Amendment SSA1-AB573

AB573-SSA1, s. 11 Section 11. 111.91 (2) (n) of the statutes is created to read:

AB573-SSA1,5,14 111.91 (2) (n) The provision to employes of the health insurance coverage required under s. 632.895 (11).

AB573-SSA1, s. 12 Section 12. 120.13 (2) (g) of the statutes is amended to read:

AB573-SSA1,5,18 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).

AB573-SSA1, s. 13 Section 13. 120.13 (2) (g) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,5,24 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3), 632.87 (4) and (5), 632.895 (9) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).

AB573-SSA1, s. 14 Section 14. 185.981 (4t) of the statutes is amended to read:

AB573-SSA1,6,3 185.981 (4t) A sickness care plan operated by a cooperative association is subject to ss. 252.14, 631.89, 632.72 (2), 632.87 (2m), (3), (4) and (5), 632.895 (10) and (11) and 632.897 (10) and ch. 155.

AB573-SSA1, s. 15 Section 15. 185.981 (4t) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,6,8 185.981 (4t) A sickness care plan operated by a cooperative association is subject to ss. 252.14, 631.89, 632.72 (2), 632.745, 632.747, 632.749, 632.87 (2m), (3), (4) and (5), 632.895 (10) and (11) and 632.897 (10) and ch. 155.

AB573-SSA1, s. 16 Section 16. 185.983 (1) (intro.) of the statutes is amended to read:

AB573-SSA1,6,15 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72 (2), 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5), 632.895 (5), (9) and (10) and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:

AB573-SSA1, s. 17 Section 17. 185.983 (1) (intro.) of the statutes, as affected by 1995 Wisconsin Acts 289 and .... (this act), is repealed and recreated to read:

AB573-SSA1,6,23 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72 (2), 632.745, 632.747, 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5), 632.895 (5) and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:

AB573-SSA1, s. 18 Section 18. 632.895 (11) of the statutes is created to read:

AB573-SSA1,7,3 632.895 (11) Inpatient hospital services, home care visits and follow-up care after childbirth. (a) In this subsection, "health care provider" means a physician, as defined in s. 448.01 (5), or a nurse-midwife granted a license under s. 441.15.

AB573-SSA1,7,6 (am) Every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, that provides maternity coverage shall provide coverage for mother and child for all of the following:

AB573-SSA1,7,9 1. After the birth of a child, inpatient hospital services related to the birth of the child for the length of time that the inpatient hospital services are provided, as ordered by the mother's or child's health care provider.

AB573-SSA1,7,13 2. If inpatient hospital services are provided for a period of less than 48 hours after the birth of a child by vaginal delivery, one postnatal follow-up care contact after the mother and child are no longer hospital inpatients, if ordered by the mother's or child's health care provider.

AB573-SSA1,7,17 3. If inpatient hospital services are provided for a period of less than 96 hours after the birth of a child by caesarean section, one postnatal follow-up care contact after the mother and child are no longer hospital inpatients, if ordered by the mother's or child's health care provider.

AB573-SSA1,7,20 4. Any home care visits or postnatal follow-up care contacts after a postnatal follow-up care contact under subd. 2. or 3. has occurred, if ordered by the mother's or child's health care provider.

AB573-SSA1,7,25 (b) The length of time for which inpatient hospital services are provided and must be covered under par. (am) 1. and whether a postnatal follow-up care contact under par. (am) 2. or 3. or home care visits or postnatal follow-up care contacts under par. (am) 4. are ordered and must be covered shall be based on medical necessity, as determined by the mother's or child's health care provider.

AB573-SSA1,8,2 (c) The coverage required under par. (am) may be subject to any copayments or deductibles that apply generally under the policy or plan to other covered services.

AB573-SSA1, s. 19 Section 19. Initial applicability.

AB573-SSA1,8,4 (1) This act first applies to all of the following:

AB573-SSA1,8,7 (a) Except as provided in paragraphs (b) and (c) , disability insurance policies that are issued or renewed, and self-insured health plans that are established, extended, modified or renewed, on the effective date of this paragraph.

AB573-SSA1,8,10 (b) Disability insurance policies covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are issued or renewed on the earlier of the following:

AB573-SSA1,8,11 1. The day on which the collective bargaining agreement expires.

AB573-SSA1,8,13 2. The day on which the collective bargaining agreement is extended, modified or renewed.

AB573-SSA1,8,16 (c) Self-insured health plans covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are established, extended, modified or renewed on the earlier of the following:

AB573-SSA1,8,17 1. The day on which the collective bargaining agreement expires.

AB573-SSA1,8,19 2. The day on which the collective bargaining agreement is extended, modified or renewed.

AB573-SSA1, s. 20 Section 20. Effective dates. This act takes effect on October 1, 1996, except as follows:

AB573-SSA1,8,24 (1) The repeal and recreation of sections 40.51 (8), 60.23 (25), 66.184, 111.70 (1) (a), 120.13 (2) (g), 185.981 (4t) and 185.983 (1) (intro.) of the statutes takes effect on May 1, 1997.

AB573-SSA1,8,25 (End)