Amendment SSA1-AB573

LRBs0732/1

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1995 - 1996 LEGISLATURE

SENATE SUBSTITUTE AMENDMENT 1, To 1995 ASSEMBLY BILL 573

May 8, 1996 - Offered by Committee on Insurance.

AB573-SSA1,1,6 An Act to amend 40.51 (8), 60.23 (25), 66.184, 111.70 (1) (a), 120.13 (2) (g), 185.981 (4t) and 185.983 (1) (intro.); to repeal and recreate 40.51 (8), 60.23 (25), 66.184, 111.70 (1) (a), 120.13 (2) (g), 185.981 (4t) and 185.983 (1) (intro.); and to create 40.51 (8p), 111.70 (4) (o), 111.91 (2) (n) and 632.895 (11) of the statutes; relating to: insurance coverage of hospital care, home care visits and follow-up care after childbirth.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB573-SSA1, s. 1 Section 1. 40.51 (8) of the statutes is amended to read:

AB573-SSA1,1,10 40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 632.72 (2), 632.87 (3) to (5), 632.895 (5m) and (8) to (10) (11) and 632.896.

AB573-SSA1, s. 2 Section 2. 40.51 (8) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,2,3 40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 632.72 (2), 632.745 (1) to (3) and (5), 632.747, 632.87 (3) to (5), 632.895 (5m) and (8) to (11) and 632.896.

AB573-SSA1, s. 3 Section 3. 40.51 (8p) of the statutes is created to read:

AB573-SSA1,2,6 40.51 (8p) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with s. 632.895 (11).

AB573-SSA1, s. 4 Section 4. 60.23 (25) of the statutes is amended to read:

AB573-SSA1,2,10 60.23 (25) Self-insured health plans. Provide health care benefits to its officers and employes on a self-insured basis if the self-insured plan complies with ss. 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (11) and 632.896.

AB573-SSA1, s. 5 Section 5. 60.23 (25) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,2,16 60.23 (25) Self-insured health plans. Provide health care benefits to its officers and employes on a self-insured basis if the self-insured plan complies with ss. 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3), 632.87 (4) and (5), 632.895 (9) and (11) and 632.896.

AB573-SSA1, s. 6 Section 6. 66.184 of the statutes is amended to read:

AB573-SSA1,2,23 66.184 Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employes on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).

AB573-SSA1, s. 7 Section 7. 66.184 of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,3,6 66.184 Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employes on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3), 632.87 (4) and (5), 632.895 (9) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).

AB573-SSA1, s. 8 Section 8. 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act 27, is amended to read:

AB573-SSA1,4,6 111.70 (1) (a) "Collective bargaining" means the performance of the mutual obligation of a municipal employer, through its officers and agents, and the representative of its municipal employes in a collective bargaining unit, to meet and confer at reasonable times, in good faith, with the intention of reaching an agreement, or to resolve questions arising under such an agreement, with respect to wages, hours and conditions of employment, and with respect to a requirement of the municipal employer for a municipal employe to perform law enforcement and fire fighting services under s. 61.66, except as provided in sub. (4) (m) and (o) and s. 40.81 (3) and except that a municipal employer shall not meet and confer with respect to any proposal to diminish or abridge the rights guaranteed to municipal employes under ch. 164. The duty to bargain, however, does not compel either party to agree to a proposal or require the making of a concession. Collective bargaining includes the reduction of any agreement reached to a written and signed document. The municipal employer shall not be required to bargain on subjects reserved to management and direction of the governmental unit except insofar as the manner of exercise of such functions affects the wages, hours and conditions of employment of the municipal employes in a collective bargaining unit. In creating this subchapter the legislature recognizes that the municipal employer must exercise its powers and responsibilities to act for the government and good order of the jurisdiction which it serves, its commercial benefit and the health, safety and welfare of the public to assure orderly operations and functions within its jurisdiction, subject to those rights secured to municipal employes by the constitutions of this state and of the United States and by this subchapter.

AB573-SSA1, s. 9 Section 9. 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,5,6 111.70 (1) (a) "Collective bargaining" means the performance of the mutual obligation of a municipal employer, through its officers and agents, and the representative of its municipal employes in a collective bargaining unit, to meet and confer at reasonable times, in good faith, with the intention of reaching an agreement, or to resolve questions arising under such an agreement, with respect to wages, hours and conditions of employment, and with respect to a requirement of the municipal employer for a municipal employe to perform law enforcement and fire fighting services under s. 61.66, except as provided in sub. (4) (m), (n) and (o) and s. 40.81 (3) and except that a municipal employer shall not meet and confer with respect to any proposal to diminish or abridge the rights guaranteed to municipal employes under ch. 164. The duty to bargain, however, does not compel either party to agree to a proposal or require the making of a concession. Collective bargaining includes the reduction of any agreement reached to a written and signed document. The municipal employer shall not be required to bargain on subjects reserved to management and direction of the governmental unit except insofar as the manner of exercise of such functions affects the wages, hours and conditions of employment of the municipal employes in a collective bargaining unit. In creating this subchapter the legislature recognizes that the municipal employer must exercise its powers and responsibilities to act for the government and good order of the jurisdiction which it serves, its commercial benefit and the health, safety and welfare of the public to assure orderly operations and functions within its jurisdiction, subject to those rights secured to municipal employes by the constitutions of this state and of the United States and by this subchapter.

AB573-SSA1, s. 10 Section 10. 111.70 (4) (o) of the statutes is created to read:

AB573-SSA1,5,11 111.70 (4) (o) Health insurance coverage of inpatient hospital services, home care visits and follow-up care after childbirth. The municipal employer is prohibited from bargaining collectively with respect to the provision of the health insurance coverage required under s. 632.895 (11).

AB573-SSA1, s. 11 Section 11. 111.91 (2) (n) of the statutes is created to read:

AB573-SSA1,5,14 111.91 (2) (n) The provision to employes of the health insurance coverage required under s. 632.895 (11).

AB573-SSA1, s. 12 Section 12. 120.13 (2) (g) of the statutes is amended to read:

AB573-SSA1,5,18 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).

AB573-SSA1, s. 13 Section 13. 120.13 (2) (g) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,5,24 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3), 632.87 (4) and (5), 632.895 (9) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).

AB573-SSA1, s. 14 Section 14. 185.981 (4t) of the statutes is amended to read:

AB573-SSA1,6,3 185.981 (4t) A sickness care plan operated by a cooperative association is subject to ss. 252.14, 631.89, 632.72 (2), 632.87 (2m), (3), (4) and (5), 632.895 (10) and (11) and 632.897 (10) and ch. 155.

AB573-SSA1, s. 15 Section 15. 185.981 (4t) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,6,8 185.981 (4t) A sickness care plan operated by a cooperative association is subject to ss. 252.14, 631.89, 632.72 (2), 632.745, 632.747, 632.749, 632.87 (2m), (3), (4) and (5), 632.895 (10) and (11) and 632.897 (10) and ch. 155.

AB573-SSA1, s. 16 Section 16. 185.983 (1) (intro.) of the statutes is amended to read:

AB573-SSA1,6,15 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72 (2), 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5), 632.895 (5), (9) and (10) and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:

AB573-SSA1, s. 17 Section 17. 185.983 (1) (intro.) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,6,23 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72 (2), 632.745, 632.747, 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5), 632.895 (5) and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:

AB573-SSA1, s. 18 Section 18. 632.895 (11) of the statutes is created to read:

AB573-SSA1,7,3 632.895 (11) Inpatient hospital services, home care visits and follow-up care after childbirth. (a) In this subsection, "health care provider" means a physician, as defined in s. 448.01 (5), or a nurse-midwife granted a license under s. 441.15.

AB573-SSA1,7,6 (am) Every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, that provides maternity coverage shall provide coverage for mother and child for all of the following:

AB573-SSA1,7,9 1. After the birth of a child, inpatient hospital services related to the birth of the child for the length of time that the inpatient hospital services are provided, as ordered by the mother's or child's health care provider.

AB573-SSA1,7,13 2. If inpatient hospital services are provided for a period of less than 48 hours after the birth of a child by vaginal delivery, one postnatal follow-up care contact after the mother and child are no longer hospital inpatients, if ordered by the mother's or child's health care provider.

AB573-SSA1,7,17 3. If inpatient hospital services are provided for a period of less than 96 hours after the birth of a child by caesarean section, one postnatal follow-up care contact after the mother and child are no longer hospital inpatients, if ordered by the mother's or child's health care provider.

AB573-SSA1,7,20 4. Any home care visits or postnatal follow-up care contacts after a postnatal follow-up care contact under subd. 2. or 3. has occurred, if ordered by the mother's or child's health care provider.

AB573-SSA1,7,25 (b) The length of time for which inpatient hospital services are provided and must be covered under par. (am) 1. and whether a postnatal follow-up care contact under par. (am) 2. or 3. or home care visits or postnatal follow-up care contacts under par. (am) 4. are ordered and must be covered shall be based on medical necessity, as determined by the mother's or child's health care provider.

AB573-SSA1,8,2 (c) The coverage required under par. (am) may be subject to any copayments or deductibles that apply generally under the policy or plan to other covered services.

AB573-SSA1, s. 19 Section 19. Initial applicability.