632.895(12m)(b)4.
4. A paraprofessional working under the supervision of a provider listed under
subds. 1. to
3m.
632.895(12m)(b)5.
5. A professional working under the supervision of an outpatient mental health clinic certified under
s. 51.038.
632.895(12m)(c)1.1. The coverage required under
par. (b) shall provide at least $50,000 for intensive-level services per insured per year, with a minimum of 30 to 35 hours of care per week for a minimum duration of 4 years, and at least $25,000 for nonintensive-level services per insured per year, except that these minimum coverage monetary amounts shall be adjusted annually, beginning in 2011, to reflect changes in the consumer price index for all urban consumers, U.S. city average, for the medical care group, as determined by the U.S. department of labor. The commissioner shall publish the new minimum coverage amounts under this subdivision each year, beginning in 2011, in the Wisconsin Administrative Register.
632.895(12m)(c)2.
2. Notwithstanding
subd. 1., the minimum coverage monetary amounts or duration required for treatment under
subd. 1., need not be met if it is determined by a supervising professional, in consultation with the insured's physician, that less treatment is medically appropriate.
632.895(12m)(d)
(d) The coverage required under
par. (b) may be subject to deductibles, coinsurance, or copayments that generally apply to other conditions covered under the policy or plan. The coverage may not be subject to limitations or exclusions, including limitations on the number of treatment visits.
632.895(12m)(e)
(e) This subsection does not apply to any of the following:
632.895(12m)(e)1.
1. A disability insurance policy that covers only certain specified diseases.
632.895(12m)(e)2.
2. A health care plan offered by a limited service health organization, as defined in
s. 609.01 (3), or by a preferred provider plan, as defined in
s. 609.01 (4), that is not a defined network plan, as defined in
s. 609.01 (1b).
632.895(12m)(f)1.1. The commissioner shall by rule further define “intensive-level services" and “nonintensive-level services" and define “paraprofessional" for purposes of
par. (b) 4. and “qualified" for purposes of providing services under this subsection. The commissioner may promulgate rules governing the interpretation or administration of this subsection.
632.895(12m)(f)2.
2. Using the procedure under
s. 227.24, the commissioner may promulgate the rules under
subd. 1. for the period before the effective date of the permanent rules promulgated under
subd. 1., but not to exceed the period authorized under
s. 227.24 (1) (c) and
(2). Notwithstanding
s. 227.24 (1) (a),
(2) (b), and
(3), the commissioner is not required to provide evidence that promulgating a rule under this subdivision as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subdivision.
632.895(13)(a)(a) Every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, that provides coverage of the surgical procedure known as a mastectomy shall provide coverage of breast reconstruction of the affected tissue incident to a mastectomy.
632.895(13)(b)
(b) The coverage required under
par. (a) may be subject to any limitations, exclusions or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan.
632.895(14)(a)1.
1. “Appropriate and necessary immunizations" means the administration of vaccine that meets the standards approved by the U.S. public health service for such biological products against at least all of the following: