AB920-AA1,1,11
3“(am) 1. An employer group qualified under sub. (2) (b) may not exclude
4coverage under a health care benefit arrangement for diagnosis and treatment of a
5condition or complaint by a licensed chiropractor within the scope of the
6chiropractor's professional license if the health care benefit arrangement covers
7diagnosis and treatment of a condition or complaint by a licensed physician or
8osteopath, even if different nomenclature is used to describe the condition or
9complaint. The health care benefit arrangement may not require examination by or
10referral from a physician before allowing coverage of chiropractic care under this
11paragraph. This paragraph does not prohibit any of the following:
AB920-AA1,2,3
1a. Application of deductibles or coinsurance under the health care benefit
2arrangement to chiropractic care if deductibles or coinsurance apply equally to
3physician care.
AB920-AA1,2,64
b. Application of cost containment or quality assurance measures to
5chiropractic services in a manner that is consistent with cost containment or quality
6assurance measures applied to physician services.
AB920-AA1,2,107
2. An employer group qualified under sub. (2) (b) may not do any of the following
8under a health care benefit arrangement that covers diagnosis and treatment of
9conditions or complaints by a licensed chiropractor within the scope of the
10chiropractor's professional license:
AB920-AA1,2,1511
a. Restrict or terminate coverage for the treatment of a condition or complaint
12by a licensed chiropractor within the scope of the chiropractor's professional license
13other than on the basis of an examination, evaluation, or recommendation by
14another licensed chiropractor or a peer review committee that includes a licensed
15chiropractor.
AB920-AA1,2,1716
b. Exclude or restrict coverage of a health condition under the health care
17benefit arrangement solely because the condition may be treated by a chiropractor.”.
