Amendment JR2 AA1-ASA1-AB1

AB1-ASA1-AA1,274,17 601.41 (9) Uniform claim processing form. (a) In this subsection, "health care provider" has the meaning given in s. 146.81 (1).

AB1-ASA1-AA1,274,22 (b) If the federal government has not developed by July 1, 2003, a uniform claim processing form that must be used by all health care providers for submitting claims to insurers and by all insurers for processing claims submitted by health care providers, the commissioner shall develop, by no later than December 31, 2003, a uniform claim processing form for that purpose.".

AB1-ASA1-AA1,274,23 258. Page 221, line 22: after that line insert:

AB1-ASA1-AA1,274,24 " Section 509cm. 610.65 of the statutes is created to read:

AB1-ASA1-AA1,275,4 610.65 Uniform claim processing form. Beginning no later than July 1, 2004, every insurer shall use the uniform claim processing form developed by the commissioner under s. 601.41 (9) (b) when processing a claim submitted by a health care provider, as defined in s. 146.81 (1).".

AB1-ASA1-AA1,275,5 259. Page 221, line 25: after that line insert:

AB1-ASA1-AA1,275,7 " Section 509gc. 632.835 (2) (b) of the statutes, as created by 1999 Wisconsin Act 155, is amended to read:

AB1-ASA1-AA1,275,15 632.835 (2) (b) Whenever If an adverse determination or an experimental treatment determination is made, the insurer involved in the determination shall provide notice to the insured of the insured's right to obtain the independent review required under this section, how to request the review, and the time within which the review must be requested. The notice shall include a current listing of independent review organizations certified under sub. (4). An independent review under this section may be conducted only by an independent review organization certified under sub. (4) and selected by the insured.

AB1-ASA1-AA1, s. 509gd Section 509gd. 632.835 (2) (bg) of the statutes is created to read:

AB1-ASA1-AA1,275,19 632.835 (2) (bg) Notwithstanding par. (b), an insurer is not required to provide the notice under par. (b) to an insured until the insurer sends notice of the disposition of the internal grievance, if all of the following apply:

AB1-ASA1-AA1,275,24 1. The health benefit plan issued by the insurer contains a description of the independent review procedure under this section, including an explanation of the insured's rights under par. (d), how to request the review, the time within which the review must be requested, and how to obtain a current listing of independent review organizations certified under sub. (4).

AB1-ASA1-AA1,276,9 2. The insurer includes on its explanation of benefits form a statement that the insured may have a right to an independent review after the internal grievance process and that an insured may be entitled to expedited independent review with respect to an urgent matter. The statement shall also include a reference to the section of the policy or certificate that contains the description of the independent review procedure as required under subd. 1. The statement shall provide a toll-free telephone number and website, if appropriate, where consumers may obtain additional information regarding internal grievance and independent review processes.

AB1-ASA1-AA1,276,19 3. For any adverse determination or experimental treatment determination for which an explanation of benefits is not provided to the insured, the insurer provides a notice that the insured may have a right to an independent review after the internal grievance process and that an insured may be entitled to expedited, independent review with respect to an urgent matter. The notice shall also include a reference to the section of the policy or certificate that contains the description of the independent review procedure as required under subd. 1. The notice shall provide a toll-free telephone number and website, if appropriate, where consumers may obtain additional information regarding internal grievance and independent review processes.

AB1-ASA1-AA1, s. 509jm Section 509jm. 635.10 of the statutes is created to read:

AB1-ASA1-AA1,277,2 635.10 Uniform employee application. Beginning no later than the first day of the 13th month beginning after the effective date of this section .... [revisor inserts date], every small employer insurer shall use the uniform employee application form developed by the commissioner by rule under s. 601.41 (8) (b) when a small employer applies for coverage under a group health benefit plan offered by the small employer insurer.

AB1-ASA1-AA1, s. 509mp Section 509mp. 635.25 of the statutes is created to read:

AB1-ASA1-AA1,277,5 635.25 Catastrophic risk. (1) Definition. In this section, "board" means the small employer catastrophic reinsurance board.

AB1-ASA1-AA1,277,10 (2) Thresholds for covered benefits. (a) By December 1, 2002, and every 2 years thereafter until December 1, 2006, every small employer insurer that chooses to participate in the program under this section shall select, and submit a report to the commissioner that specifies, the small employer insurer's threshold level of covered benefits, which may be any of the following:

AB1-ASA1-AA1,277,11 1. Fifty thousand dollars in a calendar year.

AB1-ASA1-AA1,277,12 2. One hundred thousand dollars in a calendar year.

AB1-ASA1-AA1,277,13 3. One hundred fifty thousand dollars in a calendar year.

AB1-ASA1-AA1,277,14 4. Two hundred fifty thousand dollars in a calendar year.

AB1-ASA1-AA1,277,21 (b) The threshold level of benefits specified in a report under par. (a) shall apply to each insured under every group health benefit plan issued to a small employer in this state by the small employer insurer submitting the report. In addition, the small employer insurer may in the report limit the covered benefits to which the threshold level applies, which may be costs of one or more types of health care facilities, as defined in s. 146.997 (1) (c), costs of one or more types of health care professionals, as defined in s. 180.1901 (1m), or any combination of those costs.

AB1-ASA1-AA1,278,6 (c) For each of the 2 calendar years after the year in which a small employer insurer submits a report under par. (a), if the amount of applicable covered benefits paid in a calendar year, beginning with 2003 and ending with 2007, by the small employer insurer on behalf of any insured under any group health benefit plan to which this section applies exceeds the threshold level of covered benefits specified in the report, the commissioner, at the direction of the board, shall reimburse the small employer insurer from the appropriation under s. 20.145 (1) (j), in accordance with the procedures established by rule under sub. (5) (e), for 80% of the amount paid by the small employer insurer in that calendar year in excess of the threshold level specified in the report.

AB1-ASA1-AA1,278,11 (3) Premiums for reimbursements. (a) For every group health benefit plan issued or renewed to a small employer in this state on or between the dates specified by rule under sub. (5) (b), a small employer insurer that chooses to participate in the program under this section shall charge a total premium that includes the premium amount established by rule under sub. (5) (a).

AB1-ASA1-AA1,278,16 (b) By the date specified by rule under sub. (5) (c), a small employer insurer that chooses to participate in the program under this section shall forward to the board the premiums established by rule under sub. (5) (a), in the manner required by rule under sub. (5) (d). The board shall credit all premium amounts received under this paragraph to the appropriation account under s. 20.145 (1) (j).

AB1-ASA1-AA1,278,21 (c) In addition to the disclosures required under s. 635.11, before the issuance or renewal of a group health benefit plan to a small employer in this state on or between the dates specified by rule under sub. (5) (b), a small employer insurer that chooses to participate in the program under this section shall disclose to the small employer all of the following:

AB1-ASA1-AA1,278,24 1. The small employer insurer's current threshold level of covered benefits under sub. (2) (a), the covered benefits to which the threshold level applies, and the calendar years to which the threshold level applies.

AB1-ASA1-AA1,279,3 2. The amount of the total premium that is attributable to coverage for the small employer insurer's threshold level of covered benefits and 20% of covered benefits in excess of that threshold level.

AB1-ASA1-AA1,279,5 3. The amount of the total premium that is the premium amount established by rule under sub. (5) (a).

AB1-ASA1-AA1,279,18 (4) Provider discounts. (a) The commissioner shall promulgate a rule determined by the board that establishes provider discount rates for charges for covered services provided to insureds under group health benefit plans that are issued or renewed to small employers in this state on or between the dates specified by rule under sub. (5) (b). The rule may provide for higher provider discount rates for covered benefits under group health benefit plans that are issued by small employer insurers that specify higher threshold levels under sub. (2) (a). The rule shall provide that a provider's charges for which a small employer insurer seeks reimbursement shall be discounted in the same proportion that the provider's charges bears to the total amount of provider charges for which the small employer insurer seeks reimbursement. The provider discount rates under this paragraph apply only to services for which the commissioner provides reimbursement under sub. (2) (c).

AB1-ASA1-AA1,279,24 (b) Except for copayments, coinsurance, or deductibles required or authorized under a group health benefit plan, a provider of a covered service, drug, or device shall accept as payment in full for the covered service, drug, or device the discounted payment rate under par. (a) and may not bill the insured under the group health benefit plan who receives the service, drug, or device for any amount by which the charge is reduced under par. (a).

AB1-ASA1-AA1,280,2 (5) Rules. The commissioner shall promulgate rules developed by the board for the operation of this section, including rules that do all of the following:

AB1-ASA1-AA1,280,9 (a) Establish and periodically adjust the premium amounts that must be charged to small employers under sub. (3) (c) 3. by small employer insurers that choose to participate in the program under this section. The premium amounts under sub. (3) (c) 3. shall be based on an actuarily sound charge per covered individual that is calculated to generate sufficient moneys, in conjunction with provider discounts under sub. (4), to cover the reimbursements required under sub. (2) (c).

AB1-ASA1-AA1,280,11 (b) Specify the dates that apply in sub. (3) (a), subject to the dates specified in par. (c) and sub. (2) (c).

AB1-ASA1-AA1,280,14 (c) Specify the dates by which a small employer insurer must forward to the board the premiums established under par. (a). The first date by which the premiums must be forwarded to the board may not be later than July 1, 2003.

AB1-ASA1-AA1,280,17 (d) Specify the procedures that small employer insurers must use for collecting, segregating, holding in trust, and forwarding to the board the premiums established under par. (a).

AB1-ASA1-AA1,280,21 (e) Specify the procedures that small employer insurers must use for obtaining reimbursement under sub. (2) (c), including requirements for documenting the payment of covered benefits for determining whether a small employer insurer has paid its threshold level of covered benefits.".

AB1-ASA1-AA1,280,22 260. Page 225, line 3: after that line insert:

AB1-ASA1-AA1,280,23 " Section 522n. 895.25 of the statutes is created to read:

AB1-ASA1-AA1,281,5 895.25 Multiple-form requirement. If any person is required to submit a form to a state agency, as defined in s. 20.001 (1), or a political subdivision of the state, that is composed of multiple-part, carbonless copies, that requirement is met if the person submits the number of copies required without using multiple-part, carbonless paper.".

AB1-ASA1-AA1,281,6 261. Page 225, line 22: after that line insert:

AB1-ASA1-AA1,281,7 " Section 529j. 938.295 (2) (a) of the statutes is amended to read:

AB1-ASA1-AA1,281,19 938.295 (2) (a) If there is probable cause to believe that the juvenile has committed the alleged offense and if there is reason to doubt the juvenile's competency to proceed, or upon entry of a plea under s. 938.30 (4) (c) the court shall order the juvenile to be examined by a psychiatrist or licensed psychologist. The expenses of an cost of the examination, if approved by the court, shall be paid by the county of the court ordering the examination, and the county may recover that cost from the juvenile's parent or guardian as provided in par. (c). Evaluation shall be made on an outpatient basis unless the juvenile presents a substantial risk of physical harm to the juvenile or others; or the juvenile, parent, or guardian, and legal counsel or guardian ad litem, consent to an inpatient evaluation. Any inpatient evaluation shall be for a specified period that is no longer than is necessary to complete the evaluation.

AB1-ASA1-AA1, s. 529k Section 529k. 938.295 (2) (c) of the statutes is created to read:

AB1-ASA1-AA1,282,4 938.295 (2) (c) A county that pays the cost of an examination under par. (a) may recover a reasonable contribution toward that cost from the juvenile's parent or guardian, based on the ability of the parent or guardian to pay. If the examination is provided or otherwise funded by the county department under s. 46.215, 46.22, or 46.23, the county department shall collect the contribution of the parent or guardian as provided in s. 301.03 (18). If the examination is provided or otherwise funded by the county department under s. 51.42 or 51.437, the county department shall collect the contribution of the parent or guardian as provided in s. 46.03 (18).".

AB1-ASA1-AA1,282,5 262. Page 226, line 10: after that line insert:

AB1-ASA1-AA1,282,6 " Section 531g. 938.34 (15m) (am) of the statutes is amended to read:

AB1-ASA1-AA1,282,13 938.34 (15m) (am) Except as provided in par. (bm), if the juvenile is adjudicated delinquent on the basis of any violation, or the solicitation, conspiracy, or attempt to commit any violation, under ch. 940, 944, or 948 or ss. 942.08 or 943.01 to 943.15, the court may require the juvenile to comply with the reporting requirements under s. 301.45 if the court determines that the underlying conduct was sexually motivated, as defined in s. 980.01 (5), and that it would be in the interest of public protection to have the juvenile report under s. 301.45.

AB1-ASA1-AA1, s. 531r Section 531r. 938.345 (3) (a) (intro.) of the statutes is amended to read:

AB1-ASA1-AA1,282,23 938.345 (3) (a) (intro.) If the court finds that a juvenile is in need of protection or services on the basis of a violation, or the solicitation, conspiracy , or attempt to commit a violation, under ch. 940, 944, or 948 or ss. 942.08 or 943.01 to 943.15, the court may require the juvenile to comply with the reporting requirements under s. 301.45 if the court determines that the underlying conduct was sexually motivated, as defined in s. 980.01 (5), and that it would be in the interest of public protection to have the juvenile report under s. 301.45. In determining whether it would be in the interest of public protection to have the juvenile report under s. 301.45, the court may consider any of the following:".

AB1-ASA1-AA1,282,24 263. Page 227, line 4: after that line insert:

AB1-ASA1-AA1,283,2 " Section 533g. 938.355 (4m) of the statutes is renumbered 938.355 (4m) (a) and amended to read:

AB1-ASA1-AA1,283,8 938.355 (4m) (a) A juvenile who has been adjudged delinquent may, on attaining 17 years of age, petition the court to expunge the court's record of the juvenile's adjudication. The Subject to par. (b), the court may expunge the court's record of the juvenile's adjudication if the court determines that the juvenile has satisfactorily complied with the conditions of his or her dispositional order and that the juvenile will benefit and society will not be harmed by the expungement.

AB1-ASA1-AA1, s. 533r Section 533r. 938.355 (4m) (b) of the statutes is created to read:

AB1-ASA1-AA1,283,15 938.355 (4m) (b) The court shall expunge the court's record of a juvenile's adjudication if it was the juvenile's first adjudication based on a violation of s. 942.08 (2) (b) or (c) and if the court determines that the juvenile has satisfactorily complied with the conditions of his or her dispositional order. Notwithstanding s. 938.396 (2) (a), the court shall notify the department promptly of any expungement under this paragraph.".

AB1-ASA1-AA1,283,16 264. Page 228, line 3: after that line insert:

AB1-ASA1-AA1,283,17 " Section 535m. 939.24 (2) of the statutes is amended to read:

AB1-ASA1-AA1,283,20 939.24 (2) Except as provided in ss. 940.285, 940.29 and, 940.295, and 943.76, if criminal recklessness is an element of a crime in chs. 939 to 951, the recklessness is indicated by the term "reckless" or "recklessly".".

AB1-ASA1-AA1,283,21 265. Page 255, line 2: after that line insert:

AB1-ASA1-AA1,283,22 " Section 700d. 942.08 (1) (b) of the statutes is amended to read:

AB1-ASA1-AA1,284,3 942.08 (1) (b) "Private place" means a place where a person may reasonably expect to be safe from surveillance being observed without his or her knowledge and consent.

AB1-ASA1-AA1, s. 700j Section 700j. 942.08 (2) of the statutes is renumbered 942.08 (2) (intro.) and amended to read:

AB1-ASA1-AA1,284,7 942.08 (2) (intro.) Whoever knowingly does any of the following is guilty of a Class A misdemeanor:

AB1-ASA1-AA1,284,11 (a) Knowingly installs a surveillance device in any private place, or uses a surveillance device that has been installed in a private place, with the intent to observe any nude or partially nude person without the consent of the person observed is guilty of a Class A misdemeanor.

AB1-ASA1-AA1, s. 700q Section 700q. 942.08 (2) (b) of the statutes is created to read:

AB1-ASA1-AA1,284,16 942.08 (2) (b) For the purpose of sexual arousal or gratification and without the consent of any person who is present in the private place, looks into a private place that is or is part of a public accommodation, as defined in s. 134.48 (1) (b), and in which a person may reasonably be expected to be nude or partially nude.

AB1-ASA1-AA1, s. 700w Section 700w. 942.08 (2) (c) of the statutes is created to read:

AB1-ASA1-AA1,284,22 942.08 (2) (c) Enters private property without the consent of any person present on the property and, for the purpose of sexual arousal or gratification, with the intent to intrude upon or interfere with the privacy of another, and without the consent of any person who is present in the dwelling, looks into the dwelling of another.".

AB1-ASA1-AA1,284,23 266. Page 271, line 8: after that line insert:

AB1-ASA1-AA1,285,2 " Section 810g. 943.76 (1) of the statutes, as created by 2001 Wisconsin Act 16, is renumbered 943.76 (1) (intro.) and amended to read:

AB1-ASA1-AA1,285,3 943.76 (1) (intro.) In this section, "livestock":

AB1-ASA1-AA1,285,6 (a) "Livestock" means cattle, horses, swine, sheep, goats, farm-raised deer, as defined in s. 95.001 (1) (a), poultry, and other animals used or to be used in the production of food, fiber, or other commercial products.

AB1-ASA1-AA1, s. 810k Section 810k. 943.76 (1) (b) of the statutes is created to read:

AB1-ASA1-AA1,285,8 943.76 (1) (b) "Paratuberculosis" has the meaning given in s. 95.001 (1) (c).

AB1-ASA1-AA1, s. 810n Section 810n. 943.76 (1) (c) of the statutes is created to read:

AB1-ASA1-AA1,285,12 943.76 (1) (c) "Reckless conduct" means conduct which creates a substantial risk of an animal's death or a substantial risk of bodily harm to an animal if the actor is aware of that risk.".

AB1-ASA1-AA1,285,13 267. Page 271, line 8: after that line insert:

AB1-ASA1-AA1,285,15 " Section 810d. 943.76 (1) of the statutes, as created by 2001 Wisconsin Act 16, is amended to read:

AB1-ASA1-AA1,285,18 943.76 (1) In this section, "livestock" means cattle, horses, swine, sheep, goats, farm-raised deer, as defined in s. 95.001 (1) (a), poultry, and other animals used or to be used in the production of food, fiber, or other commercial products.".

AB1-ASA1-AA1,285,19 268. Page 271, line 18: after that line insert:

AB1-ASA1-AA1,285,20 " Section 812m. 943.76 (3) of the statutes is created to read:

AB1-ASA1-AA1,285,23 943.76 (3) (a) Whoever, through reckless conduct, introduces a contagious or infectious disease other than paratuberculosis into livestock without the consent of the owner of the livestock is guilty of a Class A misdemeanor.

AB1-ASA1-AA1,286,3 (b) Whoever, through reckless conduct, introduces a contagious or infectious disease other than paratuberculosis into wild deer without the consent of the department of natural resources is guilty of a Class A misdemeanor.

AB1-ASA1-AA1,286,8 (c) This subsection does not apply if the actor's conduct is undertaken pursuant to a directive issued by the department of agriculture, trade and consumer protection or an agreement between the actor and the department of agriculture, trade and consumer protection, if the purpose of the directive or the agreement is to prevent or control the spread of the disease.".

AB1-ASA1-AA1,286,9 269. Page 271, line 18: after that line insert:

AB1-ASA1-AA1,286,10 " Section 812t. 943.76 (4) of the statutes is created to read:

AB1-ASA1-AA1,286,13 943.76 (4) (a) Whoever intentionally threatens to introduce a contagious or infectious disease into livestock located in this state without the consent of the owner of the livestock is guilty of a Class D felony if one of the following applies:

AB1-ASA1-AA1,286,15 1. The owner of the livestock is aware of the threat and reasonably believes that the actor will attempt to carry out the threat.