SB562: Bill Text

SB562,61,21 (3) Employers. (a) Subject to pars. (b), (c), and (d) and sub. (4), the board shall calculate an assessment, based on its anticipated revenue needs, that is a percent of aggregate social security wages that is at least 9 percent and not more than 12 percent.

SB562,61,24 (b) Except as provided in par. (d), for taxable year beginning after December 31, 2009, and before January 1, 2011, the assessment imposed on a small employer shall be 33 percent of the amount calculated for that employer under par. (a).

SB562,62,3 (c) Except as provided in par. (d), for taxable year beginning after December 31, 2010, and before January 1, 2012, the assessment imposed on a small employer shall be 67 percent of the amount calculated for that employer under par. (a).

SB562,62,10 (d) If a small employer begins doing business in this state, as defined in s. 71.22 (1r), during the period beginning on January 1, 2010, and ending on December 31, 2012, for the small employer's first taxable year the assessment imposed on the small employer shall be 33 percent of the amount calculated for that employer under par. (a) and for the small employer's 2nd taxable year the assessment imposed on the small employer shall be 67 percent of the amount calculated for that employer under par. (a).

SB562,62,21 (4) Collection and calculation of assessments. (a) For taxable years beginning after December 31, 2009, the department shall impose on, and collect from, individuals the assessment amounts that the board calculates under sub. (2), either through an assessment that is collected as part of the income tax under subch. I of ch. 71, or through another method devised by the department. For taxable years beginning after December 31, 2009, the department shall impose on, and collect from, employers the assessment amounts that the board calculates under sub. (3), either through an assessment that is collected as part of the tax under subch. IV of ch. 71, or through another method devised by the department. Section 71.80 (1) (c), as it applies to ch. 71, applies to the department's imposition and collection of assessments under this section.

SB562,62,23 (b) The amounts that the department collects under par. (a) shall be deposited into the Healthy Wisconsin trust fund under s. 25.775.

SB562,63,2 (c) The board may annually increase or decrease the amounts that may be assessed under subs. (2) and (3). No annual increase under this paragraph may exceed the percentage increase for medical inflation unless a greater increase is provided for by law.

SB562,63,6 (d) The maximum amount of assessment that the department may impose on, and collect from, a household under par. (a) is 4 percent of the annual limit on the contribution and benefit base of the Old-Age, Survivors, and Disability Insurance program, as calculated annually by the U.S. social security administration.

SB562,63,8 260.49 Advisory committee. (1) Duties. The board shall establish a health care advisory committee to advise the board on all of the following:

SB562,63,9 (a) Matters related to promoting healthier lifestyles.

SB562,63,10 (b) Promoting health care quality.

SB562,63,11 (c) Increasing the transparency of health care cost and quality information.

SB562,63,12 (d) Preventive care.

SB562,63,13 (e) Early identification of health disorders.

SB562,63,14 (f) Disease management.

SB562,63,16 (g) The appropriate use of primary care, medical specialists, prescription drugs, and hospital emergency rooms.

SB562,63,17 (h) Confidentiality of medical information.

SB562,63,18 (i) The appropriate use of technology.

SB562,63,19 (j) Benefit design.

SB562,63,20 (k) The availability of physicians, hospitals, and other providers.

SB562,63,21 (L) Reducing health care costs.

SB562,63,22 (m) Any other subject assigned to it by the board.

SB562,63,23 (n) Any other subject determined appropriate by the committee.

SB562,63,25 (2) Membership. The board shall appoint as members of the committee all of the following individuals:

SB562,64,1 (a) At least one member designated by the Wisconsin Medical Society, Inc.

SB562,64,3 (b) At least one member designated by the Wisconsin Academy of Family Physicians.

SB562,64,4 (c) At least one member designated by the Wisconsin Hospital Association, Inc.

SB562,64,7 (d) One member designated by the president of the Board of Regents of the University of Wisconsin System who is knowledgeable in the field of medicine and public health.

SB562,64,9 (e) One member designated by the president of the Medical College of Wisconsin.

SB562,64,12 (f) Two members designated by the Wisconsin Nurses Association, the Wisconsin Federation of Nurses and Health Professionals, and the Service Employees International Union.

SB562,64,13 (g) One member designated by the Wisconsin Dental Association.

SB562,64,15 (h) One member designated by statewide organizations interested in mental health issues.

SB562,64,16 (i) One member representing health care administrators.

SB562,64,17 (j) Other members representing health care professionals.

SB562, s. 77 Section 77. 285.59 (1) (b) of the statutes is amended to read:

SB562,65,2 285.59 (1) (b) "State agency" means any office, department, agency, institution of higher education, association, society, or other body in state government created or authorized to be created by the constitution or any law which that is entitled to expend moneys appropriated by law, including the legislature and the courts, the Wisconsin Housing and Economic Development Authority, the Bradley Center Sports and Entertainment Corporation, the University of Wisconsin Hospitals and Clinics Authority, the Fox River Navigational System Authority, the Wisconsin Aerospace Authority, and the Wisconsin Health and Educational Facilities Authority, and the Healthy Wisconsin Authority.

SB562, s. 78 Section 78. 609.01 (7) of the statutes is repealed.

SB562, s. 79 Section 79. 609.10 of the statutes is repealed.

SB562, s. 80 Section 80. 609.20 (1m) (c) of the statutes is repealed.

SB562, s. 81 Section 81. 609.20 (1m) (d) of the statutes is repealed.

SB562, s. 82 Section 82. 628.36 (4) (a) (intro.) of the statutes is amended to read:

SB562,65,11 628.36 (4) (a) (intro.) The commissioner shall provide information and assistance to the department of employee trust funds, employers and their employees, providers of health care services, and members of the public, as provided in par. (b), for the following purposes:

SB562, s. 83 Section 83. 628.36 (4) (b) 1. of the statutes is repealed.

SB562, s. 84 Section 84. 628.36 (4) (b) 2. of the statutes is repealed.

SB562, s. 85 Section 85. 628.36 (4) (b) 3. of the statutes is repealed.

SB562, s. 86 Section 86. 632.87 (5) of the statutes is amended to read:

SB562,65,23 632.87 (5) No insurer or self-insured school district, city or village may, under a policy, plan, or contract covering gynecological services or procedures, exclude or refuse to provide coverage for Papanicolaou tests, pelvic examinations , or associated laboratory fees when the test or examination is performed by a licensed nurse practitioner, as defined in s. 632.895 (8) (a) 3., within the scope of the nurse practitioner's professional license, if the policy, plan, or contract includes coverage for Papanicolaou tests, pelvic examinations, or associated laboratory fees when the test or examination is performed by a physician.

SB562, s. 87 Section 87. 632.895 (8) (f) 4. of the statutes is created to read:

SB562,66,2 632.895 (8) (f) 4. A disability insurance policy providing only health care benefits not provided under the Healthy Wisconsin Plan under ch. 260.

SB562, s. 88 Section 88. 632.895 (9) (d) 4. of the statutes is created to read:

SB562,66,5 632.895 (9) (d) 4. A disability insurance policy providing only health care benefits not provided under the Healthy Wisconsin Plan under ch. 260.

SB562, s. 89 Section 89. 632.895 (10) (a) of the statutes is amended to read:

SB562,66,14 632.895 (10) (a) Except as provided in par. (b), every disability insurance policy and every health care benefits plan provided on a self-insured basis by a county board under s. 59.52 (11), by a city or village under s. 66.0137 (4), by a political subdivision under s. 66.0137 (4m), by a town under s. 60.23 (25), or by a school district under s. 120.13 (2) shall provide coverage for blood lead tests for children under 6 years of age, which shall be conducted in accordance with any recommended lead screening methods and intervals contained in any rules promulgated by the department of health and family services under s. 254.158.

SB562, s. 90 Section 90. 632.895 (10) (b) 6. of the statutes is created to read:

SB562,66,17 632.895 (10) (b) 6. A disability insurance policy providing only health care benefits not provided under the Healthy Wisconsin Plan under ch. 260.

SB562, s. 91 Section 91. 632.895 (11) (a) (intro.) of the statutes is amended to read:

SB562,66,24 632.895 (11) (a) (intro.) Except as provided in par. (e), every disability insurance policy, and every self-insured health 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 shall provide coverage for diagnostic procedures and medically necessary surgical or nonsurgical treatment for the correction of temporomandibular disorders if all of the following apply:

SB562, s. 92 Section 92. 632.895 (11) (c) 1. of the statutes is amended to read:

SB562,67,3 632.895 (11) (c) 1. The coverage required under this subsection may be subject to any limitations, exclusions, or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan.

SB562, s. 93 Section 93. 632.895 (11) (d) of the statutes is amended to read:

SB562,67,8 632.895 (11) (d) Notwithstanding par. (c) 1., an insurer or a self-insured health plan of the state or a county, city, village, town or school district may require that an insured obtain prior authorization for any medically necessary surgical or nonsurgical treatment for the correction of temporomandibular disorders.

SB562, s. 94 Section 94. 632.895 (11) (e) 3. of the statutes is created to read:

SB562,67,11 632.895 (11) (e) 3. A disability insurance policy providing only health care benefits not provided under the Healthy Wisconsin Plan under ch. 260.

SB562, s. 95 Section 95. 632.895 (12) (b) (intro.) of the statutes is amended to read:

SB562,67,18 632.895 (12) (b) (intro.) Except as provided in par. (d), every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, shall cover hospital or ambulatory surgery center charges incurred, and anesthetics provided, in conjunction with dental care that is provided to a covered individual in a hospital or ambulatory surgery center, if any of the following applies:

SB562, s. 96 Section 96. 632.895 (12) (c) of the statutes is amended to read:

SB562,67,22 632.895 (12) (c) The coverage required under this subsection may be subject to any limitations, exclusions, or cost-sharing provisions that apply generally under the disability insurance policy or self-insured plan.

SB562, s. 97 Section 97. 632.895 (13) (a) of the statutes is amended to read:

SB562,68,2 632.895 (13) (a) Every disability insurance policy , and every self-insured health plan of the state or a county, city, village, town or school district, that provides coverage of the surgical procedure known as a mastectomy shall provide coverage of breast reconstruction of the affected tissue incident to a mastectomy.

SB562, s. 98 Section 98. 632.895 (13) (b) of the statutes is amended to read:

SB562,68,6 632.895 (13) (b) The coverage required under par. (a) may be subject to any limitations, exclusions, or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan.

SB562, s. 99 Section 99. 632.895 (14) (b) of the statutes is amended to read:

SB562,68,12 632.895 (14) (b) Except as provided in par. (d), every disability insurance policy, and every self-insured health plan of the state or a county, city, town, village or school district, that provides coverage for a dependent of the insured shall provide coverage of appropriate and necessary immunizations, from birth to the age of 6 years, for a dependent who is a child of the insured.

SB562, s. 100 Section 100. 632.895 (14) (c) of the statutes is amended to read:

SB562,68,18 632.895 (14) (c) The coverage required under par. (b) may not be subject to any deductibles, copayments, or coinsurance under the policy or plan. This paragraph applies to a defined network plan, as defined in s. 609.01 (1b), only with respect to appropriate and necessary immunizations provided by providers participating, as defined in s. 609.01 (3m), in the plan.

SB562, s. 101 Section 101. 632.895 (14) (d) 7. of the statutes is created to read:

SB562,68,21 632.895 (14) (d) 7. A disability insurance policy providing only health care benefits not provided under the Healthy Wisconsin Plan under ch. 260.

SB562, s. 102 Section 102. Nonstatutory provisions.

SB562,68,23 (1) Healthy Wisconsin Plan.

SB562,69,3 (a) Legislative findings. In establishing the Healthy Wisconsin Plan under chapter 260 of the statutes, as created by this act, the legislature finds all of the following:

SB562,69,9 1. `Costs.' Health care costs in Wisconsin are rising at an unsustainable rate making the need for comprehensive reform urgent. Rising costs are seriously threatening the ability of Wisconsin businesses to globally compete; farms to thrive; government to provide needed services; schools to educate; and local citizens to form new and successful business ventures. Some indicators of rising costs are the following:

SB562,69,11 a. Total health care spending in Wisconsin in 2007 is projected to be $42.3 billion, and is projected to grow 82 percent, to $76.9 billion, in the next decade.

SB562,69,14 b. The cost of employer-provided health care in Wisconsin increased by 9.3 percent in 2006, averaging $9,516 per employee. This figure is 26 percent more than the national average.

SB562,69,16 c. Employee premium contributions and out-of-pocket costs are rising faster than wages.

SB562,69,19 d. Rising costs have led to a decline in employer-provided health benefits. In 1979, 73 percent of private-sector Wisconsin workers had employer-based health insurance coverage; however, only 57 percent received health benefits in 2004.

SB562,69,23 e. At least one-half of all personal bankruptcies in the United States are the result of medical expenses. Over 75.7 percent of this group had insurance at the onset of illness. In 2004, there were 13,454 medical bankruptcies in Wisconsin affecting 37,360 people.

SB562,70,2 f. The costs of health services provided to individuals who are unable to pay are shifted to others. Of the $22 billion charged by hospitals in 2005, $736,000,000 was not collected. Those who bear the burden of this cost shift have an increasingly difficult time paying their own health care costs.

SB562,70,6 2. `Access.' There is a large and increasing number of people who have no health insurance or who are underinsured. For this growing population, health care is unaffordable and, most often, not received in the most timely and effective manner. Some indicators of lack of access to health care are as follows:

SB562,70,8 a. Over one 500,000 Wisconsin residents were uninsured at any given point during 2007.