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TJD&EKL:cdc
2021 - 2022 LEGISLATURE
2021 Assembly BILL 718
November 17, 2021 - Introduced by Representatives Kurtz, Swearingen, Goyke,
James, Petryk, Summerfield, Andraca, Baldeh, Behnke, Billings, Bowen,
Brandtjen, Cabral-Guevara, Callahan, Conley, Considine, Dittrich,
Doyle, Drake, Duchow, Edming, Emerson, Gundrum, Haywood, Hintz,
Kerkman, Kitchens, Knodl, Krug, Macco, Magnafici, B. Meyers, Milroy,
Moses, Mursau, L. Myers, Neubauer, Novak, Ohnstad, Oldenburg,
Ortiz-Velez, Plumer, Pope, Riemer, J. Rodriguez, Rozar, Schraa,
Shankland, Shelton, Skowronski, Snodgrass, Snyder, Spiros, Spreitzer,
Thiesfeldt, Tranel, Vining, Vruwink, Wichgers, Sinicki, Stubbs and Tusler,
cosponsored by Senators Darling, Marklein, Erpenbach, Bernier, Bewley,
Feyen, Jacque, Johnson, Nass, Petrowski, Pfaff, Ringhand, Roys, Smith, L.
Taylor
, Wirch, Wanggaard, Cowles and Carpenter. Referred to Committee
on Health.
AB718,1,2 1An Act to create 628.34 (5m) of the statutes; relating to: prohibiting certain
2practices relating to insurance coverage of clinician-administered drugs.
Analysis by the Legislative Reference Bureau
This bill prohibits certain practices relating to clinician-administered drugs
under the state's insurance unfair marketing and trade practices law. The bill
defines “clinician-administered drug” as an outpatient prescription drug, other than
a vaccine, that, due to medical necessity, cannot reasonably be self-administered by
the patient or an individual assisting the patient and is typically administered by an
authorized health care provider in a physician's office, hospital outpatient
department, or other clinical setting. Under the bill, an insurer offering a health
benefit plan, a pharmacy benefit manager, or an agent of the insurer or pharmacy
benefit manager may not do any of the following:
1. Refuse to authorize, approve, or pay a participating provider for providing
a covered clinician-administered drug and related services to an enrollee,
policyholder, or insured.