LRB-4617/1
PJK:kmg:km
1997 - 1998 LEGISLATURE
January 6, 1998 - Introduced by Representatives Kelso and Underheim,
cosponsored by Senators Moen, Burke and Roessler. Referred to Committee
on Health.
AB695,1,3
1An Act to amend 632.895 (11) (a) (intro.) and 632.895 (12) (b) (intro.); and
to
2create 632.895 (11) (d) and 632.895 (12) (d) of the statutes;
relating to:
3providing exceptions for dental plans from certain mandated coverages.
Analysis by the Legislative Reference Bureau
Under current law, beginning on January 1, 1998, every health insurance
policy, and every self-insured plan of the state or a county, city, village, town or school
district, that provides coverage of any diagnostic or surgical procedure involving a
bone, joint, muscle or tissue must provide coverage for diagnostic procedures and
medically necessary surgical or nonsurgical treatment for the correction of
temporomandibular disorders. In addition, every health insurance policy, and every
self-insured plan of the state or a county, city, village, town or school district, must
cover hospital or ambulatory surgery center charges and anesthetics charges that
are incurred when dental care is provided in a hospital or ambulatory surgery center
to an insured who satisfies certain criteria, such as having a medical condition that
requires hospitalization or general anesthesia for dental care. This bill makes
exceptions for policies that cover only dental care. Such a policy would not have to
provide either type of coverage.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB695,2,83
632.895
(11) (a) (intro.)
Every Except as provided in par. (d), every disability
4insurance policy, and every self-insured health plan of the state or a county, city,
5village, town or school district, that provides coverage of any diagnostic or surgical
6procedure involving a bone, joint, muscle or tissue shall provide coverage for
7diagnostic procedures and medically necessary surgical or nonsurgical treatment for
8the correction of temporomandibular disorders if all of the following apply:
AB695, s. 2
9Section
2. 632.895 (11) (d) of the statutes is created to read:
AB695,2,1110
632.895
(11) (d) This subsection does not apply to a disability insurance policy
11that covers only dental care.
AB695,2,1914
632.895
(12) (b) (intro.)
Every Except as provided in par. (d), every disability
15insurance policy, and every self-insured health plan of the state or a county, city,
16village, town or school district, shall cover hospital or ambulatory surgery center
17charges incurred, and anesthetics provided, in conjunction with dental care that is
18provided to a covered individual in a hospital or ambulatory surgery center, if any
19of the following applies:
AB695, s. 4
20Section
4. 632.895 (12) (d) of the statutes is created to read:
AB695,2,2221
632.895
(12) (d) This subsection does not apply to a disability insurance policy
22that covers only dental care.
AB695,2,2424
(1) This act first applies to all of the following:
AB695,3,3
1(a) Except as provided in paragraph (b), disability insurance policies that cover
2only dental care and that are issued or renewed on the effective date of this
3paragraph.
AB695,3,74
(b) Disability insurance policies that cover only dental care, that cover
5employes who are affected by a collective bargaining agreement containing
6provisions inconsistent with this act and that are issued or renewed on the earlier
7of the following:
AB695,3,8
81. The day on which the collective bargaining agreement expires.
AB695,3,10
92. The day on which the collective bargaining agreement is extended, modified
10or renewed.
