AB927,27,2320
609.91
(4) (intro.)
Conditions not affecting the immunity. The immunity of
21an
enrolled participant enrollee, policyholder or insured for health care costs, to the
22extent of the immunity provided under this section and ss. 609.92 to 609.935, is not
23affected by any of the following:
AB927, s. 76
24Section
76. 609.91 (4) (a) of the statutes is amended to read:
AB927,28,6
1609.91
(4) (a) An agreement, other than a notice of election or termination of
2election in accordance with s. 609.92 or 609.925, entered into by the provider, the
3health maintenance organization insurer, the insurer described in sub. (1m) or any
4other person, at any time, whether oral or written and whether implied or explicit,
5including an agreement that purports to hold the
enrolled participant enrollee,
6policyholder or insured liable for health care costs.
AB927, s. 77
7Section
77. 609.91 (4) (b) of the statutes is amended to read:
AB927,28,128
609.91
(4) (b) A breach of or default on an agreement by the health
9maintenance organization insurer, the insurer described in sub. (1m) or any other
10person to compensate the provider, directly or indirectly, for health care costs,
11including health care costs for which the
enrolled participant enrollee, policyholder
12or insured is not liable under sub. (1) or (1m).
AB927, s. 78
13Section
78. 609.91 (4) (c) of the statutes is amended to read:
AB927,28,2214
609.91
(4) (c) The insolvency of the health maintenance organization insurer
15or any person contracting with the health maintenance organization insurer or
16provider, or the commencement or the existence of conditions permitting the
17commencement of insolvency, delinquency or bankruptcy proceedings involving the
18health maintenance organization insurer or other person, including delinquency
19proceedings, as defined in s. 645.03 (1) (b), under ch. 645, despite whether the health
20maintenance organization insurer or other person has agreed to compensate,
21directly or indirectly, the provider for health care costs for which the
enrolled
22participant enrollee or policyholder is not liable under sub. (1).
AB927, s. 79
23Section
79. 609.91 (4) (cm) of the statutes is amended to read:
AB927,29,624
609.91
(4) (cm) The insolvency of the insurer described in sub. (1m) or any
25person contracting with the insurer or provider, or the commencement or the
1existence of conditions permitting the commencement of insolvency, delinquency or
2bankruptcy proceedings involving the insurer or other person, including
3delinquency proceedings, as defined in s. 645.03 (1) (b), under ch. 645, despite
4whether the insurer or other person has agreed to compensate, directly or indirectly,
5the provider for health care costs for which the
enrolled participant enrollee,
6policyholder or insured is not liable under sub. (1m).
AB927, s. 80
7Section
80. 609.91 (4) (d) of the statutes is amended to read:
AB927,29,128
609.91
(4) (d) The inability of the provider or other person who is owed
9compensation for health care costs to obtain compensation from the health
10maintenance organization insurer, the insurer described in sub. (1m) or any other
11person for health care costs for which the
enrolled participant enrollee, policyholder
12or insured is not liable under sub. (1) or (1m).
AB927, s. 81
13Section
81. 609.92 (5) of the statutes is amended to read:
AB927,29,1814
609.92
(5) Provider of physician services. A provider who is not under
15contract with a health maintenance organization insurer and who is not a
selected 16participating provider of a health maintenance organization insurer is not subject
17to s. 609.91 (1) (b) 2. with respect to health care costs incurred by an
enrolled
18participant enrollee of that health maintenance organization insurer.
AB927, s. 82
19Section
82. 609.94 (1) (b) of the statutes is amended to read:
AB927,29,2220
609.94
(1) (b) Each
selected participating provider of the health maintenance
21organization insurer, at the time that the provider becomes a
selected participating 22provider.
AB927, s. 83
23Section
83. 645.69 (1) of the statutes is amended to read:
AB927,30,324
645.69
(1) A claim against a health maintenance organization insurer or an
25insurer described in s. 609.91 (1m) for health care costs, as defined in s. 609.01 (1j),
1for which an
enrolled participant enrollee, as defined in s. 609.01 (1d), policyholder
2or insured of the health maintenance organization insurer or other insurer is not
3liable under ss. 609.91 to 609.935.
AB927, s. 84
4Section
84. 645.69 (2) of the statutes is amended to read:
AB927,30,75
645.69
(2) A claim for health care costs, as defined in s. 609.01 (1j), for which
6an
enrolled participant enrollee, as defined in s. 609.01 (1d), or policyholder of a
7health maintenance organization is not liable for any reason.
AB927, s. 85
8Section
85. 646.31 (1) (d) 8. of the statutes is amended to read:
AB927,30,119
646.31
(1) (d) 8. Made for health care costs, as defined in s. 609.01 (1j), for which
10an
enrolled participant enrollee, as defined in s. 609.01 (1d), or policyholder of a
11health maintenance organization insurer is not liable under ss. 609.91 to 609.935.
AB927, s. 86
12Section
86. 646.31 (1) (d) 9. of the statutes is amended to read:
AB927,30,1513
646.31
(1) (d) 9. Made for health care costs, as defined in s. 609.01 (1j), for which
14an
enrolled participant enrollee, as defined in s. 609.01 (1d), or policyholder of a
15health maintenance organization is not liable for any reason.
AB927,30,2017
(1)
If a contract that is in effect on January 1, 1999, that is affected by this act
18and that was not issued or renewed after the effective date of this subsection contains
19terms or provisions that are inconsistent with the requirements under this act, this
20act first applies to that contract upon renewal.
AB927,30,2521
(2) If a contract that is in effect on January 1, 1999, that is affected by this act
22and that is affected by a collective bargaining agreement that was not extended,
23modified or renewed after the effective date of this subsection contains terms or
24provisions that are inconsistent with this act, this act first applies to that contract
25on the earlier of the following:
AB927,31,1
1(a) The day on which the collective bargaining agreement expires.
AB927,31,32
(b) The day on which the collective bargaining agreement is extended, modified
3or renewed.
AB927, s. 88
4Section
88.
Effective dates. This act takes effect on January 1, 1999, or on
5the day after publication, whichever is later, except as follows:
AB927,31,66
(1)
Section
87 of this act takes effect on the day after publication.