SB21-SSA1,1351,25 (b) A pharmacy benefit manger shall include in each contract with a pharmacy a process to appeal, investigate, and resolve disputes regarding maximum allowable cost pricing that includes all of the following:

SB21-SSA1,1352,1 1. A 21-day limit on the right to appeal following the initial claim.

SB21-SSA1,1352,3 2. A requirement that the appeal be investigated and resolved within 21 days after the date of the appeal.

SB21-SSA1,1352,5 3. A dedicated telephone number at which the pharmacy may contact the pharmacy benefit manager to speak to a person responsible for processing appeals.

SB21-SSA1,1352,9 4. A requirement that a pharmacy benefit manager provide a reason for any appeal denial and the national drug code published in a directory by the federal food and drug administration of a prescribed drug or device that may be purchased by retail network pharmacies at a price at or below the maximum allowable cost.

SB21-SSA1,1352,11 5. A requirement that a pharmacy benefit manager make a pricing adjustment no later than one day after the date of the final determination of the appeal.

SB21-SSA1,4590r Section 4590r. 632.876 of the statutes is created to read:

SB21-SSA1,1352,17 632.876 Independent dispute resolution process relating to chiropractic treatment. The commissioner shall promulgate rules that provide for a fast, fair, cost-effective, and binding independent process for resolving disputes related to insurer conduct under s. 632.87 (3). The rules shall include at least all of the following:

SB21-SSA1,1352,20 (1) The procedures for making a request to the commissioner for an independent dispute resolution, including specification of who is eligible to request an independent dispute resolution.

SB21-SSA1,1352,23 (2) A requirement that individuals requesting an independent dispute resolution must first exhaust any internal grievance procedure established by the insurer for grievances related to conduct under s. 632.87 (3).

SB21-SSA1,1353,2 (3) The application procedure and qualifications, including conflict of interest provisions, for individuals to act as independent reviewers under the independent dispute resolution process and the inclusion of retired members of the state judiciary as individuals who are eligible to act as independent reviewers.

SB21-SSA1,1353,4 (4) The procedure for selecting an independent reviewer to review a particular complaint.

SB21-SSA1,1353,8 (5) The procedures, including timelines, that an independent reviewer must follow when reviewing a complaint and a requirement that an independent reviewer must render a decision regarding a particular complaint within 9 months after the commissioner receives the request for independent dispute resolution.

SB21-SSA1,1353,9 (6) Procedures for setting and paying the fees of the independent reviewers.

SB21-SSA1,1353,11 (7) A requirement that the insurer about which the independent dispute resolution is requested pay the fees of the independent reviewer.

SB21-SSA1,1353,14 (8) The relief to which an individual who requests independent dispute resolution and who prevails is entitled, including injunctive and declaratory relief and monetary relief due to underpayments by the insurer.

SB21-SSA1,4591 Section 4591. 632.895 (10) (a) of the statutes is amended to read:

SB21-SSA1,1353,24 632.895 (10) (a) Except as provided in par. (b), every disability insurance policy and every health care benefits plan provided on a self-insured basis by a county board under s. 59.52 (11), by a city or village under s. 66.0137 (4), by a political subdivision local governmental unit or technical college district under s. 66.0137 (4m), by a town under s. 60.23 (25), or by a school district under s. 120.13 (2) shall provide coverage for blood lead tests for children under 6 years of age, which shall be conducted in accordance with any recommended lead screening methods and intervals contained in any rules promulgated by the department of health services under s. 254.158.

SB21-SSA1,4594g Section 4594g. 655.001 (8c) of the statutes is created to read:

SB21-SSA1,1354,2 655.001 (8c) "Insurer" includes a foreign insurer that is a risk retention group that issues health care liability insurance under this chapter.

SB21-SSA1,4594m Section 4594m. 655.23 (3) (am) of the statutes is created to read:

SB21-SSA1,1354,10 655.23 (3) (am) For purposes of par. (a) only, a foreign insurer that is a risk retention group and that has not been issued a certificate of authority under s. 618.12 is authorized to do business in this state if the risk retention group is registered with the commissioner, is approved by the commissioner to provide health care liability insurance coverage under this chapter, and has and maintains a risk-based capital ratio of at least 300 percent as determined under the risk-based capital instructions adopted by the National Association of Insurance Commissioners.

SB21-SSA1,4594r Section 4594r. 703.195 (1) (c) of the statutes is amended to read:

SB21-SSA1,1354,13 703.195 (1) (c) "Condemnor" means a person specified in s. 32.01 (1) who has the authority to condemn property under ch. 32.

SB21-SSA1,4595 Section 4595. 705.04 (2g) of the statutes is amended to read:

SB21-SSA1,1354,22 705.04 (2g) Notwithstanding subs. (1) and (2), the department of health services may collect, from funds of a decedent that are held by the decedent immediately before death in a joint account or a P.O.D. account, an amount equal to the medical assistance that is recoverable under s. 49.496 (3) (a), an amount equal to aid under s. 49.68, 49.683, or 49.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), or an amount equal to long-term community support services under s. 46.27 that is recoverable under s. 46.27 (7g) (c) 1. and that was paid on behalf of the decedent or the decedent's spouse.

SB21-SSA1,4595c Section 4595c. 706.22 of the statutes is created to read:

SB21-SSA1,1354,25 706.22 Prohibition on imposing time-of-sale requirements. (1) Definitions. In this section:

SB21-SSA1,1355,7 (a) "Actions with respect to the property" include such actions as having an inspection made by an employee or agent of, or contractor with, the local governmental unit; making improvements or repairs; removing junk or debris; mowing or pruning; performing maintenance or upkeep activities; weatherproofing; upgrading electrical systems; paving; painting; repairing or replacing appliances; replacing or installing fixtures or other items; and actions relating to compliance with building codes or other property condition standards.