2023 - 2024 LEGISLATURE
January 19, 2024 - Introduced by Senators Hesselbein, Spreitzer, Agard,
Larson,
Pfaff, Roys, Smith, Taylor and Wirch, cosponsored by Representatives
Subeck, Shankland, C. Anderson, J. Anderson, Conley, Considine, Drake,
Emerson, Joers, Neubauer, Palmeri, Ratcliff, Sinicki and Stubbs. Referred
to Committee on Insurance and Small Business.
SB935,1,3
1An Act to amend 609.83; and
to create 632.895 (12r) of the statutes;
relating
2to: cost-sharing cap on epinephrine auto-injectors under health insurance
3policies and plans.
Analysis by the Legislative Reference Bureau
This bill prevents every health insurance policy and every self-insured
governmental health plan that covers medically necessary epinephrine
auto-injectors from imposing cost sharing in an amount that exceeds $60 for a
twin-pack of epinephrine auto-injectors, regardless of the type of epinephrine
auto-injector. Health insurance policies are referred to in the bill as disability
insurance policies.
This proposal may contain a health insurance mandate requiring a social and
financial impact report under s. 601.423, stats.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB935,1
4Section
1
. 609.83 of the statutes is amended to read:
SB935,1,7
5609.83 Coverage of drugs and devices. Limited service health
6organizations, preferred provider plans, and defined network plans are subject to ss.
7632.853, 632.861, and 632.895
(12r), (16t)
, and (16v).
SB935,2
1Section
2. 632.895 (12r) of the statutes is created to read:
SB935,2,52
632.895
(12r) Epinephrine auto-injectors. (a) In this subsection,
3“epinephrine auto-injector” means a device used for the automatic injection of
4epinephrine into the human body to prevent or treat a life-threatening allergic
5reaction.
SB935,2,116
(b) Every disability insurance policy, and every self-insured health plan of the
7state or a county, city, village, town, or school district, that provides coverage of
8medically necessary epinephrine auto-injectors may not impose cost sharing on
9epinephrine auto-injectors in an amount that exceeds $60 for a twin-pack of
10medically necessary epinephrine auto-injectors, regardless of the type of
11epinephrine auto-injector.
SB935,2,1612
(c) Nothing in this subsection prohibits a disability insurance policy or
13self-insured health plan from imposing cost sharing on epinephrine auto-injectors
14in an amount less than the amount specified under par. (b). Nothing in this
15paragraph requires a disability insurance policy or self-insured health plan to
16impose any cost sharing on epinephrine auto-injectors.
SB935,3
17Section
3.
Initial applicability.
SB935,2,1818
(1)
Epinephrine auto-injectors.
SB935,2,2219
(a) For policies and plans containing provisions inconsistent with s. 632.895
20(12r), the treatment of s. 632.895 (12r) first applies to policy or plan years beginning
21on January 1 of the year following the year in which this paragraph takes effect,
22except as provided in par. (b).
SB935,3,223
(b) For policies and plans that are affected by a collective bargaining agreement
24containing provisions inconsistent with s. 632.895 (12r), the treatment of s. 632.895
25(12r) first applies to policy or plan years beginning on the effective date of this
1paragraph or on the day on which the collective bargaining agreement is newly
2established, extended, modified, or renewed, whichever is later.
SB935,4
3Section 4
.
Effective date.
SB935,3,54
(1)
This act takes effect on the first day of the 4th month beginning after
5publication.
