SB70,1617,109 3. Papanicolaou test for cancer screening for women 21 years of age or older
10with an intact cervix.
SB70,1617,1211 4. Human papillomavirus testing for women who have attained the age of 30
12years but have not attained the age of 66 years.
SB70,1617,1313 5. Colorectal cancer screening in accordance with sub. (16m).
SB70,1617,1614 6. Annual tomography for lung cancer screening for adults who have attained
15the age of 55 years but have not attained the age of 80 years and who have health
16histories demonstrating a risk for lung cancer.
SB70,1617,1817 7. Skin cancer screening for individuals who have attained the age of 10 years
18but have not attained the age of 22 years.
SB70,1617,2019 8. Counseling for skin cancer prevention for adults who have attained the age
20of 18 years but have not attained the age of 25 years.
SB70,1617,2221 9. Abdominal aortic aneurysm screening for men who have attained the age of
2265 years but have not attained the age of 75 years and who have ever smoked.
SB70,1617,2523 10. Hypertension screening for adults and blood pressure testing for adults, for
24children under the age of 3 years who are at high risk for hypertension, and for
25children 3 years of age or older.
SB70,1618,2
111. Lipid disorder screening for minors 2 years of age or older, adults 20 years
2of age or older at high risk for lipid disorders, and all men 35 years of age or older.
SB70,1618,53 12. Aspirin therapy for cardiovascular health for adults who have attained the
4age of 55 years but have not attained the age of 80 years and for men who have
5attained the age of 45 years but have not attained the age of 55 years.
SB70,1618,76 13. Behavioral counseling for cardiovascular health for adults who are
7overweight or obese and who have risk factors for cardiovascular disease.
SB70,1618,88 14. Type II diabetes screening for adults with elevated blood pressure.
SB70,1618,109 15. Depression screening for minors 11 years of age or older and for adults when
10follow-up supports are available.
SB70,1618,1211 16. Hepatitis B screening for minors at high risk for infection and adults at high
12risk for infection.
SB70,1618,1413 17. Hepatitis C screening for adults at high risk for infection and onetime
14hepatitis C screening for adults born in any year from 1945 to 1965.
SB70,1618,1815 18. Obesity screening and management for all minors and adults with a body
16mass index indicating obesity, counseling and behavioral interventions for obese
17minors who are 6 years of age or older, and referral for intervention for obesity for
18adults with a body mass index of 30 kilograms per square meter or higher.
SB70,1618,2019 19. Osteoporosis screening for all women 65 years of age or older and for women
20at high risk for osteoporosis under the age of 65 years.
SB70,1618,2121 20. Immunizations in accordance with sub. (14).
SB70,1618,2422 21. Anemia screening for individuals 6 months of age or older and iron
23supplements for individuals at high risk for anemia and who have attained the age
24of 6 months but have not attained the age of 12 months.
SB70,1619,2
122. Fluoride varnish for prevention of tooth decay for minors at the age of
2eruption of their primary teeth.
SB70,1619,43 23. Fluoride supplements for prevention of tooth decay for minors 6 months of
4age or older who do not have fluoride in their water source.
SB70,1619,55 24. Gonorrhea prophylaxis treatment for newborns.
SB70,1619,66 25. Health history and physical exams for prenatal visits and for minors.
SB70,1619,87 26. Length and weight measurements for newborns and height and weight
8measurements for minors.
SB70,1619,109 27. Head circumference and weight-for-length measurements for newborns
10and minors who have not attained the age of 3 years.
SB70,1619,1111 28. Body mass index for minors 2 years of age or older.
SB70,1619,1312 29. Blood pressure measurements for minors 3 years of age or older and a blood
13pressure risk assessment at birth.
SB70,1619,1514 30. Risk assessment and referral for oral health issues for minors who have
15attained the age of 6 months but have not attained the age of 7 years.
SB70,1619,1716 31. Blood screening for newborns and minors who have not attained the age of
172 months.
SB70,1619,1818 32. Screening for critical congenital health defects for newborns.
SB70,1619,1919 33. Lead screenings in accordance with sub. (10).
SB70,1619,2120 34. Metabolic and hemoglobin screening and screening for phenylketonuria,
21sickle cell anemia, and congenital hypothyroidism for minors including newborns.
SB70,1619,2322 35. Tuberculin skin test based on risk assessment for minors one month of age
23or older.
SB70,1619,2524 36. Tobacco counseling and cessation interventions for individuals who are 5
25years of age or older.
SB70,1620,2
137. Vision and hearing screening and assessment for minors including
2newborns.
SB70,1620,43 38. Sexually transmitted infection and human immunodeficiency virus
4counseling for sexually active minors.
SB70,1620,75 39. Risk assessment for sexually transmitted infection for minors who are 10
6years of age or older and screening for sexually transmitted infection for minors who
7are 16 years of age or older.
SB70,1620,88 40. Alcohol misuse screening and counseling for minors 11 years of age or older.
SB70,1620,109 41. Autism screening for minors who have attained the age of 18 months but
10have not attained the age of 25 months.
SB70,1620,1111 42. Developmental screening and surveillance for minors including newborns.
SB70,1620,1212 43. Psychosocial and behavioral assessment for minors including newborns.
SB70,1620,1413 44. Alcohol misuse screening and counseling for pregnant adults and a risk
14assessment for all adults.
SB70,1620,1615 45. Fall prevention and counseling and preventive medication for fall
16prevention for community-dwelling adults 65 years of age or older.
SB70,1620,1717 46. Screening and counseling for intimate partner violence for adult women.
SB70,1620,2018 47. Well-woman visits for women who have attained the age of 18 years but
19have not attained the age of 65 years and well-woman visits for recommended
20preventive services, preconception care, and prenatal care.
SB70,1620,2221 48. Counseling on, consultations with a trained provider on, and equipment
22rental for breastfeeding for pregnant and lactating women.
SB70,1620,2323 49. Folic acid supplement for adult women with reproductive capacity.
SB70,1620,2424 50. Iron deficiency anemia screening for pregnant and lactating women.
SB70,1621,2
151. Preeclampsia preventive medicine for pregnant adult women at high risk
2for preeclampsia.
SB70,1621,43 52. Low-dose aspirin after 12 weeks of gestation for pregnant women at high
4risk for miscarriage, preeclampsia, or clotting disorders.
SB70,1621,55 53. Screenings for hepatitis B and bacteriuria for pregnant women.
SB70,1621,76 54. Screening for gonorrhea for pregnant and sexually active females 24 years
7of age or younger and females older than 24 years of age who are at risk for infection.
SB70,1621,108 55. Screening for chlamydia for pregnant and sexually active females 24 years
9of age and younger and females older than 24 years of age who are at risk for
10infection.
SB70,1621,1211 56. Screening for syphilis for pregnant women and adults who are at high risk
12for infection.
SB70,1621,1513 57. Human immunodeficiency virus screening for adults who have attained the
14age of 15 years but have not attained the age of 66 years and individuals at high risk
15of infection who are younger than 15 years of age or older than 65 years of age.
SB70,1621,1616 58. All contraceptives and services in accordance with sub. (17).
SB70,1621,1817 59. Any services not already specified under this paragraph having an A or B
18rating in current recommendations from the U.S. preventive services task force.
SB70,1621,2119 60. Any preventive services not already specified under this paragraph that are
20recommended by the federal health resources and services administration's Bright
21Futures project.
SB70,1621,2422 61. Any immunizations, not already specified under sub. (14), that are
23recommended and determined to be for routine use by the federal advisory
24committee on immunization practices.
SB70,1622,3
1(c) Subject to par. (d), no disability insurance policy and no self-insured health
2plan may subject the coverage of any of the preventive services under par. (b) to any
3deductibles, copayments, or coinsurance under the policy or plan.
SB70,1622,74 (d) 1. If an office visit and a preventive service specified under par. (b) are billed
5separately by the health care provider, the disability insurance policy or self-insured
6health plan may apply deductibles to and impose copayments or coinsurance on the
7office visit but not on the preventive service.
SB70,1622,108 2. If the primary reason for an office visit is not to obtain a preventive service,
9the disability insurance policy or self-insured health plan may apply deductibles to
10and impose copayments or coinsurance on the office visit.
SB70,1622,2011 3. Except as otherwise provided in this subdivision, if a preventive service
12specified under par. (b) is provided by a health care provider that is outside the
13disability insurance policy's or self-insured health plan's network of providers, the
14policy or plan may apply deductibles to and impose copayments or coinsurance on the
15office visit and the preventive service. If a preventive service specified under par. (b)
16is provided by a health care provider that is outside the disability insurance policy's
17or self-insured health plan's network of providers because there is no available
18health care provider in the policy's or plan's network of providers that provides the
19preventive service, the policy or plan may not apply deductibles to or impose
20copayments or coinsurance on the preventive service.
SB70,1622,2521 4. If multiple well-woman visits described under par. (b) 47. are required to
22fulfill all necessary preventive services and are in accordance with clinical
23recommendations, the disability insurance policy or self-insured health plan may
24not apply a deductible to or impose a copayment or coinsurance on any of those
25well-woman visits.
SB70,3101
1Section 3101. 632.895 (14) (a) 1. i. and j. of the statutes are amended to read:
SB70,1623,22 632.895 (14) (a) 1. i. Hepatitis A and B.
SB70,1623,33 j. Varicella and herpes zoster.
SB70,3102 4Section 3102 . 632.895 (14) (a) 1. k. to o. of the statutes are created to read:
SB70,1623,55 632.895 (14) (a) 1. k. Human papillomavirus.
SB70,1623,66 L. Meningococcal meningitis.
SB70,1623,77 m. Pneumococcal pneumonia.
SB70,1623,88 n. Influenza.
SB70,1623,99 o. Rotavirus.
SB70,3103 10Section 3103 . 632.895 (14) (b) of the statutes is amended to read:
SB70,1623,1611 632.895 (14) (b) Except as provided in par. (d), every disability insurance policy,
12and every self-insured health plan of the state or a county, city, town, village, or
13school district, that provides coverage for a dependent of the insured shall provide
14coverage of appropriate and necessary immunizations, from birth to the age of 6
15years,
for an insured or plan participant, including a dependent who is a child of the
16insured or plan participant.
SB70,3104 17Section 3104 . 632.895 (14) (c) of the statutes is amended to read:
SB70,1623,2218 632.895 (14) (c) The coverage required under par. (b) may not be subject to any
19deductibles, copayments, or coinsurance under the policy or plan. This paragraph
20applies to a defined network plan, as defined in s. 609.01 (1b), only with respect to
21appropriate and necessary immunizations provided by providers participating, as
22defined in s. 609.01 (3m), in the plan.
SB70,3105 23Section 3105 . 632.895 (14) (d) 3. of the statutes is amended to read:
SB70,1624,3
1632.895 (14) (d) 3. A health care plan offered by a limited service health
2organization, as defined in s. 609.01 (3), or by a preferred provider plan, as defined
3in s. 609.01 (4), that is not a defined network plan, as defined in s. 609.01 (1b)
.
SB70,3106 4Section 3106 . 632.895 (14m) of the statutes is created to read:
SB70,1624,65 632.895 (14m) Essential health benefits. (a) In this subsection,
6“self-insured health plan” has the meaning given in s. 632.85 (1) (c).
SB70,1624,107 (b) On a date specified by the commissioner, by rule, every disability insurance
8policy, except as provided in par. (g), and every self-insured health plan shall provide
9coverage for essential health benefits as determined by the commissioner, by rule,
10subject to par. (c).
SB70,1624,1211 (c) In determining the essential health benefits for which coverage is required
12under par. (b), the commissioner shall do all of the following:
SB70,1624,1413 1. Include benefits, items, and services in, at least, all of the following
14categories:
SB70,1624,1515 a. Ambulatory patient services.
SB70,1624,1616 b. Emergency services.
SB70,1624,1717 c. Hospitalization.
SB70,1624,1818 d. Maternity and newborn care.
SB70,1624,2019 e. Mental health and substance use disorder services, including behavioral
20health treatment.
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