LRB-4239/1
PJK:kmg:jf
2003 - 2004 LEGISLATURE
March 1, 2004 - Introduced by Senators Roessler and Darling, cosponsored by
Representatives Underheim, Jeskewitz, Gielow and
Musser. Referred to
Committee on Health, Children, Families, Aging and Long Term Care.
SB515,1,2
1An Act to create 609.32 (3) of the statutes;
relating to: satisfaction of quality
2assurance requirements through accreditation.
Analysis by the Legislative Reference Bureau
Under current law, defined network plans (formerly called managed care plans
in the statutes) are required to develop quality assurance standards that include
various specified features and to develop a process for selecting and evaluating
participating providers. Under administrative rules promulgated by the
commissioner of insurance (commissioner), a defined network plan must annually
submit to the commissioner a quality assurance plan that is consistent with the
requirements under the statutes.
This bill provides that, if a defined network plan is accredited by a private
national accrediting organization that is approved by the federal Centers for
Medicare and Medicaid Services for establishing quality assurance standards and
submits written verification to the commissioner of its accreditation, the defined
network plan satisfies the quality assurance requirements under the statutes and
is not required to submit a quality assurance plan to the commissioner while its
accreditation is current.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB515, s. 1
3Section
1. 609.32 (3) of the statutes is created to read:
SB515,2,5
1609.32
(3) Accreditation by national organization. (a) Notwithstanding
2subs. (1), (1m), and (2), a defined network plan that is accredited by a private national
3accrediting organization that is approved by the federal centers for medicare and
4medicaid services for establishing quality assurance standards satisfies the
5requirements under subs. (1), (1m), and (2).
SB515,2,96
(b) A defined network plan described in par. (a) shall provide the commissioner
7with written verification that its accreditation is current and is not required to
8submit to the commissioner a quality assurance plan while its accreditation is
9current.
