AB451: Bill Text

AB451,2,3 111.91 (2) (r) The requirement under 1999 Wisconsin Act .... (this act), section 3 (3 ), related to coverage of drugs or devices under revised prescription orders.

AB451, s. 2 Section 2. 111.91 (2) (r) of the statutes, as created by 1999 Wisconsin Act .... (this act), is repealed.

AB451, s. 3 Section 3 . Nonstatutory provisions.

AB451,2,7 (1) Definitions. In this section:

AB451,2,8 (a) "Device" has the meaning given in section 450.01 (6) of the statutes.

AB451,2,11 (b) "Drug" has the meaning given in section 450.01 (10) of the statutes, but does not include a controlled substance included, whether by statute or rule, in schedules II to V of chapter 961 of the statutes.

AB451,2,13 (c) "Drug product" means means a specific drug or drugs in a specific dosage form and strength from a known source of manufacture.

AB451,2,15 (d) "Health benefit plan" has the meaning given in section 632.745 (11) of the statutes.

AB451,2,16 (e) "Patient" has the meaning given in section 450.01 (14) of the statutes.

AB451,2,17 (f) "Practitioner" has the meaning given in section 450.01 (17) of the statutes.

AB451,2,20 (g) "Prescription order" means a prescription order, as defined in section 450.01 (21) of the statutes, that specifies a drug product or device in a quantity that is likely to be depleted at any time during the month of January, 2000.

AB451,3,2 (h) "Self-insured health plan" has the meaning given in section 632.745 (24) of the statutes.

AB451,3,3 (2) Revision of certain prescription orders.

AB451,3,6 (a) Upon the request of a patient, a practitioner shall revise a prescription order to ensure that the quantity of the drug product or device that is prescribed is not depleted until after January 31, 2000, if each of the following is satisfied:

AB451,3,9 1. The patient's condition for which the prescription order is issued is chronic or the drug product or device that is prescribed is likely to be appropriate to treat the patient's condition at least until January 31, 2000.

AB451,3,12 2. An interruption during the month of January, 2000, of the supply of the drug product or device that is prescribed may cause substantial physical or mental discomfort or undesirable health consequences for the patient.

AB451,3,14 (b) A patient may request only one revision of a prescription order under paragraph (a).

AB451,3,22 (3) Insurance coverage of revised prescription orders. If a patient for whom a practitioner revises a prescription order under subsection (2) is covered under a health benefit plan or a self-insured health plan that provides coverage of the drug product or device that is prescribed under the revised prescription order, the health benefit plan or self-insured health plan may not deny coverage of the drug product or device under the revised prescription order solely on the basis of the quantity of the drug product or device that is prescribed or the length of time for which the drug product or device is prescribed under the revised prescription order.

AB451, s. 4 Section 4. Initial applicability.

AB451,4,3 (1) Insurance coverage of revised prescription orders. The creation of section 111.91 (2) (r) of the statutes and Section 3 (3 ) of this act first apply to all of the following:

AB451,4,8 (a) Except as provided in paragraphs (b) and (c ), health benefit plans containing terms or provisions inconsistent with Section 3 (3 ) of this act that are renewed on the effective date of this paragraph and self-insured health plans containing terms or provisions inconsistent with Section 3 (3 ) of this act that are extended, modified or renewed on the effective date of this paragraph.

AB451,4,11 (b) Health benefit plans covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with Section 3 (3) of this act that are issued or renewed on the earlier of the following:

AB451,4,12 1. The day on which the collective bargaining agreement expires.

AB451,4,14 2. The day on which the collective bargaining agreement is extended, modified or renewed.

AB451,4,18 (c) Self-insured health plans covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with Section 3 (3) of this act that are established, extended, modified or renewed on the earlier of the following:

AB451,4,19 1. The day on which the collective bargaining agreement expires.

AB451,4,21 2. The day on which the collective bargaining agreement is extended, modified or renewed.

AB451, s. 5 Section 5. Effective dates. This act takes effect on the day after publication, except as follows:

AB451,5,2 (1) The repeal of section 111.91 (2) (r) of the statutes takes effect on February 1, 2000.

AB451,5,3 (End)