AB995,37,94 456.02 (6) In cooperation with other agencies and appropriate organizations,
5conduct a continuing study of the practice of nursing home administration within the
6state with a view to the improvement of the standards imposed for the licensing of
7such nursing home administrators and of procedures and methods for the
8enforcement of such the standards under sub. (1) with respect to nursing home
9administrators of nursing homes who have been licensed as such; under this chapter.
AB995, s. 76 10Section 76. 456.02 (7) of the statutes is amended to read:
AB995,37,1911 456.02 (7) Develop and enforce standards for the Promulgate rules
12establishing
supervised practical experience to be required requirements that,
13except as provided in s. 456.04 (2m), an individual shall satisfy before being allowed
14to take an examination
for licensure; and as a nursing home administrator. Except
15as provided in s. 456.04 (2m), the rules shall require the individual to complete at
16least 2,000 hours in any consecutive 3-year period within the 5-year period
17immediately preceding the date of application for examination in an internship,
18administrator-in-training program, or any other structured program approved by
19the examining board.
AB995, s. 77 20Section 77. 456.04 (intro.) (except 456.04 (title)) of the statutes is renumbered
21456.04 (1m) (intro.) and amended to read:
AB995,37,2422 456.04 (1m) (intro.) The Except as provided in sub. (2m), the examining board
23shall allow any person to take the examination for licensure as a nursing home
24administrator who satisfies all of the following requirements:
AB995, s. 78 25Section 78. 456.04 (1) of the statutes is renumbered 456.04 (1m) (a).
AB995, s. 79
1Section 79. 456.04 (1m) (d) of the statutes is created to read:
AB995,38,22 456.04 (1m) (d) Has one of the following:
AB995,38,43 1. A bachelor's, master's, or doctoral degree with a major in health care
4administration or long-term care from an accredited college or university.
AB995,38,75 2. A bachelor's degree in any field from an accredited college or university and
6completion of a specialized course that the examining board determines is adequate
7preparation for nursing home administration.
AB995, s. 80 8Section 80. 456.04 (1m) (e) of the statutes is created to read:
AB995,38,109 456.04 (1m) (e) Satisfies the supervised practical experience requirements
10specified in the rules promulgated under s. 456.02 (7).
AB995, s. 81 11Section 81. 456.04 (2) of the statutes is renumbered 456.04 (1m) (b).
AB995, s. 82 12Section 82. 456.04 (2m) of the statutes is created to read:
AB995,38,1513 456.04 (2m) The examining board shall allow a person to take the examination
14for licensure as a nursing home administrator if he or she satisfies the requirements
15specified in sub. (1m) (a), (b), and (c) and all of the following are satisfied:
AB995,38,2016 (a) The person was enrolled, at any time within the 2-year period before the
17effective date of this paragraph .... [revisor inserts date], in a regular course of study
18or equivalent specialized courses or a program of study that the examining board
19considered adequate academic preparation for nursing home administration under
20s. 456.04 (4), 2001 stats.
AB995,38,2321 (b) No later than 2 years after the effective date of this paragraph .... [revisor
22inserts date], the person completes the regular course of study, specialized courses,
23or program of study specified in par. (a).
AB995,39,424 (c) If the person was enrolled, at any time within the 2-year period before the
25effective date of this paragraph .... [revisor inserts date], in specialized courses or a

1program of study specified in par. (a), the person completes, no later than 2 years
2after the effective date of this paragraph .... [revisor inserts date], one year of
3supervised practical experience as specified in rules promulgated by the examining
4board.
AB995,39,95 (d) If the person was enrolled, at any time within the 2-year period before the
6effective date of this paragraph .... [revisor inserts date], in a regular course of study
7specified in par. (a), the person completes, no later than 2 years after the effective
8date of this paragraph .... [revisor inserts date], a supervised clinical practicum as
9specified in rules promulgated by the examining board.
AB995, s. 83 10Section 83. 456.04 (3) of the statutes is renumbered 456.04 (1m) (c).
AB995, s. 84 11Section 84. 456.04 (4) of the statutes is repealed.
AB995, s. 85 12Section 85. 456.08 of the statutes is renumbered 456.08 (intro.) and amended
13to read:
AB995,39,19 14456.08 Reciprocity. (intro.) The examining board may grant a nursing home
15administrator license under this chapter to a person an applicant who holds a
16current nursing home administrator license issued by the proper authorities of any
17other state or licensing jurisdiction, upon payment of the fee specified in s. 440.05 (2)
18and upon submission of satisfactory evidence of the person's qualifications. evidence
19satisfactory to the examining board that the applicant satisfies each of the following:
AB995, s. 86 20Section 86. 456.08 (1), (2), (3) and (4) of the statutes are created to read:
AB995,39,2321 456.08 (1) The applicant has a bachelor's degree in any field or holds a current
22certification as a nursing home administrator granted by the American College of
23Health Care Administrators.
AB995,40,3
1(2) The applicant has practiced as a nursing home administrator in good
2standing for at least 2,000 hours in any consecutive 3-year period within the 5-year
3period immediately preceding the date of application.
AB995,40,5 4(3) Subject to ss. 111.321, 111.322, and 111.335, the applicant does not have an
5arrest or conviction record.
AB995,40,8 6(4) The applicant has passed an examination approved by the examining board
7relating to state and federal laws governing the practice of nursing home
8administration.
AB995, s. 87 9Section 87. 456.09 (1) (c) of the statutes is amended to read:
AB995,40,1310 456.09 (1) (c) Practice Except as provided in s. 456.12, practice as a nursing
11home administrator or use in connection with his or her name any title or designation
12tending to imply that the person is a nursing home administrator unless duly
13licensed and registered to so practice under this chapter; or
AB995, s. 88 14Section 88. 456.12 of the statutes is created to read:
AB995,40,20 15456.12 Exemption. This chapter does not apply to a person who acts in the
16capacity of an administrator of a nursing home operated by adherents of a church or
17religious denomination which subscribes to the act of healing by prayer and the
18principles of which do not include medical treatment, if the person does not use in
19connection with his or her name any title or designation tending to imply that the
20person is a nursing home administrator.
AB995, s. 89 21Section 89. 609.22 (2) of the statutes is amended to read:
AB995,40,2522 609.22 (2) Adequate choice. A defined network plan that is not a preferred
23provider plan shall ensure that, with respect to covered benefits, each enrollee has
24adequate choice among participating providers and that the providers are, to the
25extent consistent with s. 628.36 (2) (b) 3. and (2m),
accessible and qualified.
AB995, s. 90
1Section 90. 609.32 (2) (a) of the statutes is amended to read:
AB995,41,102 609.32 (2) (a) A defined network plan shall develop , consistent with s. 628.36
3(2) (b) 3. and (2m),
a process for selecting participating providers, including written
4policies and procedures that the plan uses for review and approval of providers. After
5consulting with appropriately qualified providers, the plan shall establish, to the
6extent consistent with s. 628.36 (2) (b) 3. and (2m),
minimum professional
7requirements for its participating providers. The process for selection shall include
8verification of a provider's license or certificate, including the history of any
9suspensions or revocations, and the history of any liability claims made against the
10provider.
AB995, s. 91 11Section 91. 628.36 (1) of the statutes is renumbered 628.36 (1m) and amended
12to read:
AB995,41,1613 628.36 (1m) Payment methods. Any corporation operating a voluntary health
14care plan may pay health care professionals on a salary, per patient , or
15fee-for-service basis to provide health care to policyholders or beneficiaries of the
16corporation.
AB995, s. 92 17Section 92. 628.36 (1c) (intro.) of the statutes is created to read:
AB995,41,1818 628.36 (1c) Definitions. (intro.) In this section:
AB995, s. 93 19Section 93. 628.36 (2) (a) (intro.) of the statutes is amended to read:
AB995,41,2020 628.36 (2) (a) (intro.) In this section subsection:
AB995, s. 94 21Section 94. 628.36 (2) (b) 3. of the statutes is amended to read:
AB995,41,2522 628.36 (2) (b) 3. Except as provided in subd. subds. 4. and 4m., and subject to
23sub. (2m) (e)
, no provider may be denied the opportunity to participate in a health
24care plan, other than a health maintenance organization, a limited service health
25organization or a preferred provider plan,
under the terms of the plan.
AB995, s. 95
1Section 95. 628.36 (2) (b) 4. of the statutes is amended to read:
AB995,42,52 628.36 (2) (b) 4. Any health care plan may exclude a provider from participation
3in the health care plan for cause related to the practice of his or her profession. A
4health care plan that excludes a provider from participation shall advise the provider
5in writing of the reason for the exclusion.
AB995, s. 96 6Section 96. 628.36 (2) (b) 4m. of the statutes is created to read:
AB995,42,107 628.36 (2) (b) 4m. Subdivision 3. applies to a health maintenance organization,
8limited service health organization, or preferred provider plan only with respect to
9a provider located in the geographic service area of the health maintenance
10organization, limited service health organization, or preferred provider plan.
AB995, s. 97 11Section 97. 628.36 (2m) (title) of the statutes is repealed and recreated to read:
AB995,42,1212 628.36 (2m) (title) Annual participation election period.
AB995, s. 98 13Section 98. 628.36 (2m) (a) (intro.) and 2m. of the statutes are consolidated,
14renumbered 628.36 (2m) (ac) and amended to read:
AB995,42,1715 628.36 (2m) (ac) In this subsection: 2m. "Pharmaceutical, "health care
16services" do not include the administration of a drug product or device or vaccine
17under s. 450.035.
AB995, s. 99 18Section 99. 628.36 (2m) (a) 1. of the statutes is renumbered 628.36 (1c) (a).
AB995, s. 100 19Section 100. 628.36 (2m) (a) 2. of the statutes is renumbered 628.36 (1c) (b).
AB995, s. 101 20Section 101. 628.36 (2m) (a) 3. of the statutes is renumbered 628.36 (1c) (c).
AB995, s. 102 21Section 102. 628.36 (2m) (e) 1. of the statutes is amended to read:
AB995,43,822 628.36 (2m) (e) 1. A health maintenance organization, limited service health
23organization, or preferred provider plan that provides coverage of pharmaceutical
24health care services when that are performed by one or more pharmacists health care
25professionals
who are selected by the organization or plan but who are not full-time

1salaried employees or partners of the organization or plan shall provide an annual
2period of at least 30 days during which any pharmacist registered under ch. 450
3health care professional who provides those health care services, who has been
4granted a credential, as defined in s. 440.01 (2) (a), to practice in this state, and who
5is located in the geographic service area of the organization or plan
may elect to
6participate in the health maintenance organization, limited service health
7organization, or preferred provider plan under its terms as a selected provider for at
8least one year.
AB995, s. 103 9Section 103. 628.36 (2m) (e) 2. of the statutes is amended to read:
AB995,43,1410 628.36 (2m) (e) 2. Except as provided in subd. 3., subd. 1. applies to health
11maintenance organizations on and after May 10, 1984. Except as provided in subd.
124., subd. 1. applies to
, limited service health organizations, and preferred provider
13plans on or after April 28, 1990 the effective date of this subdivision .... [revisor
14inserts date]
.
AB995, s. 104 15Section 104. 628.36 (2m) (e) 3. of the statutes is amended to read:
AB995,43,2316 628.36 (2m) (e) 3. If compliance with the requirements of subd. 1. during the
17period specified in subd. 2. would impair any provision of a contract between a health
18maintenance organization, limited service health organization, or preferred
19provider plan
and any other person, and if the contract provision was in existence
20prior to May 10, 1984 the effective date of this subdivision .... [revisor inserts date],
21then immediately after the expiration of all such contract provisions the health
22maintenance organization, limited service health organization, or preferred
23provider plan
shall comply with the requirements of subd. 1.
AB995, s. 105 24Section 105. 628.36 (2m) (e) 4. of the statutes is repealed.
AB995, s. 106 25Section 106. 628.36 (3) of the statutes is amended to read:
AB995,44,9
1628.36 (3) Exemption by rule. By rule the commissioner may exempt from the
2application of any part of subs. (1) (1m) to (2m) plans which that provide innovative
3approaches to the delivery of health care or which that are designed to contain health
4care costs, and which that cannot operate successfully consistent with all of the
5provisions in subs. (1) (1m) to (2m). The commissioner may promulgate such a rule
6only if on a finding that the interests of the public require such plans as an
7experiment, to supply health care services that are not otherwise available in
8adequate quantity or quality, or to contain health care costs. The promulgated rule
9shall be as narrow as is compatible with the success of the plans.
AB995, s. 107 10Section 107. 632.89 (1) (am) of the statutes is created to read:
AB995,44,1211 632.89 (1) (am) "Consumer price index" means the consumer price index for all
12urban consumers, U.S. city average, as determined by the U.S. department of labor.
AB995, s. 108 13Section 108. 632.89 (1) (b) of the statutes is created to read:
AB995,44,1614 632.89 (1) (b) "Diagnostic testing" means procedures used to exclude the
15existence of conditions other than nervous or mental disorders or alcoholism or other
16drug abuse problems.
AB995, s. 109 17Section 109. 632.89 (2) (b) 1. of the statutes is amended to read:
AB995,44,2318 632.89 (2) (b) 1. Except as provided in subd. 2., if a group or blanket disability
19insurance policy issued by an insurer provides coverage of inpatient hospital
20treatment or outpatient treatment or both, the policy shall provide coverage in every
21policy year as provided in pars. (c) to (dm), as appropriate, except that the total
22coverage under the policy for a policy year need not exceed $7,000 $16,800 or the
23equivalent benefits measured in services rendered.
AB995, s. 110 24Section 110. 632.89 (2) (c) 2. b. of the statutes is amended to read:
AB995,45,5
1632.89 (2) (c) 2. b. Seven thousand Sixteen thousand eight hundred dollars
2minus any applicable cost sharing at the level charged under the policy for inpatient
3hospital services or the equivalent benefits measured in services rendered or, if the
4policy does not use cost sharing, $6,300 $15,100 in equivalent benefits measured in
5services rendered.
AB995, s. 111 6Section 111. 632.89 (2) (d) 2. of the statutes is amended to read:
AB995,45,117 632.89 (2) (d) 2. Except as provided in par. (b), a policy under subd. 1. shall
8provide coverage in every policy year for not less than $2,000 $3,100 minus any
9applicable cost sharing at the level charged under the policy for outpatient services
10or the equivalent benefits measured in services rendered or, if the policy does not use
11cost sharing, $1,800 $2,800 in equivalent benefits measured in services rendered.
AB995, s. 112 12Section 112. 632.89 (2) (dm) 2. of the statutes is amended to read:
AB995,45,1813 632.89 (2) (dm) 2. Except as provided in par. (b), a policy under subd. 1. shall
14provide coverage in every policy year for not less than $3,000 $4,600 minus any
15applicable cost sharing at the level charged under the policy for transitional
16treatment arrangements or the equivalent benefits measured in services rendered
17or, if the policy does not use cost sharing, $2,700 $4,100 in equivalent benefits
18measured in services rendered.
AB995, s. 113 19Section 113. 632.89 (2) (f) of the statutes is created to read:
AB995,45,2320 632.89 (2) (f) Report on coverage limits. The department of health and family
21services shall report annually to the governor and the legislature on revising the
22coverage limits specified in this subsection based on the change in the consumer price
23index for medical costs.
AB995, s. 114 24Section 114. 632.89 (6) and (7) of the statutes are created to read:
AB995,46,3
1632.89 (6) Prescription drugs and diagnostic testing. (a) The coverage
2amounts specified in sub. (2) shall not include costs incurred for prescription drugs
3or diagnostic testing.
AB995,46,54 (b) The department of health and family services may specify, by rule, the
5diagnostic testing procedures to which par. (a) applies.
AB995,46,8 6(7) Treatment of costs. The coverage amounts specified in sub. (2) apply to
7actual payments or reimbursements made by an insurer if the payment or
8reimbursement amounts are less than the amounts charged by a provider.
AB995, s. 115 9Section 115. 895.48 (1m) of the statutes, as affected by 2003 Wisconsin Act 33,
10is renumbered 895.48 (1m) (a).
AB995, s. 116 11Section 116. 895.48 (1m) (b) of the statutes is created to read:
AB995,46,1312 895.48 (1m) (b) This subsection does not apply to health care services provided
13by a volunteer health care provider under s. 146.89.
AB995, s. 117 14Section 117 . Nonstatutory provisions.
AB995,46,1815 (1) The department of health and family services shall submit in proposed form
16the rules required under section 46.03 (44) of the statutes, as created by this act, to
17the legislative council staff under section 227.15 (1) of the statutes no later than the
18first day of the 7th month beginning after the effective date of this subsection.
AB995, s. 118 19Section 118 . Initial applicability.
AB995,46,2220 (1) The treatment of section 49.688 (4r) of the statutes first applies to eligibility
21determinations made and deductible amounts paid on the effective date of this
22subsection.
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