SB762: Bill Text

SB762,51,22 (1) Penalties. (a) Except as provided in par. (b), a person who violates a provision of this subchapter or a rule promulgated under this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both.

SB762,51,23 (b) A person who violates s. 448.9755 (3) may be fined not more than $250.

SB762,52,3 (2) Appeal. A person aggrieved by an action taken under this subchapter by the affiliated credentialing board, its officers, or its agents may apply for judicial review as provided in ch. 227, and shall file notice of such appeal with the affiliated credentialing board within 30 days. No court of this state may enter an ex parte stay of an action taken by the affiliated credentialing board under this subchapter.

SB762,52,6 448.978 Rules. The affiliated credentialing board shall promulgate rules defining the acts or attempted acts of commission or omission that constitute unprofessional conduct under s. 448.976 (1).

SB762,52,15 448.9785 Informed consent. Any primary spinal care practitioner who treats a patient shall inform the patient about the availability of reasonable alternate modes of treatment and about the benefits and risks of these treatments. The reasonable primary spinal care practitioner standard is the standard for informing a patient under this section. The reasonable primary spinal care practitioner standard requires disclosure only of information that a reasonable primary spinal care practitioner would know and disclose under the circumstances. The primary spinal care practitioner's duty to inform the patient under this section does not require disclosure of any of the following:

SB762,52,17 (1) Detailed technical information that in all probability a patient would not understand.

SB762,52,18 (2) Risks apparent or known to the patient.

SB762,52,20 (3) Extremely remote possibilities that might falsely or detrimentally alarm the patient.

SB762,52,22 (4) Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment.

SB762,52,23 (5) Information in cases where the patient is incapable of consenting.

SB762,53,3 (6) Information about alternate modes of treatment for any condition the primary spinal care practitioner has not included in his or her diagnosis at the time the primary spinal care practitioner informs the patient.

SB762,91 Section 91. Subchapter VIII of chapter 448 [precedes 448.980] of the statutes, as created by 2015 Wisconsin Act 116, is renumbered subchapter IX of chapter 448 [precedes 448.980].

SB762,92 Section 92. 450.10 (3) (a) 5. of the statutes is amended to read:

SB762,53,10 450.10 (3) (a) 5. A physician, physician assistant, podiatrist, primary spinal care practitioner, physical therapist, physical therapist assistant, occupational therapist, or occupational therapy assistant licensed under ch. 448.

SB762,93 Section 93. 450.11 (8) (f) of the statutes is created to read:

SB762,53,13 450.11 (8) (f) The spinal medicine affiliated credentialing board, insofar as this section applies to primary spinal care practitioners.

SB762,94 Section 94. 454.02 (2) (a) of the statutes is amended to read:

SB762,53,18 454.02 (2) (a) Services performed by a person licensed, certified or registered under the laws of this state as a physician, physician assistant, podiatrist, primary spinal care practitioner, physical therapist, nurse or funeral director if those services are within the scope of the license, certificate or registration.

SB762,95 Section 95. 462.02 (2) (g) of the statutes is created to read:

SB762,53,23 462.02 (2) (g) A primary spinal care practitioner licensed under s. 448.9725 or a person under the direct supervision of such a primary spinal care practitioner, if the person has successfully completed a course of instruction approved by the chiropractic examining board related to X-ray examinations.

SB762,96 Section 96. 462.04 of the statutes is amended to read:

SB762,54,8 462.04 Prescription or order required. A person who holds a license or limited X-ray machine operator permit under this chapter may not use diagnostic X-ray equipment on humans for diagnostic purposes unless authorized to do so by prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed under s. 447.04 (1), a podiatrist licensed under s. 448.63, a primary spinal care practitioner licensed under s. 448.9725, a chiropractor licensed under s. 446.02, an advanced practice nurse certified under s. 441.16 (2), or a physician assistant licensed under s. 448.04 (1) (f).

SB762,97 Section 97. 600.03 (38s) of the statutes is created to read:

SB762,54,11 600.03 (38s) "Primary spinal care practitioner" has the meaning given in s. 448.971 (4).

SB762,98 Section 98. 600.03 (41s) of the statutes is created to read:

SB762,54,13 600.03 (41s) "Spinal medicine" has the meaning given in s. 448.971 (5).

SB762,99 Section 99. 609.70 (title) of the statutes is amended to read:

SB762,54,15 609.70 (title) Chiropractic and spinal medicine coverage.

SB762,100 Section 100. 628.46 (2m) (a) of the statutes is amended to read:

SB762,54,23 628.46 (2m) (a) Notwithstanding subs. (1) and (2) and except as provided in par. (b), a claim for payment for chiropractic or spinal medicine services is overdue if not paid within 30 days after the insurer receives clinical documentation from the chiropractor or primary spinal care practitioner that the services were provided unless, within those 30 days, the insurer provides to the insured and to the chiropractor or primary spinal care practitioner the written statement under s. 632.875 (2).

SB762,101 Section 101. 632.32 (2) (am) of the statutes is amended to read:

SB762,55,4 632.32 (2) (am) "Medical payments coverage" means coverage to indemnify for medical payments or chiropractic payments or both for the protection of all persons using the insured motor vehicle from losses resulting from bodily injury or death. "Medical payments coverage" includes coverage for spinal medicine.

SB762,102 Section 102. 632.64 of the statutes is amended to read:

SB762,55,16 632.64 Certification of disability. For the purpose of insurance policies that they issue, insurers doing a life insurance business in this state shall afford equal weight to a certification of disability signed by a physician with respect to matters within the scope of the physician's professional license, to a certification of disability signed by a chiropractor with respect to matters within the scope of the chiropractor's professional license, and to a certification of disability signed by a podiatrist with respect to matters within the scope of the podiatrist's professional license, and to a certification of a disability signed by a primary spinal care practitioner with respect to matters within the scope of the primary spinal care pratitioner's professional license. This section does not require an insurer to treat a certificate of disability as conclusive evidence of disability.

SB762,103 Section 103. 632.87 (3) (a) (intro.) of the statutes is amended to read:

SB762,56,2 632.87 (3) (a) (intro.) No policy, plan or contract may exclude coverage for diagnosis and treatment of a condition or complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license, if the policy, plan or contract covers diagnosis and treatment of the condition or complaint by a licensed physician or osteopath, even if different nomenclature is used to describe the condition or complaint. Examination by or referral from a physician shall not be a condition precedent for receipt of chiropractic or spinal medicine care under this paragraph. This paragraph does not:

SB762,104 Section 104. 632.87 (3) (a) 1. of the statutes is amended to read:

SB762,56,5 632.87 (3) (a) 1. Prohibit the application of deductibles or coinsurance provisions to chiropractic, spinal medicine, and physician charges on an equal basis.

SB762,105 Section 105. 632.87 (3) (a) 2. of the statutes is amended to read:

SB762,56,10 632.87 (3) (a) 2. Prohibit the application of cost containment or quality assurance measures to chiropractic or spinal medicine services in a manner that is consistent with cost containment or quality assurance measures generally applicable to physician services and that is consistent with this section.

SB762,106 Section 106. 632.87 (3) (b) (intro.) of the statutes is amended to read:

SB762,56,15 632.87 (3) (b) (intro.) No insurer, under a policy, plan or contract covering diagnosis and treatment of a condition or complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license, may do any of the following:

SB762,107 Section 107. 632.87 (3) (b) 1. of the statutes is amended to read:

SB762,56,22 632.87 (3) (b) 1. Restrict or terminate coverage for the treatment of a condition or a complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license on the basis of other than an examination or evaluation by or a recommendation of a licensed chiropractor or licensed primary spinal care practitioner or a peer review committee that includes a licensed chiropractor or licensed primary spinal care practitioner.

SB762,108 Section 108. 632.87 (3) (b) 2. of the statutes is amended to read:

SB762,56,25 632.87 (3) (b) 2. Refuse to provide coverage to an individual because that individual has been treated by a chiropractor or primary spinal care practitioner.

SB762,109 Section 109. 632.87 (3) (b) 3. of the statutes is amended to read:

SB762,57,4 632.87 (3) (b) 3. Establish underwriting standards that are more restrictive for chiropractic or spinal medicine care than for care provided by other health care providers.

SB762,110 Section 110. 632.87 (3) (b) 4. of the statutes is amended to read:

SB762,57,8 632.87 (3) (b) 4. Exclude or restrict health care coverage of a health condition solely because the condition may be treated by a chiropractor or primary spinal care practitioner.

SB762,111 Section 111. 632.875 (1) (b) of the statutes is amended to read:

SB762,57,12 632.875 (1) (b) "Independent evaluation" means an examination or evaluation by or recommendation of a chiropractor or licensed primary spinal care practitioner or a peer review committee under s. 632.87 (3) (b) 1.

SB762,112 Section 112. 632.875 (1) (bm) of the statutes is created to read:

SB762,57,15 632.875 (1) (bm) "Licensed primary spinal care practitioner" means a person licensed under s. 448.9725.

SB762,113 Section 113. 632.875 (1) (c) of the statutes is amended to read:

SB762,57,18 632.875 (1) (c) "Patient" means a person whose treatment by a chiropractor or licensed primary spinal care practitioner is the subject of an independent evaluation.

SB762,114 Section 114. 632.875 (1) (dm) of the statutes is created to read:

SB762,57,22 632.875 (1) (dm) "Treating primary spinal care practitioner" means a licensed primary spinal care practitioner who is treating a patient and whose treatment of the patient is the subject of an independent evaluation.

SB762,115 Section 115. 632.875 (2) (intro.) of the statutes is amended to read:

SB762,58,6 632.875 (2) (intro.) If, on the basis of an independent evaluation, an insurer restricts or terminates a patient's coverage for the treatment of a condition or complaint by a chiropractor or licensed primary spinal care practitioner acting within the scope of his or her license and the restriction or termination of coverage results in the patient becoming liable for payment for his or her treatment, the insurer shall, within the time required under s. 628.46 (2m), provide to the patient and to the treating chiropractor or licensed primary spinal care practitioner a written statement that contains all of the following:

SB762,116 Section 116. 632.875 (2) (b) of the statutes is amended to read:

SB762,58,9 632.875 (2) (b) The name of the treating chiropractor or treating primary spinal care practitioner.

SB762,117 Section 117. 632.875 (3) (a) of the statutes is amended to read:

SB762,58,15 632.875 (3) (a) In this subsection, "claim" means a patient's claim for coverage, under a policy, plan or contract covering diagnosis and treatment of a condition or complaint by a licensed chiropractor or licensed primary spinal care practitioner within the scope of the chiropractor's his or her professional license, the restriction or termination of which coverage is the subject of an independent evaluation.

SB762,118 Section 118. 632.875 (3) (b) of the statutes is amended to read:

SB762,58,20 632.875 (3) (b) A chiropractor or licensed primary spinal care practitioner who conducts an independent evaluation may not be compensated by an insurer based on a percentage of the dollar amount by which a claim is reduced as a result of the independent evaluation.

SB762,119 Section 119. 632.99 of the statutes is amended to read:

SB762,59,7 632.99 Certifications of disability. For the purpose of insurance policies that they issue, every insurer doing a health or disability insurance business in this state shall afford equal weight to a certification of disability signed by a physician with respect to matters within the scope of the physician's professional license, to a certification of disability signed by a chiropractor with respect to matters within the scope of the chiropractor's professional license, and to a certification of disability signed by a podiatrist with respect to matters within the scope of the podiatrist's professional license, and to a certification of a disability signed by a primary spinal care practitioner with respect to matters within the scope of the primary spinal care practitioner's professional license. This section does not require an insurer to treat any certification of disability as conclusive evidence of disability.

SB762,120 Section 120. 655.45 (1) of the statutes is amended to read:

SB762,59,14 655.45 (1) For the quarter beginning on July 1, 1986, and for each quarter thereafter, the director of state courts shall file reports complying with sub. (2) with the medical examining board, the physical therapy examining board, the podiatry affiliated credentialing board, the spinal medicine affiliated credentialing board, the board of nursing and the department, respectively, regarding health care providers licensed by the respective bodies.

SB762,121 Section 121. 895.453 (title) of the statutes is amended to read:

SB762,59,17 895.453 (title) Payments of chiropractic and spinal medicine services from attorney contingency fees.

SB762,122 Section 122. 895.453 (1) (am) of the statutes is created to read:

SB762,59,20 895.453 (1) (am) "Primary spinal care practitioner" means a person licensed under s. 448.9725.

SB762,123 Section 123. 895.453 (1) (cm) of the statutes is created to read:

SB762,59,22 895.453 (1) (cm) "Spinal medicine" has the meaning given in s. 448.971 (5).

SB762,124 Section 124. 895.453 (2) (intro.) of the statutes is amended to read:

SB762,60,2 895.453 (2) (intro.) Notwithstanding s. 803.03, if all of the following conditions exist, fees for chiropractic or spinal medicine services provided to an injured person shall be paid out of the amount of fees due to his or her attorney under the contingency fee arrangement made between the person and the attorney:

SB762,125 Section 125. 895.453 (2) (b) of the statutes is amended to read:

SB762,60,5 895.453 (2) (b) The services were provided by a chiropractor or primary spinal care practitioner because of the injuries arising from the motor vehicle accident.

SB762,126 Section 126. 895.453 (2) (e) of the statutes is amended to read:

SB762,60,10 895.453 (2) (e) Prior to the person's acceptance of the settlement agreement, the chiropractor or primary spinal care practitioner has not been paid for his or her services and has provided written notification to the person's attorney of the services that were provided to the person.

SB762,127 Section 127. 895.453 (3) of the statutes is amended to read:

SB762,60,18 895.453 (3) Except as provided in sub. (4), if the conditions under sub. (2) are met, the distribution of the amount due under the contingency fee arrangement shall be allocated on a pro rata basis between the person's attorney and each chiropractor and primary spinal care practitioner who provided services, based on the percentage obtained by comparing the outstanding fees owed to the attorney and each chiropractor and primary spinal care practitioner to the aggregate outstanding attorney and, chiropractic, and spinal medicine fees.

SB762,128 Section 128. 895.453 (4) (a) of the statutes is amended to read:

SB762,60,22 895.453 (4) (a) The chiropractor or primary spinal care practitioner is eligible for payment for the services provided to the person under any health insurance contract or self-insured health plan.

SB762,129 Section 129. 895.453 (4) (b) of the statutes is amended to read:

SB762,61,3 895.453 (4) (b) The chiropractor or primary spinal care practitioner is eligible for payment for the services provided to the person under any governmental health plan or program, including Medicaid or Medicare.

SB762,130 Section 130. 895.48 (1m) (a) (intro.) of the statutes is amended to read: