2007 Wisconsin Act 20

601.48 (1) National Association of Insurance Commissioners. The commissioner and the office of the commissioner shall maintain close relations with the commissioners of other states and shall participate in the activities and affairs of the National Association of Insurance Commissioners and other organizations so far as it will, in the judgment of the commissioner, enhance the purposes of chs. 600 to 655. The actual and necessary expenses incurred thereby shall be reimbursed out of the appropriation under s. 20.145 (1) (g) 1.

20,3658 Section 3658. 601.62 (4) of the statutes is amended to read:

601.62 (4) Fees in investigations and hearings. The fees for stenographic services in investigations, examinations, and hearings may not exceed the sum provided for like services in the circuit court. The fees of officers, witnesses, interpreters, and stenographers on behalf of the commissioner or the state shall be paid by the secretary of administration, authorized by the certificate of the commissioner, and shall be charged to the appropriation under s. 20.145 (1) (g) 1.

20,3659 Section 3659. 604.04 (3) of the statutes is amended to read:

604.04 (3) Expenses. No full-time state officer or employee may receive additional compensation for services under chs. 604 to 607. Appropriate portions of the salaries of such persons who do work for the funds or supervise them, and other expenses including reasonable charges for state-owned or state-rented office space and the use of state-owned or state-rented office equipment shall be charged against each fund. Each fund shall pay to the commissioner amounts charged for organizational support services, which shall be credited to the appropriation account under s. 20.145 (1) (g) 2. Each fund shall also be charged a sum equivalent to the state premium tax that would be paid by a domestic mutual insurer organized or operating under ch. 611 and doing the same kind of insurance business, except that no such charge shall be made for the insurance of governmental units.

20,3660g Section 3660g. 616.10 of the statutes is amended to read:

616.10 Exemption from taxation. Every mutual designated a school benefit insurer under s. 616.03, every plan authorized under s. 616.06, and every corporation organized under s. 616.08 is declared to be a charitable and benevolent corporation, and its property, real, personal and mixed, and its income and property transferred to it, are exempt from taxation as provided in ss. 70.11, 71.26 (1) (a) and 71.45 (1) (a).

20,3661 Section 3661. 628.095 (4) (a) of the statutes is amended to read:

628.095 (4) (a) The commissioner shall disclose a social security number obtained under sub. (1) or (3) to the department of workforce development children and families in the administration of s. 49.22, as provided in a memorandum of understanding entered into under s. 49.857.

20,3662 Section 3662. 628.095 (5) of the statutes is amended to read:

628.095 (5) If applicant or intermediary has no social security number. If an applicant who is a natural person does not have a social security number, the applicant shall provide to the commissioner, along with the application for a license and on a form prescribed by the department of workforce development children and families, a statement made or subscribed under oath or affirmation that the applicant does not have a social security number. If an intermediary who is a natural person does not have a social security number, the intermediary shall provide to the commissioner, each time that the annual fee is paid under s. 601.31 (1) (m) and on a form prescribed by the department of workforce development children and families, a statement made or subscribed under oath or affirmation that the applicant does not have a social security number.

20,3663 Section 3663. 628.097 (1m) of the statutes is amended to read:

628.097 (1m) For failure to pay support or to comply with subpoena or warrant. The commissioner shall refuse to issue to a natural person a license, including a temporary license, under this subchapter if the natural person is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the natural person fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3664 Section 3664. 628.10 (2) (c) of the statutes is amended to read:

628.10 (2) (c) For failure to pay support or to comply with subpoena or warrant. The commissioner shall suspend or limit the license of an intermediary who is a natural person, or a temporary license of a natural person under s. 628.09, if the natural person is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the natural person fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3664c Section 3664c. 628.348 of the statutes is created to read:

628.348 Sale of long-term care insurance. (1) Training requirement. No person may solicit, negotiate, or sell long-term care insurance unless the person is a licensed intermediary and he or she completes the initial training portion of the training program under s. 49.45 (31) (c) by January 1, 2009, and completes the ongoing training under s. 49.45 (31) (c) every 24 months after completing the initial training.

(2) Insurer verification. Insurers providing long-term care insurance shall do all of the following:

(a) Obtain from intermediaries selling long-term care insurance on behalf of the insurer verification that the intermediary is in compliance with the training requirements under sub. (1).

(b) Maintain records related to the verifications obtained under par. (a).

(c) Make the records under par. (b) available to the commissioner upon request.

20,3666 Section 3666. 632.48 (3) of the statutes is created to read:

632.48 (3) Notice of changes. An insurer that receives a request from the department of health and family services under s. 49.47 (4) (cr) 2. for notification shall comply with the request and notify the department of any changes to or payments made under the annuity contract to which the request for notification relates.

20,3667 Section 3667. 632.68 (2) (b) 3m. of the statutes is amended to read:

632.68 (2) (b) 3m. If a natural person who does not have a social security number, provides on a form prescribed by the department of workforce development children and families a statement made or subscribed under oath or affirmation that the applicant does not have a social security number.

20,3668 Section 3668. 632.68 (2) (bc) 1. of the statutes is amended to read:

632.68 (2) (bc) 1. The commissioner shall disclose a social security number obtained under par. (b) to the department of workforce development children and families in the administration of s. 49.22, as provided in a memorandum of understanding entered into under s. 49.857.

20,3669 Section 3669. 632.68 (2) (bm) 1. of the statutes is amended to read:

632.68 (2) (bm) 1. Notwithstanding par. (b), the commissioner may not issue a license under this subsection to a natural person who is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or who fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3670 Section 3670. 632.68 (2) (e) of the statutes is amended to read:

632.68 (2) (e) Except as provided in sub. (3), a license issued under this subsection shall be renewed annually on July 1 upon payment of the fee specified in s. 601.31 (1) (mp) and upon providing the licensee's social security number, unless the licensee does not have a social security number, or federal employer identification number, as applicable, if not previously provided on the application for the license or at a previous renewal of the license. If the licensee is a natural person who does not have a social security number, the license shall be renewed annually on July 1 upon payment of the fee specified in s. 601.31 (1) (mp) and upon providing to the commissioner a statement made or subscribed under oath or affirmation, on a form prescribed by the department of workforce development children and families, that the licensee does not have a social security number.

20,3671 Section 3671. 632.68 (3) (b) 1. of the statutes is amended to read:

632.68 (3) (b) 1. The commissioner shall suspend, limit or refuse to renew a viatical settlement provider license issued to a natural person if the natural person is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the natural person fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3672 Section 3672. 632.68 (4) (b) of the statutes is amended to read:

632.68 (4) (b) A person may apply to the commissioner for a viatical settlement broker license on a form prescribed by the commissioner for that purpose. The application form shall require the applicant to provide the applicant's social security number, if the applicant is a natural person unless the applicant does not have a social security number, or the applicant's federal employer identification number, if the applicant is not a natural person. The fee specified in s. 601.31 (1) (mr) shall accompany the application. The commissioner may not issue a license under this subsection unless the applicant provides his or her social security number, unless the applicant does not have a social security number, or its federal employer identification number, whichever is applicable. If the applicant is a natural person who does not have a social security number, the commissioner may not issue a license under this subsection unless the applicant provides, on a form prescribed by the department of workforce development children and families, a statement made or subscribed under oath or affirmation that the applicant does not have a social security number.

20,3673 Section 3673. 632.68 (4) (bc) 1. of the statutes is amended to read:

632.68 (4) (bc) 1. The commissioner shall disclose a social security number obtained under par. (b) to the department of workforce development children and families in the administration of s. 49.22, as provided in a memorandum of understanding entered into under s. 49.857.

20,3674 Section 3674. 632.68 (4) (bm) 1. of the statutes is amended to read:

632.68 (4) (bm) 1. The commissioner may not issue a license under this subsection to a natural person who is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or who fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3675 Section 3675. 632.68 (4) (c) of the statutes is amended to read:

632.68 (4) (c) Except as provided in sub. (5), a license issued under this subsection shall be renewed annually on July 1 upon payment of the fee specified in s. 601.31 (1) (ms) and upon providing the licensee's social security number, unless the licensee does not have a social security number, or federal employer identification number, as applicable, if not previously provided on the application for the license or at a previous renewal of the license. If the licensee is a natural person who does not have a social security number, the license shall be renewed annually, except as provided in sub. (5), on July 1 upon payment of the fee specified in s. 601.31 (1) (ms) and upon providing to the commissioner a statement made or subscribed under oath or affirmation, on a form prescribed by the department of workforce development children and families, that the licensee does not have a social security number.

20,3676 Section 3676. 632.68 (5) (b) 1. of the statutes is amended to read:

632.68 (5) (b) 1. The commissioner shall suspend, limit or refuse to renew a viatical settlement broker license issued to a natural person if the natural person is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the natural person fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3677c Section 3677c. 632.726 of the statutes is created to read:

632.726 Current procedural terminology code changes. (1) In this section, "current procedural terminology code" means a number established by the American Medical Association that a health care provider puts on a health insurance claim form to describe the services that he or she performed.

(2) If an insurer changes a current procedural terminology code that was submitted by a health care provider on a health insurance claim form, the insurer shall include on the explanation of benefits form the reason for the change to the current procedural terminology code and shall cite on the explanation of benefits form the source for the change.

20,3678 Section 3678. 632.745 (6) (a) 2m. of the statutes is amended to read:

632.745 (6) (a) 2m. A family long-term care district under s. 46.2895.

20,3679 Section 3679. 632.746 (7m) (b) 1. of the statutes is amended to read:

632.746 (7m) (b) 1. The employee or dependent is eligible for benefits under the Medical Assistance program under s. 49.471 or 49.472 or for coverage under the Badger Care health care program under s. 49.665.

20,3685f Section 3685f. 632.857 of the statutes is created to read:

632.857 Explanation required for restriction or termination of coverage. If an insurer restricts or terminates an insured's coverage for the treatment of a condition or complaint and, as a result, the insured becomes liable for payment for all of his or her treatment for the condition or complaint, the insurer shall provide on the explanation of benefits form a detailed explanation of the clinical rationale and of the basis in the policy, plan, or contract or in applicable law for the insurer's restriction or termination of coverage.

20,3686w Section 3686w. 632.875 (2) (g) of the statutes is amended to read:

632.875 (2) (g) A reasonable detailed explanation of the factual basis clinical rationale and of the basis in the policy, plan, or contract or in applicable law for the insurer's restriction or termination of coverage.

20,3689 Section 3689. 632.897 (10) (am) 2. of the statutes is amended to read:

632.897 (10) (am) 2. Provide family coverage under the group policy or individual policy for the individual's child, if eligible for coverage, upon application by the individual, the child's other parent, the department of workforce development children and families or the county child support agency under s. 59.53 (5).

20,3690 Section 3690. 633.14 (1) (e) of the statutes is amended to read:

633.14 (1) (e) If an individual who does not have a social security number, provides on a form prescribed by the department of workforce development children and families a statement made or subscribed under oath or affirmation that he or she does not have a social security number.

20,3691 Section 3691. 633.14 (2c) (a) of the statutes is amended to read:

633.14 (2c) (a) The commissioner shall disclose a social security number obtained under sub. (1) (d) to the department of workforce development children and families in the administration of s. 49.22, as provided in a memorandum of understanding entered into under s. 49.857.

20,3692 Section 3692. 633.14 (2m) (a) of the statutes is amended to read:

633.14 (2m) (a) Notwithstanding sub. (1), the commissioner may not issue a license under this section if the individual applying for the license is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the individual fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3693 Section 3693. 633.15 (1m) of the statutes is amended to read:

633.15 (1m) Social security number, federal employer identification number or statement. At an annual renewal, an administrator shall provide his or her social security number, if the administrator is an individual unless he or she does not have a social security number, or its federal employer identification number, if the administrator is a corporation, limited liability company or partnership, if the social security number or federal employer identification number was not previously provided on the application for the license or at a previous renewal of the license. If an administrator who is an individual does not have a social security number, the individual shall provide to the commissioner, at each annual renewal and on a form prescribed by the department of workforce development children and families, a statement made or subscribed under oath or affirmation that the administrator does not have a social security number.

20,3694 Section 3694. 633.15 (2) (c) of the statutes is amended to read:

633.15 (2) (c) Failure to pay support or to comply with subpoena or warrant. The commissioner shall suspend, limit or refuse to renew a license issued under this section to an individual if the individual is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the individual fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s. 49.857.

20,3695 Section 3695. 645.09 (2) (a) of the statutes is amended to read:

645.09 (2) (a) Causes of delinquency. The commissioner may include in his or her annual report, not later than the 2nd annual report following the initiation of any formal proceedings under this chapter, a detailed analysis of the basic causes and the contributing factors making the initiation of formal proceedings necessary, and may make recommendations for remedial legislation. For this purpose the commissioner may appoint a special assistant qualified in insurance, finance, and accounting to conduct the study and prepare the analysis, and may determine the special assistant's compensation, which shall be paid from the appropriation under s. 20.145 (1) (g) 1.

20,3696 Section 3696. 645.09 (2) (b) of the statutes is amended to read:

645.09 (2) (b) Final study. The commissioner may include in his or her annual report, not later than the 2nd annual report following discharge of the receiver, a detailed study of the delinquency proceeding for each insurer subjected to a formal proceeding, with an analysis of the problems faced and their solutions. The commissioner may also suggest alternative solutions, as well as other material of interest, for the purpose of assisting and guiding liquidators or rehabilitators in the future. For this purpose the commissioner may appoint a special assistant qualified to conduct the study and prepare the analysis, and may determine his or her compensation, which shall be paid from the appropriation under s. 20.145 (1) (g) 1.

20,3697 Section 3697. 645.46 (4) of the statutes is amended to read:

645.46 (4) Defray all expenses of taking possession of, conserving, conducting, liquidating, disposing of, or otherwise dealing with the business and property of the insurer. If the property of the insurer does not contain sufficient cash or liquid assets to defray the costs incurred, the liquidator may advance the costs so incurred out of the appropriation under s. 20.145 (1) (g) 1. Any amounts so paid shall be deemed expense of administration and shall be repaid for the credit of the office of the commissioner of insurance out of the first available moneys of the insurer.

20,3698 Section 3698. 647.02 (2) (g) of the statutes is amended to read:

647.02 (2) (g) The figure to be used by the provider as the actual or projected length of a resident's stay in the facility in the formula in the contract provision required under s. 647.05 (9) (1m) (i) and supporting information showing how the figure was determined.

20,3699 Section 3699. 647.04 (5) of the statutes is amended to read:

647.04 (5) Inform the commissioner of any change in the figure used by the provider as the actual or projected length of a resident's stay in the facility in the formula in the contract provision required under s. 647.05 (9) (1m) (i) within 30 days after the change is made and submit supporting information showing how the change was determined.

20,3700 Section 3700. 647.05 of the statutes is renumbered 647.05 (1m), and 647.05 (1m) (g), as renumbered, is amended to read:

647.05 (1m) (g) Provides that if a resident dies or the continuing care contract is terminated after the first 30 days of occupancy, but within the first 90 days of occupancy, the provider will refund at least 90% of the amount computed under sub. (6) par. (f).

20,3701 Section 3701. 647.05 (2m) of the statutes is created to read:

647.05 (2m) Subject to s. 49.455, a continuing care contract may require that, before a resident applies for medical assistance, the resident must spend on his or her care the resources declared for purposes of admission to the facility.

20,3701c Section 3701c. 655.26 (2) of the statutes is amended to read:

655.26 (2) By the 15th day of each month, the board of governors shall report the information specified in sub. (1) to the medical examining board for each claim paid by the fund or from the appropriation under s. 20.145 (2) (a) during the previous month for damages arising out of the rendering of health care services by a health care provider or an employee of a health care provider.

20,3702 Section 3702. 655.27 (2) of the statutes is amended to read:

655.27 (2) Fund administration and operation. Management of the fund shall be vested with the board of governors. The commissioner shall either provide staff services necessary for the operation of the fund or, with the approval of the board of governors, contract for all or part of these services. Such a contract is subject to ss. 16.753 and 16.765, but is otherwise exempt from subch. IV of ch. 16. The commissioner shall adopt rules governing the procedures for creating and implementing these contracts before entering into the contracts. At least annually, the contractor shall report to the commissioner and to the board of governors regarding all expenses incurred and subcontracting arrangements. If the board of governors approves, the contractor may hire legal counsel as needed to provide staff services. The cost of contracting for staff services shall be funded from the appropriation under s. 20.145 (2) (u). The fund shall pay to the commissioner amounts charged for organizational support services, which shall be credited to the appropriation account under s. 20.145 (1) (g) 2.

20,3702d Section 3702d. 655.27 (3) (a) 5. of the statutes is created to read:

655.27 (3) (a) 5. The supplemental appropriation under s. 20.145 (2) (a) for payment of claims.

20,3702f Section 3702f. 655.27 (3) (am) of the statutes is amended to read:

655.27 (3) (am) Assessments for peer review council. The fund, a mandatory health care liability risk-sharing plan established under s. 619.04, and a private health care liability insurer shall be assessed, as appropriate, fees sufficient to cover the costs of the injured patients and families compensation fund peer review council, including costs of administration, for reviewing claims paid by the fund, or from the appropriation under s. 20.145 (2) (a), by the plan, and by the insurer, respectively, under s. 655.275 (5). The fees shall be set by the commissioner by rule, after approval by the board of governors, and shall be collected by the commissioner for deposit in the fund. The costs of the injured patients and families compensation fund peer review council shall be funded from the appropriation under s. 20.145 (2) (um).

20,3702h Section 3702h. 655.27 (4) (a) of the statutes is amended to read: