SB70,1582,17 1. Notify each enrollee of the termination of the contract or benefits and of the right for the enrollee to elect to continue transitional care from the participating provider or participating facility under this subsection.

SB70,1582,19 2. Provide the enrollee an opportunity to notify the plan of the need for transitional care.

SB70,1583,2 3. Allow the enrollee to elect to continue to have the benefits provided under the plan under the same terms and conditions as would have applied to the item or service if the termination had not occurred for the course of treatment related to the enrollee's status as a continuing care patient beginning on the date on which the notice under subd. 1. is provided and ending 90 days after the date on which the notice under subd. 1. is provided or the date on which the enrollee is no longer a continuing care patient, whichever is earlier.

SB70,1583,5 (c) The provisions of s. 609.24 apply to a continuing care patient to the extent that s. 609.24 does not conflict with this subsection so as to limit the enrollee's rights under this subsection.

SB70,1583,12 (8) Rule making. The commissioner may promulgate any rules necessary to implement this section, including specifying the independent dispute resolution process under sub. (6). The commissioner may promulgate rules to modify the list of those items and services for which a provider may not balance bill under sub. (4) (c). In promulgating rules under this subsection, the commissioner may consider any rules promulgated by the federal department of health and human services pursuant to the federal No Suprises Act, 42 USC 300gg-111, et seq.

SB70,3051 Section 3051. 609.20 (3) of the statutes is created to read:

SB70,1583,20 609.20 (3) The commissioner may promulgate rules to establish minimum network time and distance standards and minimum network wait-time standards for defined network plans and preferred provider plans. In promulgating rules under this subsection, the commissioner shall consider standards adopted by the federal centers for medicare and medicaid services for qualified health plans, as defined in 42 USC 18021 (a), that are offered through the federal health insurance exchange established pursuant to 42 USC 18041 (c).

SB70,3052 Section 3052. 609.24 (5) of the statutes is created to read:

SB70,1583,24 609.24 (5) If an enrollee is a continuing care patient, as defined in s. 609.045 (7) (a), and if any of the situations described under s. 609.045 (7) (b) (intro.) applies, all of the following apply to the enrollee's defined network plan:

SB70,1584,3 (a) Subsection (1) (c) shall apply to any of the participating providers providing the enrollee's course of treatment under s. 609.045 (7), including the enrollee's primary care physician.

SB70,1584,6 (b) Subsection (1) (c) shall apply to lengthen the period in which benefits are provided under s. 609.045 (7) (b) 3., but shall not be applied to shorten the period in which benefits are provided under s. 609.045 (7) (b) 3.

SB70,1584,8 (c) Subsection (1) (d) shall not be applied in a manner that limits the enrollee's rights under s. 609.045 (7) (b) 3.

SB70,1584,11 (d) No plan may contract or arrange with a participating provider to provide notice of the termination of the participating provider's participation, pursuant to sub. (4).

SB70,3053 Section 3053 . 609.712 of the statutes is created to read:

SB70,1584,14 609.712 Essential health benefits; preventive services. Defined network plans and preferred provider plans are subject to s. 632.895 (13m) and (14m).

SB70,3054 Section 3054 . 609.713 of the statutes is created to read:

SB70,1584,18 609.713 Qualified treatment trainee coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (7).

SB70,3055 Section 3055. 609.714 of the statutes is created to read:

SB70,1584,22 609.714 Substance abuse counselor coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (8).

SB70,3056 Section 3056. 609.719 of the statutes is created to read:

SB70,1585,3 609.719 Coverage for telehealth services. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.871.

SB70,3057 Section 3057 . 609.74 of the statutes is created to read:

SB70,1585,6 609.74 Coverage of infertility services. Defined network plans and preferred provider plans are subject to s. 632.895 (15m).

SB70,3058 Section 3058. 609.83 of the statutes is amended to read:

SB70,1585,11 609.83 Coverage of drugs and devices ; application of payments. Limited service health organizations, preferred provider plans, and defined network plans are subject to ss. 632.853, 632.861, 632.862, and 632.895 (6) (b), (16t), and (16v).

SB70,3059 Section 3059 . 609.847 of the statutes is created to read:

SB70,1585,15 609.847 Preexisting condition discrimination and certain benefit limits prohibited. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.728.

SB70,3060 Section 3060. 611.11 (4) (a) of the statutes is amended to read: