SB55-SSA1-CA1,933,7 609.83 Coverage of drugs and devices. Limited service health organizations, preferred provider plans, and managed care defined network plans are subject to s. 632.853.

SB55-SSA1-CA1, s. 3741xmg Section 3741xmg. 609.84 of the statutes is amended to read:

SB55-SSA1-CA1,933,11 609.84 Experimental treatment. Limited service health organizations, preferred provider plans, and managed care defined network plans are subject to s. 632.855.

SB55-SSA1-CA1, s. 3741xmp Section 3741xmp. 609.88 of the statutes is amended to read:

SB55-SSA1-CA1,933,14 609.88 Coverage of immunizations. Managed care Defined network plans are subject to s. 632.895 (14).

SB55-SSA1-CA1, s. 3741xmr Section 3741xmr. 609.89 of the statutes is amended to read:

SB55-SSA1-CA1,933,18 609.89 Written reason for coverage denial. Limited service health organizations, preferred provider plans, and managed care defined network plans are subject to s. 631.17.

SB55-SSA1-CA1, s. 3741xmt Section 3741xmt. 609.90 of the statutes is amended to read:

SB55-SSA1-CA1,933,22 609.90 Restrictions related to domestic abuse. Limited service health organizations, preferred provider plans, and managed care defined network plans are subject to s. 631.95.".

SB55-SSA1-CA1,933,23 1473. Page 1180, line 21: after that line insert:

SB55-SSA1-CA1,933,24 " Section 3741d. 607.25 of the statutes is created to read:

SB55-SSA1-CA1,934,12 607.25 Loan to general fund. No later than the first day of the 2nd month after the effective date of this section .... [revisor inserts date], the life fund shall make a loan of $850,000 to the general fund. Notwithstanding s. 604.03 (2), no interest shall be charged on the loan during the period of the loan. The general fund shall repay the loan from moneys lapsed to the general fund from the appropriation under s. 20.515 (2) (a) at the end of the 2001-03 fiscal biennium, if any, and from moneys lapsed to the general fund from the appropriation under s. 20.515 (2) (g) in the amounts specified in s. 40.98 (6m). If the secretary of administration determines that the moneys lapsed from these appropriations will not be sufficient to repay the loan within a reasonable period of time, as determined by the secretary and the commissioner, the secretary shall transfer from the general fund to the life fund an amount sufficient to repay the loan.".

SB55-SSA1-CA1,934,13 1474. Page 1181, line 3: after that line insert:

SB55-SSA1-CA1,934,14 " Section 3755g. 628.46 (2m) of the statutes is created to read:

SB55-SSA1-CA1,934,19 628.46 (2m) Notwithstanding subs. (1) and (2), a claim for payment for chiropractic services is overdue if not paid within 30 days after the insurer receives clinical documentation from the chiropractor that the services were provided unless, within those 30 days, the insurer provides to the insured and to the chiropractor the written statement under s. 632.875 (2).

SB55-SSA1-CA1, s. 3760m Section 3760m. 632.875 (2) (intro.) of the statutes is amended to read:

SB55-SSA1-CA1,935,3 632.875 (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 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 a written statement that contains all of the following:".

SB55-SSA1-CA1,935,4 1475. Page 1181, line 12: after that line insert:

SB55-SSA1-CA1,935,5 " Section 3766r. 635.19 (6) of the statutes is repealed.".

SB55-SSA1-CA1,935,6 1476. Page 1181, line 12: after that line insert:

SB55-SSA1-CA1,935,7 " Section 3763f. 632.895 (14) (c) of the statutes is amended to read:

SB55-SSA1-CA1,935,12 632.895 (14) (c) The coverage required under par. (b) may not be subject to any deductibles, copayments, or coinsurance under the policy or plan. This paragraph applies to a managed care defined network plan, as defined in s. 609.01 (3c) (1b), only with respect to appropriate and necessary immunizations provided by providers participating, as defined in s. 609.01 (3m), in the plan.

SB55-SSA1-CA1, s. 3763g Section 3763g. 632.895 (14) (d) 3. of the statutes is amended to read:

SB55-SSA1-CA1,935,17 632.895 (14) (d) 3. 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 managed care defined network plan, as defined in s. 609.01 (3c) (1b).".

SB55-SSA1-CA1,935,18 1477. Page 1181, line 12: after that line insert:

SB55-SSA1-CA1,935,19 " Section 3766e. 635.02 (2) of the statutes is amended to read:

SB55-SSA1-CA1,936,2 635.02 (2) "Case characteristics" means the demographic, actuarially based characteristics of the employees of a small employer, and the employer, if covered, such as age, sex, and geographic location and occupation, used by a small employer insurer to determine premium rates for a small employer. "Case characteristics" does not include loss or claim history, health status, occupation, duration of coverage, or other factors related to claim experience.

SB55-SSA1-CA1, s. 3766ec Section 3766ec. 635.02 (3e) of the statutes is created to read:

SB55-SSA1-CA1,936,4 635.02 (3e) "Eligible employee" has the meaning given in s. 632.745 (5) (a).