LRB-0231/1
PJK:jld:km
2001 - 2002 LEGISLATURE
December 7, 2001 - Introduced by Representatives Black, Berceau, Wasserman,
J. Lehman, Pocan, Morris-Tatum, Richards, Sinicki, Young, Bock
and
Turner, cosponsored by Senator Risser. Referred to Committee on Health.
AB674,1,4 1An Act to amend 40.51 (8), 40.51 (8m), 60.23 (25), 66.0137 (4), 111.91 (2) (n),
2120.13 (2) (g), 185.981 (4t) and 185.983 (1) (intro.); and to create 609.87 and
3632.895 (15) of the statutes; relating to: health insurance coverage of smoking
4cessation treatment and medications.
Analysis by the Legislative Reference Bureau
This bill requires a health care plan to provide coverage of smoking cessation
treatment that is provided in conformity with recommendations set forth in a
publication of the federal agency for health care policy and research, as well as
coverage of certain specified smoking cessation medications. The coverage
requirement applies to both individual and group health insurance policies and
plans, including managed care plans and plans offered by cooperative sickness care
associations; to health care plans offered by the state to its employees, including a
self-insured plan; and to self-insured health plans of counties, cities, towns,
villages, and school districts. The requirement does not apply to health care plans
that are offered by limited service health organizations or to health care plans that
cover only specified diseases. The requirement may be subject to any limitations,
exclusions, or cost-sharing provisions that apply generally under the policy or plan.

For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB674, s. 1 1Section 1. 40.51 (8) of the statutes is amended to read:
AB674,2,52 40.51 (8) Every health care coverage plan offered by the state under sub. (6)
3shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.746 (1) to (8)
4and (10), 632.747, 632.748, 632.83, 632.835, 632.85, 632.853, 632.855, 632.87 (3) to
5(5), 632.895 (5m) and (8) to (14) (15) and 632.896.
AB674, s. 2 6Section 2. 40.51 (8m) of the statutes is amended to read:
AB674,2,97 40.51 (8m) Every health care coverage plan offered by the group insurance
8board under sub. (7) shall comply with ss. 631.95, 632.746 (1) to (8) and (10), 632.747,
9632.748, 632.83, 632.835, 632.85, 632.853, 632.855 and 632.895 (11) to (14) (15).
AB674, s. 3 10Section 3. 60.23 (25) of the statutes is amended to read:
AB674,2,1411 60.23 (25) Self-insured health plans. Provide health care benefits to its
12officers and employees on a self-insured basis if the self-insured plan complies with
13ss. 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.85,
14632.853, 632.855, 632.87 (4) and (5), 632.895 (9) and (11) to (14) (15) and 632.896.
AB674, s. 4 15Section 4. 66.0137 (4) of the statutes is amended to read:
AB674,2,2116 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or
17a village provides health care benefits under its home rule power, or if a town
18provides health care benefits, to its officers and employees on a self-insured basis,
19the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
20632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.85, 632.853, 632.855, 632.87 (4) and (5),
21632.895 (9) to (14) (15), 632.896 and 767.25 (4m) (d).
AB674, s. 5
1Section 5. 111.91 (2) (n) of the statutes is amended to read:
AB674,3,32 111.91 (2) (n) The provision to employees of the health insurance coverage
3required under s. 632.895 (11) to (14) (15).
AB674, s. 6 4Section 6. 120.13 (2) (g) of the statutes is amended to read:
AB674,3,85 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
649.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
7632.85, 632.853, 632.855, 632.87 (4) and (5), 632.895 (9) to (14) (15), 632.896 and
8767.25 (4m) (d).
AB674, s. 7 9Section 7. 185.981 (4t) of the statutes is amended to read:
AB674,3,1310 185.981 (4t) A sickness care plan operated by a cooperative association is
11subject to ss. 252.14, 631.17, 631.89, 631.95, 632.72 (2), 632.745 to 632.749, 632.85,
12632.853, 632.855, 632.87 (2m), (3), (4) and (5), 632.895 (10) to (14) (15) and 632.897
13(10) and chs. 149 and 155.
AB674, s. 8 14Section 8. 185.983 (1) (intro.) of the statutes is amended to read:
AB674,3,2115 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be
16exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
17601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.17, 631.89, 631.93,
18631.95, 632.72 (2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.85, 632.853,
19632.855, 632.87 (2m), (3), (4) and (5), 632.895 (5) and (9) to (14) (15), 632.896 and
20632.897 (10) and chs. 609, 630, 635, 645 and 646, but the sponsoring association
21shall:
AB674, s. 9 22Section 9. 609.87 of the statutes is created to read:
AB674,3,24 23609.87 Coverage of smoking cessation treatment. Managed care plans
24are subject to s. 632.895 (15).
AB674, s. 10 25Section 10. 632.895 (15) of the statutes is created to read:
AB674,4,3
1632.895 (15) Smoking cessation treatment and medication. (a) In this
2subsection, "self-insured health plan" means a self-insured health plan of the state
3or a county, city, village, town, or school district.
AB674,4,94 (b) 1. Subject to subd. 2. and except as provided in par. (e), every disability
5insurance policy and every self-insured health plan shall provide coverage of
6smoking cessation treatment that is provided in conformity with the
7recommendations set forth in Clinical Practice Guideline Number 18, Smoking
8Cessation, publication number 96-0692, published by the federal department of
9health and human services, agency for health care policy and research.
AB674,4,1110 2. A disability insurance policy or self-insured health plan is not required to
11cover smoking cessation treatment more than 3 times for any insured.
AB674,4,1512 (c) Except as provided in par. (e), every disability insurance policy and every
13self-insured health plan shall provide coverage of all of the following medications if
14approved for use by the federal food and drug administration and if prescribed for
15smoking cessation:
AB674,4,1616 1. Nicotine gum.
AB674,4,1717 2. Nicotine patch.
AB674,4,1818 3. Nicotine nasal spray.
AB674,4,1919 4. Nicotine inhaler.
AB674,4,2020 5. Zyban or its generic equivalent.
AB674,4,2321 (d) The coverage required under pars. (b) and (c) may be subject to any
22limitations, exclusions, or cost-sharing provisions that apply generally under the
23disability insurance policy or self-insured health plan.
AB674,4,2424 (e) This subsection does not apply to any of the following:
AB674,4,2525 1. A limited service health organization, as defined in s. 609.01 (3).
AB674,5,2
12. A preferred provider plan, as defined in s. 609.01 (4), that is not a managed
2care plan, as defined in s. 609.01 (3c).
AB674,5,33 3. A disability insurance policy that covers only certain specified diseases.
AB674, s. 11 4Section 11. Initial applicability.
AB674,5,55 (1) This act first applies to all of the following:
AB674,5,86 (a) Except as provided in paragraphs (b) and (c ), disability insurance policies
7that are issued or renewed, and self-insured health plans that are established,
8extended, modified, or renewed, on the effective date of this paragraph.
AB674,5,119 (b) Disability insurance policies covering employees who are affected by a
10collective bargaining agreement containing provisions inconsistent with this act
11that are issued or renewed on the earlier of the following:
AB674,5,12 121. The day on which the collective bargaining agreement expires.
AB674,5,14 132. The day on which the collective bargaining agreement is extended, modified,
14or renewed.
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