LRB-5942/1
TJD:ahe
2019 - 2020 LEGISLATURE
March 26, 2020 - Introduced by Senator Jacque, cosponsored by Representative
Wichgers. Referred to Committee on Health and Human Services.
SB913,1,3
1An Act to amend 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g) and 185.983
2(1) (intro.); and
to create 49.45 (61) (f), 609.713 and 632.872 of the statutes;
3relating to: coverage of telehealth services.
Analysis by the Legislative Reference Bureau
The bill prohibits a private insurer or a self-insured health plan of the state or
a county, city, village, town, or school district from denying coverage or refusing to
reimburse a health care provider for a treatment or service provided before May 1,
2021, through telehealth, which includes audio-only telephone, if that treatment or
service is covered under the policy or plan when provided in person by a health care
provider. Telehealth is a practice of health care delivery, diagnosis, consultation,
treatment, or transfer of medically relevant data by means of audio, video, or data
communications that are used either during a patient visit or a consultation or are
used to transfer medically relevant data about a patient.
2019 Wisconsin Act 56 requires the coverage by and reimburse for certain
telehealth services under the Medical Assistance program. Act 56 excluded from the
definition of telehealth audio-only telephone communications unless the
Department of Health Services specified by rule that those communications are
considered telehealth reimburseable by the Medical Assistance program. The bill
specifies that DHS must consider mental health therapy conducted before May 1,
2021, over audio-only telephone communications as interactive telehealth that is
eligible for coverage and reimbursement under the Medical Assistance program.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB913,1
1Section
1. 40.51 (8) of the statutes is amended to read:
SB913,2,62
40.51
(8) Every health care coverage plan offered by the state under sub. (6)
3shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.746 (1) to (8)
4and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855,
5632.867, 632.87 (3) to (6),
632.872, 632.885, 632.89, 632.895 (5m) and (8) to (17), and
6632.896.
SB913,2
7Section
2. 40.51 (8m) of the statutes is amended to read:
SB913,2,118
40.51
(8m) Every health care coverage plan offered by the group insurance
9board under sub. (7) shall comply with ss. 631.95, 632.746 (1) to (8) and (10), 632.747,
10632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.867,
632.872, 11632.885, 632.89, and 632.895 (11) to (17).
SB913,3
12Section
3. 49.45 (61) (f) of the statutes is created to read:
SB913,2,1613
49.45
(61) (f) Notwithstanding par. (a) 4., for dates of services before May 1,
142021, the department shall consider mental health therapy conducted over
15audio-only telephone as interactive telehealth that is eligible for coverage and
16reimbursement under the Medical Assistance program.
SB913,4
17Section
4. 66.0137 (4) of the statutes is amended to read:
SB913,3,318
66.0137
(4) Self-insured health plans. If a city, including a 1st class city, or
19a village provides health care benefits under its home rule power, or if a town
20provides health care benefits, to its officers and employees on a self-insured basis,
21the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
1632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.867,
2632.87 (4) to (6),
632.872, 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513
3(4).
SB913,5
4Section
5. 120.13 (2) (g) of the statutes is amended to read:
SB913,3,85
120.13
(2) (g) Every self-insured plan under par. (b) shall comply with ss.
649.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
7632.798, 632.85, 632.853, 632.855, 632.867, 632.87 (4) to (6),
632.872, 632.885,
8632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).
SB913,6
9Section
6. 185.983 (1) (intro.) of the statutes is amended to read:
SB913,3,1710
185.983
(1) (intro.) Every voluntary nonprofit health care plan operated by a
11cooperative association organized under s. 185.981 shall be exempt from chs. 600 to
12646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44,
13601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93,
14631.95, 632.72 (2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.798, 632.85,
15632.853, 632.855, 632.867, 632.87 (2) to (6),
632.872, 632.885, 632.89, 632.895 (5) and
16(8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but
17the sponsoring association shall:
SB913,7
18Section
7. 609.713 of the statutes is created to read:
SB913,3,20
19609.713 Telehealth services. Limited service health organizations,
20preferred provider plans, and defined network plans are subject to s. 632.872.
SB913,8
21Section
8. 632.872 of the statutes is created to read:
SB913,3,22
22632.872 Telehealth services. (1)
Definitions. In this section:
SB913,3,2323
(a) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
SB913,4,224
(b) “Telehealth” means a practice of health care delivery, diagnosis,
25consultation, treatment, or transfer of medically relevant data by means of audio,
1video, or data communications that are used either during a patient visit or
2consultation or are used to transfer medically relevant data about a patient.
SB913,4,8
3(2) Telehealth coverage and reimbursement. For dates of service before May
41, 2021, no insurer or self-insured health plan may deny coverage or refuse to
5reimburse a health care provider for a treatment or service provided through
6telehealth, including provided over audio-only telephone or interactive video, if that
7treatment or service is covered and reimburseable by a plan or a policy offered by the
8insurer when provided in person by the health care provider.
SB913,9
9Section
9.
Initial applicability.
SB913,4,1210
(1) This act first applies to dates of service for services provided under health
11insurance policies, self-insured health plans, or the Medical Assistance program
12beginning on the effective date of this subsection.
