SB653: Bill Text

SB653,40,20 Health care liability insurance requirements

SB653,26 Section 26. 655.90 of the statutes is created to read:

SB653,40,24 655.90 Insurance policy requirements. No health care liability policy or self-insured health care provider may exclude or deny coverage for reproductive health care services, including all of the following:

SB653,40,25 (1) Contraceptive implant procedures.

SB653,41,1 (2) Intrauterine contraception procedures.

SB653,41,2 (3) Endometrial biopsies.

SB653,41,3 (4) Medically indicated and elective abortions.

SB653,41,4 (5) Miscarriages.

SB653,41,6 (6) Any other procedures utilizing intrauterine instrumentation for which the health care provider, as defined in 146.81(1), is trained.

SB653,41,8 (7) Any treatment regimens or methods attendant to the procedures covered under this section.

SB653,41,10 (8) Any follow-up treatment regimens or counseling services attendant to the procedures covered under this section.

SB653,27 Section 27. 655.92 of the statutes is created to read:

SB653,41,15 655.92 Rates and classification of procedures. (1) (a) An insurer shall consider medically indicated and elective abortions as having equivalent actuarial risk and shall include medically indicated and elective abortions in the same risk classes or subclasses representing similar actuarial risk.

SB653,41,20 (b) An insurer shall classify intrauterine contraception procedures, contraceptive implant procedures, and the exclusive and entire method applicable for both abortion and the procedures used after miscarriage under family or general medicine, including outpatient gynecology, and in a class or subclass with comparable actuarial risks established for comparable methods and procedures.

SB653,41,24 (c) An insurer shall classify the regimen that involves prescribing and using medication only for abortion under family or general medicine, including outpatient gynecology, in a class or subclass with similar actuarial risks that permit prescribing medications with comparable safety and efficacy in the general practice of medicine.

SB653,42,6 (d) An insurer shall classify endometrial or related biopsies, procedures using intrauterine instrumentation, and miscarriage and abortion procedures, not including the procedures in pars. (b) and (c), performed during or before the 14th week of gestation in a class or subclass limited to procedures with comparable actuarial risks, including miscarriage treatment procedures and excluding surgical procedures with higher risk factors.

SB653,42,11 (2) Subject to s. 625.11, one rate within a class or subclass for health care liability insurance and liability insurance normally incidental to health care liability insurance is unfairly discriminatory in relation to another rate within the same class or subclass if it fails to reasonably and equitably reflect comparable differences in expected losses and expenses.

SB653,42,16 (3) (a) Rates for health care liability insurance and liability insurance normally incidental to health care liability insurance are excessive and unfairly discriminatory if they are likely to produce a long-run profit that is unreasonably high in relation to the riskiness of the class of business or if expenses are unreasonably high in relation to the services rendered.

SB653,42,20 (b) Rates for health care liability insurance and liability insurance normally incidental to health care liability insurance shall be based on sound actuarial evidence and standards of care, and may not take into account unfairly discriminatory factors, including:

SB653,42,22 1. Political or social concerns associated with providing insurance covering medically indicated and elective abortion procedures.

SB653,42,23 2. Ethical or religious considerations or opinions about abortion.

SB653,43,3 3. The assignment of higher rates for services when only incomplete actuarial data are available and using such data to limit the liability associated with insuring an unknown risk.

SB653,28 Section 28. 655.94 of the statutes is created to read:

SB653,43,8 655.94 Petition by health care providers. (1) Prior to filing a petition to the commissioner, a health care provider shall exhaust all remedies for appealing coverage or rates contained in the provider's health care liability insurance policy or liability insurance normally incidental to health care liability insurance.

SB653,43,14 (2) A health care provider may petition the commissioner for a review of the final determination of rates under its health care liability policy for a review of classification or rates. The petition shall state the basis for the health care provider's belief that the classification or rates are incorrect, or that the classification or rates violate ss. 625.11, 625.12, or 655.92. The commissioner shall refer a petition as specified in sub. (3).

SB653,43,16 (3) (a) The commissioner shall appoint a committee for the review of classification or rates as follows:

SB653,43,20 1. If the health care provider is a hospital or entity affiliated with a hospital, then consisting of 2 representatives of hospitals, other than the health care provider's hospital, and one other person who is knowledgeable about insurance classifications and rates and not affiliated with the insurer.

SB653,43,24 2. If the health care provider is any entity not specified in subd. 1., then consisting of 2 physicians not directly or indirectly affiliated or associated with the health care provider and one other person who is knowledgeable about insurance classifications and rates and not affiliated with the insurer.

SB653,44,3 (b) The appointed committee shall review the classification and rates and report its decision in writing to the health care provider and the commissioner within 5 days after completing the review.

SB653,44,5 (c) Any party to the review adversely affected by the decision of the committee may file a written request for a hearing under subch. III of ch. 227.

SB653,29 Section 29. 655.96 of the statutes is created to read:

SB653,44,11 655.96 Cancelation by insurer. Notwithstanding ss. 631.36, 631.37, and 655.24, an insurer may not cancel or refuse to renew a policy of primary health care liability insurance and liability insurance normally incidental to health care liability insurance except for nonpayment of premiums or if the health care provider provider's license is revoked by the appropriate licensing board.

SB653,30 Section 30. 939.75 (2) (b) 1. of the statutes is amended to read:

SB653,44,15 939.75 (2) (b) 1. An act committed during an induced abortion. This subdivision does not limit the applicability of ss. 940.04, 940.13, 940.15 and 940.16 to an induced abortion.

SB653,31 Section 31. 940.04 of the statutes is repealed.

SB653,32 Section 32. 940.32 (1) (a) 10. of the statutes is renumbered 940.32 (1) (a) 12. and amended to read:

SB653,44,20 940.32 (1) (a) 12. Causing a person to engage in any of the acts described in subds. 1. to 9. 11.

SB653,33 Section 33. 940.32 (1) (a) 11. of the statutes is created to read:

SB653,44,23 940.32 (1) (a) 11. Impeding access to a health care facility where the victim seeks, obtains, or provides health care.

SB653,34 Section 34. 968.26 (1b) (a) 2. a. of the statutes, as created by 2015 Wisconsin Act 64, is amended to read:

SB653,45,6 968.26 (1b) (a) 2. a. Section 940.04, 940.11, 940.19 (2), (4), (5), or (6), 940.195 (2), (4), (5), or (6), 940.20, 940.201, 940.203, 940.205, 940.207, 940.208, 940.22 (2), 940.225 (3), 940.29, 940.302 (2) (c), 940.32, 941.32, 941.38 (2), 942.09 (2), 943.10, 943.205, 943.32 (1), 946.43, 946.44, 946.47, 946.48, 948.02 (3), 948.03 (2) (b) or (c), (3), or (4), 948.04, 948.055, 948.095, 948.10 (1) (a), 948.11, 948.13 (2) (a), 948.14, 948.20, 948.23 (1), (2), or (3) (c) 2. or 3., or 948.30 (1).

SB653,35 Section 35. 990.001 (17) (b) of the statutes is amended to read:

SB653,45,13 990.001 (17) (b) If a statute or rule refers to a live birth or to the circumstance in which an individual is born alive, the statute or rule shall be construed so that whoever undergoes a live birth as the result of an induced abortion, as defined in s. 253.10 (2) (a) 69.01 (13m), has the same legal status and legal rights as a human being at any point after the human being undergoes a live birth as the result of natural or induced labor or a cesarean section.

SB653,36 Section 36. 990.01 (19j) (b) of the statutes is amended to read:

SB653,45,21 990.01 (19j) (b) "Live birth" means the complete expulsion or extraction from his or her mother, of a human being, at any stage of development, who, after the expulsion or extraction, breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, a cesarean section, or an induced abortion, as defined in s. 253.10 (2) (a) 69.01 (13m).

SB653,37 Section 37. Effective dates. This act takes effect on the day after publication, except as follows:

SB653,45,25 (1) The treatment of section 448.02 (3) (a) of the statutes (by Section 18) takes effect on April 1, 2017.

SB653,46,2 (2) The treatment of sections 69.186 (1) (hf), (k), and (L) and 253.107 of the statutes takes effect on February 1, 2016.

SB653,46,3 (End)