,88(3) A defined network plan or preferred provider plan shall provide a print copy of the provider directory to an enrollee or prospective enrollee upon request. AB789,,99(4) A defined network plan or preferred provider plan shall do all of the following, regardless of whether the directory is electronic or in print: AB789,,1010(a) Provide information in each directory on providers for each of the plan’s covered services. AB789,,1111(b) Prominently indicate in each directory which providers are accepting new patients at the time the directory is updated. AB789,,1212(c) Accommodate the communication needs of persons with disabilities and persons with limited proficiency in English.
