SB762: Bill Text

SB762,56,2 632.87 (3) (a) (intro.) No policy, plan or contract may exclude coverage for diagnosis and treatment of a condition or complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license, if the policy, plan or contract covers diagnosis and treatment of the condition or complaint by a licensed physician or osteopath, even if different nomenclature is used to describe the condition or complaint. Examination by or referral from a physician shall not be a condition precedent for receipt of chiropractic or spinal medicine care under this paragraph. This paragraph does not:

SB762,104 Section 104. 632.87 (3) (a) 1. of the statutes is amended to read:

SB762,56,5 632.87 (3) (a) 1. Prohibit the application of deductibles or coinsurance provisions to chiropractic, spinal medicine, and physician charges on an equal basis.

SB762,105 Section 105. 632.87 (3) (a) 2. of the statutes is amended to read:

SB762,56,10 632.87 (3) (a) 2. Prohibit the application of cost containment or quality assurance measures to chiropractic or spinal medicine services in a manner that is consistent with cost containment or quality assurance measures generally applicable to physician services and that is consistent with this section.

SB762,106 Section 106. 632.87 (3) (b) (intro.) of the statutes is amended to read:

SB762,56,15 632.87 (3) (b) (intro.) No insurer, under a policy, plan or contract covering diagnosis and treatment of a condition or complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license, may do any of the following:

SB762,107 Section 107. 632.87 (3) (b) 1. of the statutes is amended to read:

SB762,56,22 632.87 (3) (b) 1. Restrict or terminate coverage for the treatment of a condition or a complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license on the basis of other than an examination or evaluation by or a recommendation of a licensed chiropractor or licensed primary spinal care practitioner or a peer review committee that includes a licensed chiropractor or licensed primary spinal care practitioner.

SB762,108 Section 108. 632.87 (3) (b) 2. of the statutes is amended to read:

SB762,56,25 632.87 (3) (b) 2. Refuse to provide coverage to an individual because that individual has been treated by a chiropractor or primary spinal care practitioner.

SB762,109 Section 109. 632.87 (3) (b) 3. of the statutes is amended to read:

SB762,57,4 632.87 (3) (b) 3. Establish underwriting standards that are more restrictive for chiropractic or spinal medicine care than for care provided by other health care providers.

SB762,110 Section 110. 632.87 (3) (b) 4. of the statutes is amended to read:

SB762,57,8 632.87 (3) (b) 4. Exclude or restrict health care coverage of a health condition solely because the condition may be treated by a chiropractor or primary spinal care practitioner.

SB762,111 Section 111. 632.875 (1) (b) of the statutes is amended to read:

SB762,57,12 632.875 (1) (b) "Independent evaluation" means an examination or evaluation by or recommendation of a chiropractor or licensed primary spinal care practitioner or a peer review committee under s. 632.87 (3) (b) 1.

SB762,112 Section 112. 632.875 (1) (bm) of the statutes is created to read:

SB762,57,15 632.875 (1) (bm) "Licensed primary spinal care practitioner" means a person licensed under s. 448.9725.

SB762,113 Section 113. 632.875 (1) (c) of the statutes is amended to read:

SB762,57,18 632.875 (1) (c) "Patient" means a person whose treatment by a chiropractor or licensed primary spinal care practitioner is the subject of an independent evaluation.

SB762,114 Section 114. 632.875 (1) (dm) of the statutes is created to read:

SB762,57,22 632.875 (1) (dm) "Treating primary spinal care practitioner" means a licensed primary spinal care practitioner who is treating a patient and whose treatment of the patient is the subject of an independent evaluation.

SB762,115 Section 115. 632.875 (2) (intro.) of the statutes is amended to read:

SB762,58,6 632.875 (2) (intro.) If, on the basis of an independent evaluation, an insurer restricts or terminates a patient's coverage for the treatment of a condition or complaint by a chiropractor or licensed primary spinal care practitioner acting within the scope of his or her license and the restriction or termination of coverage results in the patient becoming liable for payment for his or her treatment, the insurer shall, within the time required under s. 628.46 (2m), provide to the patient and to the treating chiropractor or licensed primary spinal care practitioner a written statement that contains all of the following:

SB762,116 Section 116. 632.875 (2) (b) of the statutes is amended to read:

SB762,58,9 632.875 (2) (b) The name of the treating chiropractor or treating primary spinal care practitioner.

SB762,117 Section 117. 632.875 (3) (a) of the statutes is amended to read:

SB762,58,15 632.875 (3) (a) In this subsection, "claim" means a patient's claim for coverage, under a policy, plan or contract covering diagnosis and treatment of a condition or complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license, the restriction or termination of which coverage is the subject of an independent evaluation.

SB762,118 Section 118. 632.875 (3) (b) of the statutes is amended to read:

SB762,58,20 632.875 (3) (b) A chiropractor or licensed primary spinal care practitioner who conducts an independent evaluation may not be compensated by an insurer based on a percentage of the dollar amount by which a claim is reduced as a result of the independent evaluation.

SB762,119 Section 119. 632.99 of the statutes is amended to read:

SB762,59,7 632.99 Certifications of disability. For the purpose of insurance policies that they issue, every insurer doing a health or disability insurance business in this state shall afford equal weight to a certification of disability signed by a physician with respect to matters within the scope of the physician's professional license, to a certification of disability signed by a chiropractor with respect to matters within the scope of the chiropractor's professional license, and to a certification of disability signed by a podiatrist with respect to matters within the scope of the podiatrist's professional license, and to a certification of a disability signed by a primary spinal care practitioner with respect to matters within the scope of the primary spinal care practitioner's professional license. This section does not require an insurer to treat any certification of disability as conclusive evidence of disability.

SB762,120 Section 120. 655.45 (1) of the statutes is amended to read:

SB762,59,14 655.45 (1) For the quarter beginning on July 1, 1986, and for each quarter thereafter, the director of state courts shall file reports complying with sub. (2) with the medical examining board, the physical therapy examining board, the podiatry affiliated credentialing board, the spinal medicine affiliated credentialing board, the board of nursing and the department, respectively, regarding health care providers licensed by the respective bodies.

SB762,121 Section 121. 895.453 (title) of the statutes is amended to read:

SB762,59,17 895.453 (title) Payments of chiropractic and spinal medicine services from attorney contingency fees.

SB762,122 Section 122. 895.453 (1) (am) of the statutes is created to read:

SB762,59,20 895.453 (1) (am) "Primary spinal care practitioner" means a person licensed under s. 448.9725.

SB762,123 Section 123. 895.453 (1) (cm) of the statutes is created to read:

SB762,59,22 895.453 (1) (cm) "Spinal medicine" has the meaning given in s. 448.971 (5).

SB762,124 Section 124. 895.453 (2) (intro.) of the statutes is amended to read:

SB762,60,2 895.453 (2) (intro.) Notwithstanding s. 803.03, if all of the following conditions exist, fees for chiropractic or spinal medicine services provided to an injured person shall be paid out of the amount of fees due to his or her attorney under the contingency fee arrangement made between the person and the attorney:

SB762,125 Section 125. 895.453 (2) (b) of the statutes is amended to read:

SB762,60,5 895.453 (2) (b) The services were provided by a chiropractor or primary spinal care practitioner because of the injuries arising from the motor vehicle accident.

SB762,126 Section 126. 895.453 (2) (e) of the statutes is amended to read:

SB762,60,10 895.453 (2) (e) Prior to the person's acceptance of the settlement agreement, the chiropractor or primary spinal care practitioner has not been paid for his or her services and has provided written notification to the person's attorney of the services that were provided to the person.

SB762,127 Section 127. 895.453 (3) of the statutes is amended to read:

SB762,60,18 895.453 (3) Except as provided in sub. (4), if the conditions under sub. (2) are met, the distribution of the amount due under the contingency fee arrangement shall be allocated on a pro rata basis between the person's attorney and each chiropractor and primary spinal care practitioner who provided services, based on the percentage obtained by comparing the outstanding fees owed to the attorney and each chiropractor and primary spinal care practitioner to the aggregate outstanding attorney and, chiropractic, and spinal medicine fees.

SB762,128 Section 128. 895.453 (4) (a) of the statutes is amended to read:

SB762,60,22 895.453 (4) (a) The chiropractor or primary spinal care practitioner is eligible for payment for the services provided to the person under any health insurance contract or self-insured health plan.

SB762,129 Section 129. 895.453 (4) (b) of the statutes is amended to read:

SB762,61,3 895.453 (4) (b) The chiropractor or primary spinal care practitioner is eligible for payment for the services provided to the person under any governmental health plan or program, including Medicaid or Medicare.

SB762,130 Section 130. 895.48 (1m) (a) (intro.) of the statutes is amended to read:

SB762,61,15 895.48 (1m) (a) (intro.) Except as provided in par. (b), any physician, physician assistant, podiatrist, primary spinal care practitioner, or athletic trainer licensed under ch. 448, chiropractor licensed under ch. 446, dentist licensed under ch. 447, emergency medical technician licensed under s. 256.15, first responder certified under s. 256.15 (8), registered nurse licensed under ch. 441, or a massage therapist or bodywork therapist licensed under ch. 460 who renders voluntary health care to a participant in an athletic event or contest sponsored by a nonprofit corporation, as defined in s. 66.0129 (6) (b), a private school, as defined in s. 115.001 (3r), a tribal school, as defined in s. 115.001 (15m), a public agency, as defined in s. 46.856 (1) (b), or a school, as defined in s. 609.655 (1) (c), is immune from civil liability for his or her acts or omissions in rendering that care if all of the following conditions exist:

SB762,131 Section 131. 895.48 (1m) (a) 2. of the statutes is amended to read:

SB762,61,21 895.48 (1m) (a) 2. The physician, podiatrist, primary spinal care practitioner, athletic trainer, chiropractor, dentist, emergency medical technician, first responder, physician assistant, registered nurse, massage therapist or bodywork therapist does not receive compensation for the health care, other than reimbursement for expenses.

SB762,132 Section 132. 905.04 (title) of the statutes is amended to read:

SB762,62,2 905.04 (title) Physician-patient, registered nurse-patient, chiropractor-patient, psychologist-patient, social worker-patient, marriage and family therapist-patient, podiatrist-patient, primary spinal care practitioner-patient, and professional counselor-patient privilege.

SB762,133 Section 133. 905.04 (1) (b) of the statutes is amended to read:

SB762,62,11 905.04 (1) (b) A communication or information is "confidential" if not intended to be disclosed to 3rd persons other than those present to further the interest of the patient in the consultation, examination, or interview, to persons reasonably necessary for the transmission of the communication or information, or to persons who are participating in the diagnosis and treatment under the direction of the physician, podiatrist, primary spinal care practitioner, registered nurse, chiropractor, psychologist, social worker, marriage and family therapist or professional counselor, including the members of the patient's family.

SB762,134 Section 134. 905.04 (1) (bd) of the statutes is created to read:

SB762,62,15 905.04 (1) (bd) "Primary spinal care practitioner" means a person licensed under s. 448.9725 or a person reasonably believed by the patient to be a primary spinal care practitioner.

SB762,135 Section 135. 905.04 (1) (c) of the statutes is amended to read:

SB762,62,20 905.04 (1) (c) "Patient" means an individual, couple, family or group of individuals who consults with or is examined or interviewed by a physician, podiatrist, primary spinal care practitioner, registered nurse, chiropractor, psychologist, social worker, marriage and family therapist or professional counselor.

SB762,136 Section 136. 905.04 (2) of the statutes is amended to read:

SB762,63,8 905.04 (2) General rule of privilege. A patient has a privilege to refuse to disclose and to prevent any other person from disclosing confidential communications made or information obtained or disseminated for purposes of diagnosis or treatment of the patient's physical, mental or emotional condition, among the patient, the patient's physician, the patient's podiatrist, the patient's primary spinal care practitioner, the patient's registered nurse, the patient's chiropractor, the patient's psychologist, the patient's social worker, the patient's marriage and family therapist, the patient's professional counselor or persons, including members of the patient's family, who are participating in the diagnosis or treatment under the direction of the physician, podiatrist, primary spinal care practitioner, registered nurse, chiropractor, psychologist, social worker, marriage and family therapist or professional counselor.

SB762,137 Section 137. 905.04 (3) of the statutes is amended to read:

SB762,63,16 905.04 (3) Who may claim the privilege. The privilege may be claimed by the patient, by the patient's guardian or conservator, or by the personal representative of a deceased patient. The person who was the physician, podiatrist, primary spinal care practitioner, registered nurse, chiropractor, psychologist, social worker, marriage and family therapist or professional counselor may claim the privilege but only on behalf of the patient. The authority so to do is presumed in the absence of evidence to the contrary.

SB762,138 Section 138. 905.04 (4) (a) of the statutes is amended to read:

SB762,64,5 905.04 (4) (a) Proceedings for commitment, guardianship, protective services, or protective placement or for control, care, or treatment of a sexually violent person. There is no privilege under this rule as to communications and information relevant to an issue in probable cause or final proceedings to commit the patient for mental illness under s. 51.20, to appoint a guardian in this state, for court-ordered protective services or protective placement, for review of guardianship, protective services, or protective placement orders, or for control, care, or treatment of a sexually violent person under ch. 980, if the physician, registered nurse, primary spinal care practitioner, chiropractor, psychologist, social worker, marriage and family therapist, or professional counselor in the course of diagnosis or treatment has determined that the patient is in need of commitment, guardianship, protective services, or protective placement or control, care, and treatment as a sexually violent person.

SB762,139 Section 139. 905.04 (4) (e) 3. of the statutes is amended to read:

SB762,64,14 905.04 (4) (e) 3. There is no privilege in situations where the examination of the expectant mother of an abused unborn child creates a reasonable ground for an opinion of the physician, registered nurse, primary spinal care practitioner, chiropractor, psychologist, social worker, marriage and family therapist or professional counselor that the physical injury inflicted on the unborn child was caused by the habitual lack of self-control of the expectant mother of the unborn child in the use of alcohol beverages, controlled substances or controlled substance analogs, exhibited to a severe degree.

SB762,140 Section 140. 949.01 (4) of the statutes is amended to read:

SB762,64,21 949.01 (4) "Medical treatment" includes medical, surgical, dental, optometric, chiropractic, podiatric, spinal medicine, as defined in s. 448.971 (5), and hospital care; medicines; medical, dental and surgical supplies; crutches; artificial members; appliances and training in the use of artificial members and appliances. "Medical treatment" includes any Christian Science treatment for cure or relief from the effects of injury.

SB762,141 Section 141. 949.04 (3) of the statutes is amended to read:

SB762,65,4 949.04 (3) Medical and dental records. The applicant shall submit to the department reports from all physicians, osteopaths, dentists, optometrists, chiropractors or, podiatrists, or primary spinal care practitioners who treated or examined the victim at the time of or subsequent to the victim's injury or death. The department may also order such other examinations and reports of the victim's previous medical and dental history, injury or death as it believes would be of material aid in its determination.

SB762,142 Section 142. 961.01 (19) (a) of the statutes is amended to read:

SB762,65,11 961.01 (19) (a) A physician, advanced practice nurse, dentist, veterinarian, podiatrist, primary spinal care practitioner, optometrist, scientific investigator or, subject to s. 448.21 (3), a physician assistant, or other person licensed, registered, certified or otherwise permitted to distribute, dispense, conduct research with respect to, administer or use in teaching or chemical analysis a controlled substance in the course of professional practice or research in this state.

SB762,143 Section 143. Nonstatutory provisions.

SB762,65,20 (1) Board; staggering of terms. Notwithstanding the length of terms specified for the members of the spinal medicine affiliated credentialing board under section 15.406 (7) of the statutes, as created by this act, one of the initial members shall be appointed for a term expiring on July 1, 2017; one of the initial members shall be appointed for a term expiring on July 1, 2018; one of the initial members shall be appointed for a term expiring on July 1, 2019; one of the initial members shall be appointed for a term expiring on July 1, 2020; and the remaining initial member shall be appointed for a term expiring on July 1, 2021.

SB762,66,2 (2) Board; credentials of initial members. Notwithstanding section 15.406 (7) (a) of the statutes, as created by this act, the initial members appointed to the spinal medicine affiliated credentialing board under section 15.406 (7) (a) of the statutes, as created by this act, need not be licensed under subchapter VIII of chapter 448 of the statutes, as created by this act, but shall be chiropractors licensed under chapter 446 of the statutes.

SB762,66,3 (End)