1. The bill requires that an insurer must classify certain procedures and
medication regimens related to reproductive health and abortion in the same risk
classes as other procedures with similar actuarial risks. The bill also requires
medically indicated abortions to be classified in the same risk classes as elective
abortions.
2. Under current law, the commissioner of insurance has the authority to
promulgate rules for the procedure under which a health care provider may
challenge the classification and rates contained in its liability policy. Under this bill,
a health care provider is first required to exhaust all remedies contained in its
insurance contract for challenging classification and rates. This bill also codifies the
procedure promulgated by the commissioner, which permits a health care provider
to, after exhausting its remedies under the insurance contract, petition the
commissioner for review of the classification and rates. If the health care provider
is not satisfied with the result of the petition, the health care provider may then
appeal the decision to an administrative law judge.
3. Under current law, an insurer may not provide rates that are unfairly
discriminatory. Unfair discrimination occurs when one rate in relation to another
does not reflect the differences in expected losses and expenses. Under this bill, rates
are also unfairly discriminatory if they consider political, social, ethical, or religious
concerns associated with providing insurance for abortion procedures. Rates are also
unfairly discriminatory if an insurer charges a higher rate for services when there

is incomplete actuarial data for assessing the risk. The bill specifies that sound
actuarial principles do not include political, social, ethical, and religious
considerations, charging higher rates for services of which there is only incomplete
data, and using incomplete data to limit liability associated with insuring unknown
risks.
4. The bill provides that all health care liability insurance policies must include
coverage for certain regimens, methods, and procedures, including contraceptive
implant procedures, intrauterine contraception procedures, endometrial biopsies,
medically indicated and elective abortions, miscarriages, and other procedures using
intrauterine instrumentation for which the health care provider is trained. The
policies are also required to include coverage for counseling and follow-up services
associated with these regimens, methods, and procedures.
Comprehensive Women's Health Research Council
The bill creates the Comprehensive Women's Health Research Council that is
required to identify and assess the needs for research on voluntary termination of
pregnancy, prioritize research projects most likely to improve health outcomes for
women in Wisconsin, and propose ways and means to fund those projects.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB653,1 1Section 1. 15.194 (2) of the statutes is created to read:
SB653,7,52 15.194 (2) Office of advancement in medical knowledge and care. There is
3created an office of advancement in medical knowledge and care in the department
4of health services. The director of the office shall be appointed by, and report directly
5to, the secretary of health services.
SB653,2 6Section 2. 15.197 (12m) of the statutes is created to read:
SB653,7,107 15.197 (12m) Comprehensive women's health research council. There is
8created in the department of health services a comprehensive women's health
9research council that consists of the following members appointed by the secretary
10of the department of health services:
SB653,8,2
1(a) The chairperson of a statewide professional medical organization, as
2defined in s. 258.01 (11), that specializes in obstetrics and gynecology.
SB653,8,63 (b) The chair of the department that specializes in obstetrics and gynecology
4at a medical school located in this state that is accredited by the Liaison Committee
5on Medical Education or the American Osteopathic Association Commission on
6Osteopathic College Accreditation, or the chair's designee.
SB653,8,107 (c) The chair of the department that specializes in family medicine at a medical
8school located in this state that is accredited by the Liaison Committee on Medical
9Education or the American Osteopathic Association Commission on Osteopathic
10College Accreditation, or the chair's designee.
SB653,8,1411 (d) The chair of the department that specializes in biostatistics at a medical
12school located in this state that is accredited by the Liaison Committee on Medical
13Education or the American Osteopathic Association Commission on Osteopathic
14College Accreditation, or the chair's designee.
SB653,8,1815 (e) The chair of the department that specializes in population health at a
16medical school in this state that is accredited by the Liaison Committee on Medical
17Education or the American Osteopathic Association Commission on Osteopathic
18College Accreditation, or the chair's designee.
SB653,3 19Section 3. 20.9275 (1) (a) of the statutes is amended to read:
SB653,8,2120 20.9275 (1) (a) "Abortion" has the meaning given in s. 253.10 (2) (a) for "induced
21abortion" under s. 69.01 (13m)
.
SB653,4 22Section 4. 46.245 of the statutes is repealed.
SB653,5 23Section 5. 48.375 (4) (a) 1. of the statutes is amended to read:
SB653,9,724 48.375 (4) (a) 1. The person or the person's agent has, either directly or through
25a referring physician or his or her agent, received and made part of the minor's

1medical record, under the requirements of s. 253.10, the voluntary and informed
2written consent of the minor and the voluntary and informed written consent of one
3of her parents; or of the minor's guardian or legal custodian, if one has been
4appointed; or of an adult family member of the minor; or of one of the minor's foster
5parents, if the minor has been placed in a foster home and the minor's parent has
6signed a waiver granting the department, a county department, or the foster parent
7the authority to consent to medical services or treatment on behalf of the minor.
SB653,6 8Section 6. 69.186 (1) (hf) of the statutes, as created by 2015 Wisconsin Act 56,
9is repealed.
SB653,7 10Section 7. 69.186 (1) (k) of the statutes, as created by 2015 Wisconsin Act 56,
11is repealed.
SB653,8 12Section 8. 69.186 (1) (L) of the statutes, as created by 2015 Wisconsin Act 56,
13is repealed.
SB653,9 14Section 9. 253.09 of the statutes is repealed.
SB653,10 15Section 10. 253.095 of the statutes is repealed.
SB653,11 16Section 11. 253.10 of the statutes, as affected by 2015 Wisconsin Act 56, is
17repealed.
SB653,12 18Section 12. 253.105 of the statutes is repealed.
SB653,13 19Section 13. 253.107 of the statutes, as created by 2015 Wisconsin Act 56, is
20repealed.
SB653,14 21Section 14. Chapter 258 of the statutes is created to read:
SB653,9,2422 Chapter 258
23 Patients' Reproductive
24 health act
SB653,9,25 25258.01 Definitions. In this chapter:
SB653,10,7
1(1) "Biomedical and behavioral research" includes studies designed primarily
2to increase the scientific base of information about normal or abnormal physiology
3and development; studies primarily intended to evaluate the safety, effectiveness, or
4usefulness of a medical product, procedure, or intervention; and studies on the
5behavior of individuals and populations to establish a body of demonstrable,
6replicable facts and theories that contribute to knowledge and amelioration of
7human problems.
SB653,10,8 8(2) "Department" means the department of health services.
SB653,10,15 9(3) "Deprecatory matter" means, in the context of patient and health care
10provider protection, any knowingly false communication or publication that exposes
11an individual who is seeking, is obtaining, or has obtained health care services, who
12is aiding or has aided an individual to obtain health care services, or who provides
13health care services to hatred, contempt, ridicule, degradation, or disgrace in society
14or exposes that individual or health care provider to injury in the individual's or
15health care provider's business or occupation.
SB653,10,22 16(4) "Employment retribution" means a retaliatory action taken by an employer
17in response to an exercise of a health care provider's rights specifically created or
18recognized in law, including termination of employment, employment suspensions
19or probationary periods, written or oral warnings, failure to promote, diminishment
20in employment responsibilities, adverse changes in compensation, removal from or
21adverse changes in titled positions, denial of medical staff or other privileges, or
22unwanted work schedule changes.
SB653,11,4 23(5) "Health care provider" means an employer, employee, independent
24contractor, or consultant who provides health care under state law, a business or
25corporation providing health care services authorized by the state, including a

1physician of medicine or osteopathy, a physician's assistant, a specialist assistant,
2a nurse, a nurse practitioner, a hospital, a critical access hospital, a skilled nursing
3facility, a comprehensive outpatient rehabilitative facility, a health center, a home
4health agency, an ambulatory surgery center, a dialysis center, or a hospice program.
SB653,11,9 5(6) "Immediate family member" means, for a certain individual, in the context
6of patient and health care provider protection, a spouse, parent, brother or sister,
7child or person to whom the individual stands in loco parentis, or any other person
8living in the individual's household and related to that individual by blood or
9marriage.
SB653,11,21 10(7) "Medically accurate" means information relevant to informed
11decision-making based on the weight of current scientific evidence, derived from
12research using accepted scientific methods, consistent with generally recognized
13scientific theory, and, if available, published in peer-reviewed journals, and
14recognized as accurate, objective, and complete by professional medical
15organizations including the American Medical Association, the American Congress
16of Obstetricians and Gynecologists, the American Public Health Association, or the
17American Academy of Pediatrics; by government agencies, including the Center for
18Disease Control, the Food and Drug Administration, the National Cancer Institute,
19the American Psychological Association, or the National Institute of Health; or by
20scientific advisory groups including the Institute of Medicine and the Advisory
21Committee on Immunization Practices.
SB653,11,2322 (8) "Physical obstruction" means, in the context of patient and health care
23provider protection, willfully or recklessly doing any of the following:
SB653,12,3
1(a) Obstructing, hindering, detaining, depriving, impeding the clear passage
2to, or blocking an individual's access to or egress from, a health care facility or from
3the common areas of the real property upon which the facility is located.
SB653,12,84 (b) Without the consent of the individual, intruding within 6 feet of an
5individual entering or exiting a health care facility or from the common areas of the
6real property upon which the facility is located in a manner that deprives or delays
7the individual from obtaining, aiding another to obtain, or providing health care
8services.
SB653,12,9 9(9) "Physician" has the meaning given in s. 448.01 (5).
SB653,12,14 10(10) "Procedure or treatment form" means any information a patient receives
11relating to giving consent to a procedure or treatment the patient may elect to
12proceed with, whether in a brochure, a notice, a posting, an agreement, or other
13document, provided in writing, electronically, or by video, without regard to whether
14or not the communication requires a signature.
SB653,12,20 15(11) "Professional medical organization" means an entity widely regarded as
16the leading organization or association within its field that serves a single profession,
17or a specialty within a single profession, that possesses a primary standing in that
18profession that requires of its members a significant amount of education, training,
19or experience, or a license or certificate from a state or authorized private authority
20to practice the profession or specialty.
SB653,12,25 21(12) "Referral" means providing names and contact information of health care
22providers, securing or assisting a patient in scheduling appointments with health
23care providers, and communicating with referred health care providers about
24medical care that may be in the patient's best interest in the judgment of the health
25care provider.
SB653,13,5
1(13) "Scientific advisory group" means, in the context of providing medically
2accurate information to patients, a group that is recognized as an authoritative
3scientific source by the medical profession and is comprised of knowledgeable,
4prominent, and credible members in their field of expertise and that offers scientific
5opinions on health matters.
SB653,13,10 6(14) "Suffer serious emotional distress" means to feel terrified, intimidated,
7threatened, harassed, or tormented on account of an actor's intentional conduct or
8behavior if such conduct or behavior would cause a reasonable person under the
9same circumstances to feel terrified, intimidated, threatened, harassed, or
10tormented.
SB653,13,11 11(15) "Targeted and dangerous activity" means any of the following:
SB653,13,1412 (a) Any act or threat involving murder, kidnapping, arson, robbery, other
13substantial bodily harm, bribery, or extortion, which is chargeable under the law and
14punishable by imprisonment for more than one year.
SB653,13,1615 (b) Any act dangerous to human life that is a violation of the laws of the United
16States or of this state.
SB653,13,21 17258.05 Patient rights to medically accurate information. (1) In this
18section, "patient" means any individual who presents himself or herself at or before
19a health care provider for the purpose of obtaining medical investigation,
20examination, diagnosis, stabilization, consultation, treatment, procedure, or
21referral.
SB653,13,25 22(2) A patient has the right to receive medically accurate information from a
23physician providing medical care, including but not limited to, investigation,
24examination, diagnosis, stabilization, consultation, treatment, procedure, and
25referral.
SB653,14,3
1(3) A physician has the right and obligation to provide medically accurate
2information to patients to whom the physician provides medical care, and to make
3referrals for patients to other licensed physicians and health care providers.
SB653,14,6 4(4) No person, including the state or any political subdivision of the state, may
5interfere with or otherwise diminish the rights and obligations specified in sub. (2)
6or (3).
SB653,14,10 7(5) Employment retribution by any person against a physician based on the
8physician's exercise of the rights and obligations specified in subs. (2) and (3), or the
9physician's provision of medical care to a patient based on such rights and
10obligations, is prohibited.
SB653,14,12 11(6) The state, including any political subdivision or instrumentality of the
12state, may not do any of the following:
SB653,14,1613 (a) Require the inclusion of any content in a procedure or treatment form that
14is not medically accurate, or promote or support, in any manner, an entity that
15promulgates, for distribution to a patient or other person seeking medical advice
16from an entity, information that is not medically accurate.
SB653,14,2517 (b) Prohibit a physician from adding medically accurate information or from
18deleting information in a procedure or treatment form that, in the physician's
19medical judgment, is either not medically accurate or that does not align with a
20patient's specific request for medical care concerning diagnosis, reservations
21relevant to the diagnosis, the nature and purpose of the proposed procedure or
22treatment, risks and consequences of the proposed procedure or treatment,
23reasonable alternatives to the procedure or treatment appropriate for the patient's
24situation, patient counseling, or prognosis if a patient elects not to proceed with a
25proposed procedure or treatment.
SB653,15,1
1(7) (a) A patient in this state has the right to all of the following:
SB653,15,32 1. Access, generally, to continually improving, medically accurate, high quality,
3safe patient care.
SB653,15,94 2. Access, particularly, to continually improving, medically accurate, high
5quality, safe patient care from obstetricians, gynecologists, pediatricians, emergency
6room physicians, and family medicine physicians who attended medical residency
7programs that provided training in evidence-based, clinically sound and current,
8comprehensive reproductive health care with reliance on up-to-date, medically
9accurate didactic materials.
SB653,15,1610 (b) The office of advancement in medical knowledge and care shall investigate
11developments affecting the policy of the state and patient rights under this section,
12submit an annual report of its findings to the appropriate standing committees of the
13legislature handling issues relating to health, as determined by the speaker of the
14assembly and the president of the senate under s. 13.172 (3), and distribute the
15report to the governor, the deans of all schools of medicine in the state, and the
16directors of all medical residency programs in the state.
SB653,15,18 17(8) Whoever violates this section shall be subject to the civil remedies under
18s. 258.55.
SB653,15,21 19258.10 Employment retribution and discrimination prohibition. (1)
20In this section, "adverse employment action" means any of the following actions
21engaged in or taken by an employer:
SB653,15,2422 (a) Employment retribution, or unfair discrimination in employment under s.
23111.31, in the hiring, licensing, terms or conditions of employment, compensation,
24promotion, privileges, or termination of any health care provider.
SB653,16,2
1(b) Employment retribution, or unfair discrimination in employment under s.
2111.31, in the extension of staff or other privileges to any health care provider.
SB653,16,63 (c) Any adverse action against a health care provider with respect to hiring,
4licensing, terms or conditions of employment, compensation, promotion, privileges,
5termination, or quantity, schedule, or nature of the health care provider's
6assignments or duties.
SB653,16,8 7(2) No person may take any adverse employment action against a health care
8provider because the health care provider does any of the following:
SB653,16,119 (a) Performs or assists or has performed or assisted in a sterilization procedure,
10an abortion procedure, or other reproductive health service for an employer or as a
11volunteer.
SB653,16,1212 (b) Participates in or has participated in biomedical and behavioral research.
SB653,16,1413 (c) Engages or has engaged in activities that support or promote any of the
14procedures, services, or research described under par. (a) or (b).
SB653,16,1715 (d) Has asserted or exercised, under s. 258.25, a conscientious belief to not
16provide or to provide any standard reproductive health care services, as defined in
17s. 258.25 (1) (k).
SB653,16,21 18(3) A hospital or health care facility shall provide a written notice to each
19health care provider applicant, and annually to each health care provider, describing
20the employment retribution and discrimination prohibitions under sub. (2). Notices
21may be provided to applicants and employees electronically.
SB653,17,2 22(4) A hospital or health care facility may not, without the express consent of
23a health care provider, disclose information about a health care provider's
24procedures, services, or research to that health care provider's potential or
25prospective employers if the disclosure divulges activities that the hospital or health

1care facility could not use itself for disciplinary or other prohibited purposes under
2sub. (2).
SB653,17,5 3(5) Whoever engages in employment retribution or discrimination against a
4health care provider in violation of sub. (2), (3), or (4) shall be subject to the civil
5remedies under s. 258.55.
SB653,17,7 6258.15 Implementation health care task force. (1) In this section, "task
7force" means the implementation health care task force established under sub. (2).
SB653,17,12 8(2) The secretary of the department shall establish a special committee under
9s. 15.04 (1) (c) called the implementation health care task force to examine and report
10annually upon the challenges and successes in achieving the state policies and rights
11created or described in this chapter. The task force described in this section shall be
12comprised of the following members:
SB653,17,1513 (a) A law enforcement officer designated by the Wisconsin Professional Police
14Association who specializes in investigating crimes involving harassment under s.
15947.013 or stalking under s. 940.32.
SB653,17,1616 (b) The state public defender, or his or her designee.
SB653,17,1817 (c) A representative designated by a statewide professional medical
18organization that represents registered nurses.
SB653,17,2119 (d) An assistant district attorney designated by the association of state
20prosecutors who has significant professional experience prosecuting crimes
21involving harassment under s. 947.013 or stalking under s. 940.32.
SB653,17,2422 (e) A representative designated by a statewide nonprofit organization
23dedicated to advancing access to standard reproductive health care services, as
24defined in s. 258.25 (1) (k).
SB653,18,2
1(f) A representative designated by a statewide professional medical
2organization that specializes in the fields of obstetrics and gynecology.
SB653,18,43 (g) A representative designated by a statewide professional medical
4organization that specializes in the field of family medicine.
SB653,18,55 (h) A representative designated by a scientific advisory group.
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