AB68,1563,9 (b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

AB68,1563,15 (c) “Telehealth" means a practice of health care delivery, diagnosis, consultation, treatment, or transfer of medically relevant data by means of audio, video, or data communications that are used either during a patient visit or a consultation or are used to transfer medically relevant data about a patient. “Telehealth" does not include communications delivered solely by audio-only telephone, facsimile machine, or e-mail unless specified otherwise by rule.

AB68,1563,22 (2) Coverage denial prohibited. No disability insurance policy or self-insured health plan may deny coverage for a treatment or service provided through telehealth on the basis that the treatment or service is provided through telehealth if that treatment or service is covered by the policy or plan when provided in person. A disability insurance policy or self-insured health plan may limit coverage of treatments or services provided through telehealth to those treatments or services that are medically necessary.

AB68,1564,2 (3) Certain limitations on telehealth prohibited. A disability insurance policy or self-insured health plan may not subject a treatment or service provided through telehealth for which coverage is required under sub. (2) to any of the following:

AB68,1564,4 (a) Any greater deductible, copayment, or coinsurance amount than would be applicable if the treatment or service is provided in person.

AB68,1564,7 (b) Any policy or calendar year or lifetime benefit limit or other maximum limitation that is not imposed on other treatments or services covered by the plan that are not provided through telehealth.

AB68,1564,9 (c) Prior authorization requirements that are not required for the same treatment or service when provided in person.

AB68,1564,10 (d) Unique location requirements.

AB68,1564,15 (4) Disclosure of coverage of certain telehealth services. A disability insurance policy or self-insured health plan that covers a telehealth treatment or service that has no equivalent in-person treatment or service, such as remote patient monitoring, shall specify in policy or plan materials the coverage of that telehealth treatment or service.

AB68,2972 Section 2972. 632.895 (6) (title) of the statutes is amended to read:

AB68,1564,17 632.895 (6) (title) Equipment and supplies for treatment of diabetes; insulin.

AB68,2973 Section 2973 . 632.895 (6) of the statutes is renumbered 632.895 (6) (a) and amended to read:

AB68,1565,5 632.895 (6) (a) Every disability insurance policy which that provides coverage of expenses incurred for treatment of diabetes shall provide coverage for expenses incurred by the installation and use of an insulin infusion pump, coverage for all other equipment and supplies, including insulin or any other prescription medication, used in the treatment of diabetes, and coverage of diabetic self-management education programs. Coverage Except as provided in par. (b), coverage required under this subsection shall be subject to the same exclusions, limitations, deductibles, and coinsurance provisions of the policy as other covered expenses, except that insulin infusion pump coverage may be limited to the purchase of one pump per year and the insurer may require the insured to use a pump for 30 days before purchase.

AB68,2974 Section 2974 . 632.895 (6) (b) of the statutes is created to read:

AB68,1565,7 632.895 (6) (b) 1. In this paragraph:

AB68,1565,9 a. “Cost sharing” means the total of any deductible, copayment, or coinsurance amounts imposed on a person covered under a policy or plan.

AB68,1565,10 b. “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

AB68,1565,13 2. Every disability insurance policy and self-insured health plan that covers insulin and imposes cost sharing on prescription drugs may not impose cost sharing on insulin in an amount that exceeds $50 for a one-month supply of insulin.

AB68,1565,18 3. Nothing in this paragraph prohibits a disability insurance policy or self-insured health plan from imposing cost sharing on insulin in an amount less than the amount specified under subd. 2. Nothing in this paragraph requires a disability insurance policy or self-insured health plan to impose any cost sharing on insulin.

AB68,2975 Section 2975. 632.895 (8) (d) of the statutes is amended to read:

AB68,1566,2 632.895 (8) (d) Coverage is required under this subsection despite whether the woman shows any symptoms of breast cancer. Except as provided in pars. (b), (c), and (e), coverage under this subsection may only be subject to exclusions and limitations, including deductibles, copayments and restrictions on excessive charges, that are applied to other radiological examinations covered under the disability insurance policy. Coverage under this subsection may not be subject to any deductibles, copayments, or coinsurance.

AB68,2976 Section 2976. 632.895 (13m) of the statutes is created to read:

AB68,1566,5 632.895 (13m) Preventive services. (a) In this section, “self-insured health plan” has the meaning given in s. 632.85 (1) (c).

AB68,1566,8 (b) Every disability insurance policy, except any disability insurance policy that is described in s. 632.745 (11) (b) 1. to 12., and every self-insured health plan shall provide coverage for all of the following preventive services:

AB68,1566,9 1. Mammography in accordance with sub. (8).

AB68,1566,11 2. Genetic breast cancer screening and counseling and preventive medication for adult women at high risk for breast cancer.

AB68,1566,13 3. Papanicolaou test for cancer screening for women 21 years of age or older with an intact cervix.

AB68,1566,15 4. Human papillomavirus testing for women who have attained the age of 30 years but have not attained the age of 66 years.

AB68,1566,16 5. Colorectal cancer screening in accordance with sub. (16m).