LRB-3975/1
TJD:emw&ahe
2017 - 2018 LEGISLATURE
March 12, 2018 - Introduced by Representatives Anderson, Kolste, Berceau,
Zamarripa, Sargent, Ohnstad, Spreitzer, Sinicki, Subeck, Brostoff and
Pope, cosponsored by Senators Larson, Vinehout and Risser. Referred to
Committee on Insurance.
AB1019,1,2
1An Act to create 609.047 of the statutes;
relating to: provider directories for
2certain health plans.
Analysis by the Legislative Reference Bureau
This bill requires a defined network plan or preferred provider plan to make a
current directory of health care providers in the plan's network of providers available
to anyone considering enrollment in the plan and to the plan's enrollees at least
annually. Defined network plans and preferred provider plans are types of managed
care organizations that provide health care benefits to their enrollees. The bill
requires the plan to maintain a current provider directory on its Internet site, to
ensure that the directory on the site is updated at least quarterly, and to ensure that
the public may view the provider directory on the site without creating or accessing
an account or entering a policy or contract number. A plan is also required by the bill
to provide information in each electronic and print directory on providers for each of
the plan's covered services, prominently indicate in each electronic and print
directory which providers are accepting new patients at the time the directory is
updated, and accommodate with each electronic and print directory the
communication needs of persons with disabilities and persons with limited English
proficiency.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB1019,1
1Section
1. 609.047 of the statutes is created to read:
AB1019,2,5
2609.047 Network directories. (1) A defined network plan or a preferred
3provider plan shall make a current provider directory of all providers in the plan's
4network available to persons considering enrollment in the plan and to enrollees no
5less frequently than annually.
AB1019,2,11
6(2) The defined network plan or preferred provider plan shall maintain a
7current provider directory on the plan's Internet site and shall ensure that the
8directory on the Internet site is updated no less frequently than quarterly. The
9defined network plan or preferred provider plan shall ensure that the public is able
10to view the Internet provider directory through a clearly identifiable link or tab
11without creating or accessing an account or entering a policy or contract number.
AB1019,2,13
12(3) The defined network plan or preferred provider plan shall provide a print
13copy of the provider directory to an enrollee or prospective enrollee upon request.
AB1019,2,15
14(4) The defined network plan or preferred provider plan shall do all of the
15following, regardless of whether the directory is electronic or in print:
AB1019,2,1716
(a) Provide information in each directory on providers for each of the plan's
17covered services.
AB1019,2,1918
(b) Prominently indicate in each directory which providers are accepting new
19patients at the time the directory is updated.
AB1019,2,2120
(c) Accommodate the communication needs of persons with disabilities and
21persons with limited proficiency in English.
